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MIDS 127 > Kidneys > Flashcards

Kidneys Flashcards

1
Q

Location of kidneys?

A

Along posterior abdominal wall between lower ribs + iliac crest

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2
Q

3 poles of kidneys?

A

-Upper
-Mid
-Lower

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3
Q

Which kidney sits lower?

A

Right sits 2-8cm lower

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4
Q

What are the 4 different layers of supportive tissue?

A

-Renal capsule (innermost)
-Perirenal fat/Adipose capsule (middle)
-Renal/Gerota fascia (outer, is around kidney + adrenals)
-Pararenal fat (outermost)

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5
Q

What are the 2 renal fascia’s?

A

-Anterior gerota fascia
-Posterior zuckerkandl fascia

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6
Q

Which RA is longer?

A

Right

(b/c AO is further away, it has to pass behind IVC to reach right kidney)

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7
Q

Measurement of RA’s?

A

5-6mm

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8
Q

Measurement of RV’s?

A

10-12mm

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9
Q

What is the course of the RRV + LRV?

A

RRV - shorter, goes directly into IVC + does NOT receive blood from other veins

LRV - longer, receives blood from L adrenal, L gonadal + inferior phrenic veins before entering IVC

(think opposite of the renal arteries)

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10
Q

Function of the kidneys?

A

-Filters blood, puts back into body + removes waste through urine
-Regulates body
-Produces hormones

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11
Q

What does the nephron do?

A

-Filters blood by removing waste + returned for circulation (99%)
-Produces urine (1%)
-Regulates pH

(over 1 million nephrons in each kidney)

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12
Q

What are the 3 components of a nephron?

A

-Renal corpuscle
-Renal tubule
-Vascular component

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13
Q

Describe the BUN test?

A

-Increased with renal failure (older + diabetics)
-Measures amount of urea nitrogen in blood

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14
Q

Describe the creatinine test, does it increase or decrease?

A

-Increased if kidney isn’t functioning right
-Only increases

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15
Q

Describe the eGFR test, does it increase or decrease?

A

-Only decreases
-Glomeruli isn’t filtering blood correctly

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16
Q

Describe the hematuria test?

A

-RBC in urine
-Gross (visible in urine)
-Microscopic (visible on urinalysis)
-Kidney stones is a cause

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17
Q

Describe the albuminuria test?

A

-Increased albumin protein in urine

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18
Q

Describe the proteinuria test?

A

-Protein passing through glomerulus into urine
-Diabetes is cause

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19
Q

Measurements of kidney?

A

9-12cm long
5-7cm wide
3-5cm thick

(should be 2cm of each other in length)

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20
Q

When should we do a volume measurement?

A

-Pediatrics
-If kidneys are small in adults
-To assess renal function

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21
Q

What is a sonographic sign of renal disease?

A

A thin cortex
(Sinus to capsule measurement is 15-20mm)

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22
Q

What does the renal cortex look like?

A

-Hypoechoic/isoechoic to liver
-Hypoechoic to spleen
(will be brighter in peds)
-Smooth in adults
-Bumpy in children (think lobulations)
-Homogeneous

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23
Q

What is the renal medulla?

A

-Inner part kidney
-Contains pyramids
-Hypoechoic circles in cortex
-Larger in children
-See if pt is well hydrated

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24
Q

What is the renal sinus?

A

-Contains calyces, renal pelvis, vessels, fat, nerves + lymphatics
-Echogenic
-Middle part kidney

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25
Q

What is the renal hilum?

A

-Middle indent
-Site where vessels, ureters + lymphatics come in/out
(vein is ant to artery, ureter is post to artery)

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26
Q

What is the renal pelvis?

A

-Urine from calyces empty into pelvis
-Cavity beside hilum that is continuous with ureter
-Can’t see on u/s (unless dilated, pt is hydrated or has extra pelvis)

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27
Q

What is the diameter of the ureters?

A

3-4mm
(only see if dilated)

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28
Q

What is pelviectasis?

A

Dilation of renal pelvis

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29
Q

What is pelvicaliectasis?

A

Dilation of renal pelvis + calyces

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30
Q

What is m/c cause of hydronephrosis in young adults?

A

Nephrolithiasis

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31
Q

What is m/c cause of hydronephrosis in adult men?

A

Enlarged prostate

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32
Q

What is m/c cause of hydronephrosis in adult women?

A

Pelvic mass

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33
Q

What is a staghorn stone?

A

Very large stone that fills the entire renal pelvis (must be surgically removed)

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34
Q

What does chronic renal disease look like sonographically?

A

Small echogenic kidneys

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35
Q

What is UPJ?

A

-Uteropelvic junction
(renal pelvis + calyces dilated if stone)

-Junction where ureter exits kidney

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36
Q

What is UVJ?

A

-Uterovesical junction
(renal pelvis, calyces + ureter dilated if stone)

-Junction where ureter meets bladder

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37
Q

Lightbulb for adenoma?

A

-Malignant potential
-Less than 2-3cm

38
Q

Lightbulb for onocytoma?

A

-Central stellate scar
-Up to 20cm
-Men

39
Q

Lightbulb for AML?

A

-Hyperechoic in cortex
-Women

40
Q

Lightbulb for juxtaglomerular?

A

-Increased renin
-Women

41
Q

Lightbulb for RCC?

A

-Basket sign!
-Men
-Smoking
-Hematuria
-Cortex

42
Q

Lightbulb for TCC?

A

-Men
-Hypoechoic
-Mass in renal pelvis!
-Smoking

43
Q

Lightbulb for SCC?

A

-Staghorn
-Horseshoe
(think “S” in SCC for staghorn)

44
Q

Lightbulb for lymphoma?

A

Never hyperechoic

45
Q

What does acute pyelonephritis look like?

A

-Inflamed renal pelvis
-Enlarged kidneys
(may also look normal)

46
Q

What does chronic pyelonephritis look like?

A

-Caliceal clubbing (thick + dilated renal pelvis)
-Small + asymmetrical kidneys

47
Q

Lightbulb for xanthroganulomatous?

A

-Staghorn
-Diabetes + women

48
Q

Lightbulb for emphesymatous?

A

-Gas
-Echogenic lines
-Diabetes + women

49
Q

What is dromedary hump?

A

Spleen presses on LK causing hump mid pole

50
Q

What is hypertrophied column of bertin?

A

Hypoechoic cortex goes half way through echogenic sinus

(m/c left)

51
Q

What is junctional parenchymal defect?

A

Hyperechoic area on anterior aspect kidney
(incomplete fusion of UP + LP)

52
Q

What is extrarenal pelvis?

A

Pelvis outside renal hilum (instead of in the sinus)

53
Q

What is renal sinus lipomatosis?

A

Increased fat in sinus causes very thin cortex

54
Q

What is renal hypoplasia?

A

Small kidney/no kidney on 1 side, other side has enlarged kidney to compensate

55
Q

What is renal agenesis?

A

No kidney on 1 side

56
Q

M/c spot for ectopic kidney?

A

Pelvis

57
Q

What is crossed ectopic kidney?

A

-When UP ectopic kidney fuses with LP of normal kidney
-Is when both kidneys are on the same side of the body (m/c R side)

(hard to tell if 1 large kidney or fused kidneys)

58
Q

What is nephroptosis?

A

Wandering kidney

59
Q

What is horseshoe kidney?

A

Fusion of UP’s or LP’s (m/c) + goes across chest

(ureters pass anterior to fused part)

60
Q

What is duplicated collecting system?

A

Hypoechoic cortex goes completely through echogenic sinus
(is the m/c anomaly)

61
Q

What is supernumerary kidneys?

A

More than 2 kidneys

62
Q

What are congenital megacalyces + megaureters?

A

-Megacalyces: enlarged calycles
-Megaureters: enlarged ureters

(both m/c in pediatrics)

63
Q

What is hydronephrosis?

A

Urine dilation in calyces + pelvis
(pregnancy associated + RK)

64
Q

What are the different grades of hydropnephrosis?

A

1/mild - sinus
2/mild - sinus + some calyces
3/moderate - sinus + all calyces
4/severe - very dilated all around

65
Q

What is pyonephrosis?

A

-Pus in collecting system
-Very urgent
-M/c cause nephrolithiasis

66
Q

What is nephrolithiasis along with the m/c symptoms + risk factors?

A

-Kidney stones (less than 4mm can pass)
-M/c in men
-Dehydration is main r/f
-Renal colic is main symptom (painful spasms)

(stones in medulla is m/c than in cortex)

67
Q

What are parapelvic cysts + what does it look like?

A

-From kidney tissue into sinus
-Solitary, large + well defined

68
Q

What are peripelvic cysts?

A

-From sinus
-Multiple, small + irregular walls

69
Q

What does septated/multilocular cyst look like?

A

Echogenic line through cyst

70
Q

What is a milk of calcium cyst?

A

Anechoic cyst with echogenic calcium under it
(m/c UP)

71
Q

What is ACKD?

A

-3+ cysts
-Seen with dialysis + men

72
Q

What is ADPKD?

A

Enlarged kidneys with multiple cysts

73
Q

What is von hippel lindau?

A

-Cysts
-RCC complication

74
Q

What is medullary sponge kidney?

A

-Cysts in medulla too small to see
-Caroli’s + nephrocalcinosis (too much calcium in kidneys) associated
-Women
-Pyramids look echogenic w/o shadowing (b/c can’t see cysts) + normally sized

75
Q

What is an increased risk when someone has tuberous sclerosis?

A

RCC

76
Q

Name the 4 bosniak cyst definitions

A

1 - simple benign
2 - mildy complex (thin calcifications)
2F - moderately complex (greater than 3cm, needs follow up)
3 - intermediately complex (thick calcifications)
4 - very complex

77
Q

Why do renal abscesses develop?

A

M/c cause due to UTI’s

78
Q

Who are fungal infections most common in?

A

Children
(has renal fungus ball in kidney, is hyperechoic)

79
Q

What is the S/F sign for TB?

A

Putty kidney
(echogenic, small, calcified kidneys)

80
Q

What does papillary necrosis look like?

A

Anechoic spaces with multiple echogenic foci + shadowing

81
Q

What does lupus look like?

A

VERY echogenic kidneys!!!
(m/c women - think selena gomez)

82
Q

What are the m/c causes of acute tubular injury?

A

Ischemia or toxic injury
(looks like hyperechoic pyramids)

83
Q

What is the cause of acute interstitial nephritis?

A

Allergic reaction to drugs

84
Q

What are the m/c causes + appearance of chronic kidney disease?

A

-Diabetes
-Hypertension
-Small, echogenic kidneys + can’t see pyramids or sinus

(m/c elderly people)

85
Q

What are patients prone to getting when on dialysis?

A

Cysts

86
Q

What is measurement for cortical thickness?

A

15-20mm

(quiz answer was just greater than 15mm)

87
Q

What is the m/c cause of nephrotic syndrome?

A

Primary - FSGS
Secondary - diabetes (M/C)

88
Q

SF of AIDS nephropathy?

A

Very echogenic kidneys that are a normal size

89
Q

What LABS indicate AIDS?

A

Increased creatinine + BUN

90
Q

What are the 2 types of dialysis?

A

Hemodialysis - blood filtered through machine + back into body

Peritoneal dialysis - tube in body brings fluid to abdomen which drains waste out of blood via a catheter

91
Q

What is a struvite stone?

A

Staghorn

MIDS 127 (14 decks)

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