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Genitourinary > Kidneys > Flashcards

Kidneys Flashcards

1
Q

Associated with uterine anomalies in females and ipsilateral seminal vesicle cysts in males, the adrenal gland may appear enlarged

A

renal agenesis

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2
Q

most common renal fusion anomaly

A

horseshoe kidney

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3
Q

In horseshoe kidney, renal pelvises are malrotated directed more ____ and the lower pole calyces directed ___

A

pelvises- more anteriorly

lower pole calyces- medially

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4
Q

Fused kidney is low in position in the abdomen because

A

normal ascent is prevented by renal tissue encountering the IMA in midline

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5
Q

Complications of horseshoe kidney

A

increased susceptibility to trauma, urinary stasis

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6
Q

two kidneys are fused on one side of the abdomen

A

Crossed-fused renal ectopia

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7
Q

in crossed-fused renal ectopia, ureters insert in normal or ectopic location to the bladder?

A

normal

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8
Q

accounts for 85% of all renal neoplasm, most common in men, presents at age 50-70 years

A

renal cell carcinoma

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9
Q

most common type of RCC comprising of 80%

A

conventional clear cell adenocarcinoma

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10
Q

what type of RCC has the best prognosis

A

chromophobe tumors

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11
Q

Size of RCC that can be treated with laparoscopic partial nephrectomy or percutaneous radiofrequency ablation

A

<3cm

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12
Q

important radiologic findings in RCC include

A

extension beyond Gerota capsule, tumor invasion of renal vein and IVC and distant metastasis

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13
Q

RCC tumor evaluation and staging method of choice is

A

MDCT plain and with contrast

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14
Q

Pattern of enhancement in clear cell carcinoma RCC

A

avid heterogeneous tumor

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15
Q

Enhancement pattern of papillary and chromophore tumor RCC

A

lesser degree and a more peripheral pattern of enhancement

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16
Q

Highly predictive of RCC tumor spread in perirenal fat

A

soft tissue nodules, not stranding

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17
Q

Cystic and multilocular cystic forms of RCC are Bosniak __ and ___, characterised by nodular thickening of the wall and septa that entrance with contrast

A

Bosniak III and IV

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18
Q

Clear cell carcinoma enhances

A

avidly and is hypervascular

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19
Q

Uncommon benign mesenchymal tumor composed of varying amounts of fat, smooth muscle and abnormal blood vessels lacking elastic tissue

A

Angiomyolipoma

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20
Q

Angiomyolipomas are mostly solitary or multiple and unilateral or bilateral discovered mostly in middle-aged women

A

solitary and unilateral

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21
Q

angiomyolipomas in pattens with tuberous sclerosis are commonly

A

multicentric and bilateral

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22
Q

AML’s are prone to haemorrhage which may be massive, due to

A

abnormal thin-walled vessels

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23
Q

Rare well-encapsulated, benign tumor composed of eosinophilic cells

A

oncocytoma

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24
Q

large oncocytomas demonstrate _____ scar that is suggestive of the diagnosis

A

stellate central scar

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25
Q

True or false: oncocytomas are not reliably distinguished from RCC by all imaging methods and must be surgically removed to confirm the diagnosis

A

True

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26
Q

True or false: Kidney is commonly involved by direct invasion from retroperitoneal lymphoma or by metastatic lymphoma

A

True

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27
Q

common primary tutors that metastasise to the kidneys

A

lung, breast, colon and melanoma

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28
Q

most common renal mass

A

simple renal cyst

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29
Q

3 types of cysts in Bosniak II

A

A- cyst with delicate thin septations with no more than 1-2 mm thick
B- Cysts with delicate thin calcification in the wall or septum
C- High density cysts that are hyperdense on CT because of high concentration of protein or blood breakdown products and <3cm

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30
Q

Bosniak type that are very likely benign but require additional follow-up imaging to confirm benignancy. These lesions may have many thin septa or minimal smooth thickening of walls or septa but without measurable contrast enhancement

A

Bosniak IIF

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31
Q

Cysts with thick or nodular calcification in wall or septa but without measurable contrast enhancement, high-density cysts <3cm.

A

Bosniak IIF

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32
Q

Recommended imaging follow-up for IIF lesions

A

3,6 and 12 months

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33
Q

indeterminate cysts that may be benign or malignant, most are treated surgically, with thick irregular calcification, irregular margins, thick or enhancing septa, areas of modularity, thick walls and multilocular mass

A

Bosniak III

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34
Q

Bosniak category which include multilocular cystic nephrons, multilocular clear cell RCC and complex benign hemorrhagic or chronically infected cysts

A

Bosniak III

35
Q

Malignant necrotic cystic neoplasms that arise in the wall of a cyst. Include irregular solid nodules, irregular thick shaggy walls and nodular septations, with enhancement of solid components

A

Bosniak IV

36
Q

Most common appearance of renal abscess

A

focal renal mass with a thick wall

37
Q

also called adult cystic nephroma or mixed epithelial and stromal tumor (MEST), it is an uncommon benign neoplasm consisting of a cluster of noncommunicating cysts of varying size separated by connective tissue septations of varying thickness

A

Multilocular cystic nephroma

38
Q

ADPKD usually manifests clinically early or later in life?

A

later in life

39
Q

renal cystic disease that is associated with intracranial aneurysms, seen in 20% of patients

A

ADPKD

40
Q

Multiple simple cysts can be differentiated with adult polycystic disease by

A

simple cysts usually are older, fewer cyst, no renal failure, no family history, cysts are not found in other organs

41
Q

rare inherited multi system disease associated with development of multiple renal cysts, multiple and bilateral RCC, adrenal pheochromocytoma, pancreatic cysts (serous cyst adenomas) and pancreatic adenocarcinomas

A

Von-Hippel- Lindau disease

42
Q

neurocutaneous syndrome that combines multiple simple renal cysts and multiple AML (55-75%).

A

Tuberous sclerosis

43
Q

Associated with cutaneous, retinal and cerebral hamartomas

A

tuberous sclerosis

44
Q

term applied to the development of multiple cysts in the native kidneys of patients on long-term hemodialysis. affected kidneys are usually small, reflecting chronic renal disease. cysts are predominantly cortical and rarely exceed 2 cm in size

A

acquired uremic cystic kidney disease

45
Q

ARPKD usually presents at what age

A

neonate

46
Q

type of renal cystic disease that is usually bilateral, relatively symmetrical, with marked enlargement of kidneys and occasionally the liver. affected patients have a combination of cystic renal disease and hepatic fibrosis

A

ARPKD

47
Q

primary defect in seen in ARPKD is

A

fusiform dilatation and lengthening of the collecting tubules

48
Q

Hepatic defects in ARPKD include

A

excessive number of dilated, irregular bile ducts associated with fibrosis of portal tracts

49
Q

Refers to dysplastic dilation of the collecting tubules in papilla, dilatation is cylindrical or saccular in configuration, that may cause urinary stasis, resulting to stone formation and infection

A

Medullary sponge kidney

50
Q

true or false:medullary sponge kidney is usually asymptomatic with no genetic predisposition and no risk of renal failure

A

true

51
Q

Medullary sponge kidney are usually unilateral/ bilateral and symmetrical/asymmetrical

A

bilateral and symmetrical

52
Q

Basic defect is progressive tubular atrophy with glomerular sclerosis and medullary cyst formation, presents with renal failure, anemia and salt wasting

A

Uremic medullary cystic disease

53
Q

appears as a mass of noncommunicating cysts of varying size, with time the kidney progressively atrophies, so in the adult a nubbin of tissue, which is often calcified, is all that remains. ureter is usually atretic

A

Multicystic dysplastic kidney

54
Q

75% of renal AVM and AV fistulas are acquired or congenital?

A

acquired

55
Q

congenital AVM are classified into two:

A

cirsoid- supplied by multiple arteries

cavernous- supplied by one artery

56
Q

result of ascending urinary tract infection caused by gram-negative organisms

A

acute pyelonephritis

57
Q

usual pathologic agent of acute pyelonephritis

A

E.coli

58
Q

what modality is more sensitive in than US in demonstrating subtle changes in renal parenchyma associated with uncomplicated pyelonephritis

A

CT

59
Q

“striated nephrogram” can be seen with

A

acute pyelonephritis

60
Q

complications of acute pyelonephritis include

A

infrarenal or perirenal abscess

61
Q

form of acute pyelonephritis with gas in the renal parenchyma

A

emphysematous pyelonephritis

62
Q

refers to infection with gas confined to the renal collecting system, sparing the parenchyma; less aggressive and morbidity is not as high

A

emphysematous pyelitis

63
Q

refers to chronic interstitial nephritis caused by infection

A

chronic pyelonephritis and reflux neprhopathy

64
Q

In children, what is the most common cause of chronic pyelonephritis

A

vesicoureteral reflux

65
Q

infrarenal reflux is usually most prominent at what part of kidney

A

upper pole

66
Q

chronic pyelonephritis in adults is usually associated with

A

calculi and chronic obstruction

67
Q

hallmark of chronic pyelonephritis

A

focal cortical scar that overlies a blunted calyx

68
Q

Rare chronic destructive granulomatous process that may diffusely involve an obstructed kidney or present as a focal renal mass. an obstructing stone, often a stag horn calculus is usually present

A

xanthogranulomatous pyelonephritis

69
Q

common etiologic agents of xanthogranulomatous pyelonephritis

A

proteus mirabilis, pseudomonas, klebsiella and E.coli

70
Q

renal tuberculosis can happen following pulmonary TB after how many years

A

10-15 years

71
Q

most frequent site of extrapulmonary TB

A

urinary tract

72
Q

in patients with renal TB, usual presentation is

A

asymptomatic hematuria or sterile pyuria

73
Q

hallmarks of renal TB are

A

papillary necrosis, parenchymal destruction, cavity formation leading to uneven caliectasis, fibrosis and scarring of the collecting system and renal parenhcyma, parenhcymal masses owing to granuloma formation, strictures of the collecting system and ureters and widely variant patterns of calcification

74
Q

appearance of end-stage nonfunctional TB kidneys

A

hydronephrotic sacs or appear as atrophic and calcified masses in renal bed

75
Q

called a putty kidney reflecting the physical texture of caseous necrosis mixed with calcification

A

end-stage renal TB

76
Q

sonographic signs of renal parenchymal disease include

A

diffuse increase in renal parenchymal echogenicity often associated with loss of corticomedullary differentiation

77
Q

mottled striated nephrogram are usually seen in

A

HIV nephropathy

78
Q

causes of medullary nephrocalcinosis

A

hyperparathyroidism, medullary sponge kidney, renal tubular acidosis (distal form), milk-alkali syndrome, hypervitaminosis D, hypercalcemic/hypercalcoiuric states

79
Q

primary cause of renal failure in HIV infected patients

A

HIV nephropathy

80
Q

what HIV related disease can cause renal enlargement associated with irregular cortical low attenuation areas on CT

A

Kaposi sarcoma

81
Q

anti-retroviral drug that can cause development of unusual calculi that cause obstruction, hydronephrosis and nape

A

indinavir

82
Q

broad term that refers to pathologic deposition of calcium in renal parenchyma

A

nephrocalcinosis

83
Q

nephrocalcinosis is usually unilateral or bilateral?

A

bilateral

84
Q

what is more common between cortical and medullary nephrocalcinosis?

A

medullary nephrocalcinosis

Genitourinary (5 decks)

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