Kidneys and ureters Flashcards
which is false about renal size in cats?
a) intact cats have smaller kidneys
b) normal range is 3-4.5cm
c) kidneys reduce in size with increasing age
d) the right kidney is sometimes longer than the left
A- intact cats have larger kidneys
typically the renal cortex is ___ to the liver
hypo- to isoechoic
what part of the normal anatomy are the arrows pointing to?
outer medulla: can be hyperechoic in small or young dogs.
can be isoechoic to the cortex and look like cortical thickening
how can subclinical renal dysplasia look on ultrasound?
hyperechoic or speckled medulla, reduced corticomedullary definition. Severely affected kidneys tend to become small, irregular,
and diffusely hyperechoic, similarly to kidneys
with chronic inflammatory disease.
Although these renal anomalies can be confirmed only
with histological analysis, renal dysplasia or juvenile
nephropathy should be suspected in a young dog with
deformed kidneys and clinical renal insufficiency.
which of these diseases most often causes increased corticomedullary definition, with a markedly hyperechoic cortex?
a) chronic nephropathy
b) ethylene glycol toxicity
c) leptospirosis
B
This can be dramatic in cases of acute tubular necrosis and
calcium oxalate deposition caused by ethylene glycol
toxicity. In other cases, both medulla and
cortex can become hyperechoic, causing reduced corticomedullary
border distinction. This is particularly evident in dogs and cat swith chronic renal disease. The medulla may be more specifically hyperechoic with leptospirosis, diffusely or forming a band as a the result of congestion, edema, hemorrhage, and necrosis
true or false, renal hyperechogenicity is an accurate indicator of renal disease?
false, can be seen in normal dogs
true or false, the medullary rim sign is an accurate indicator of renal disease?
false, can be seen in normal dogs
a) nephroliths
b) nephrocalcinosis
c) ethylene glycol toxicity
d) amyloidosis
B
Renal parenchymal mineralization (nephrocalcinosis) in dogs and cats with or without hypercalcemia can cause renal diffuse cortical and/or medullary
hyperechogenicity, a medullary rim sign, and/or dispersed hyperechoic foci
polycystic kidney disease is…
a) autosomal recessive
b) autosomal dominant
c) x linked recessive
d) x linked dominant
B.
Most of these cysts are in the cortex
or at the corticomedullary junction
polycystic kidney disease is common in which dog breed?
a) pugs
b) GSDs
c) Boston terriers
d) cairn terriers
D
polycystic kidney disease is common in which cat breed?
a) persians
b) BSH
c) DSH
d) devon rex
A and other related breeds
polycystic kidney disease can be diagnosed as early as what age in cats?
a) 3 months
b) 10 months
c) 15 months
d) 18 months
A with 96% sens and 91% spec
how can you differentiate a renal cyst from an abscess?
a) cysts are always anechoic and abscesses are centrally echogenic with debris
b) cysts have well defined thin capsules, abscesses often have a poorly demarcated, irregular contour
c) abscesses have distal acoustic enhancement and cysts do not
B,
in cysts, even with some debris, distal enhancement can still be seen if the cell count is small.
when comparing ultrasound to CT for the detection of renal nodules, excluding cysts, which is true?
a) all nodules seen on ct were visible on ultrasound to some degree
b) ultrasound overestimated the number of renal nodules compared to CT
c) ultrasound underestimated the number of renal nodules compared to CT
C
renal cystadenocarcinomas, associated with dermatofibrosis, are common in which breed?
a) GSDs
b) Persian cats
c) DSH cats
d) cairn terriers
A
what is renal telangectasia
Renal telangiectasia has been reported in Welsh corgis, and consists of cavernous masses filled with blood that can mimic neoplasia
list all main causes of pyelectasia (5)
increased diuresis (e.g., diuretic therapy
or chronic renal insufficiency), congenital malformation (e.g., ureteral ectopia), pyelonephritis, lower urinary obstruction and neoplasia
which is true about pyelonephritis?
a) in chronic pyelonephritis the renal pelvis and diverticula may be normal
b) in acute pyelonephritis the renal pelvis and diverticula might have a hyperechoic rim.
c) distortion of the shape of the diverticula is more common in chronic pyelonephritis
d) a renal pelvis dilation more them 10mm is highly suggestive of pyelonephritis
C is true
a- this is true for acute pyelonephritis
b) this is true for chronic pyelonephritis
also the pelvic content might be echogenic or/ and sedimenting. the retroperitoneal fast might be hyperechoic.
define hydronephrosis
renal pelvis and diverticula dilation due to outflow obstruction. Ureteral distension, also termed hydroureter, is usually observed in combination with hydronephrosis in cases of urine outflow obstruction.
define pyonephrosis
Pyonephrosis represents a consequence of obstructive pyelonephritis, or outflow obstruction with secondary ascending infection
Although transitional cell carcinomas infiltrating the bladder trigone and/or ureter are more commonly responsible for ureteral obstruction, especially in dogs, other processes such as lymphoma,
retroperitoneal soft-tissue sarcomas, abscesses, or granulomas can also compress and/or infiltrate the
ureter . Ureteral fibroepithelial polyps
have also been reported in dogs as intraluminal, pedunculated masses causing ureteral obstruction and hydronephrosis (Reichle et al. 2003). Ureteral obstruction can also be caused by a blood clot or an inflammatory stricture, which can be more
challenging to diagnose and differentiate. Other imaging tests, such as excretory urography, which can be combined with CT, can be required in patients in which a clear diagnosis cannot be made by using
ultrasonography. also masses originating in the renal pelvis eg haemangiosaarcoma
seeing a utereral jet in the trigone rules out ectopic ureter, true or false?
false, the ectopic ureter may have multiple fenestrations, with some that open in to the bladder
name two less common sites where ureters can terminate
colon or vagina
most common is the urethra
