Lesson 19b: Fetal Genitourinary System

Question 1

Urinary tract anomalies tend to show a predominance in this sex:

Answer 1

Male

Question 2

Polycystic kidneys and horseshoe kidney has a predominance in this sex:

Answer 2

Male

Question 3

In the first trimester the kidneys appear ___________ to the surrounding tissue

Answer 3

Isoechoic

Question 4

What week is kidney evaluation optimal?

Answer 4

Week 20
(due to corticomedullary differentiation)

Question 5

What week can the kidneys be easily identified and thoroughly evaluated in 95% of patients?

Answer 5

Week 22

Question 6

In week 20, kidneys measure about _____cm.

Answer 6

2

Question 7

By full term, kidneys measure nearly ____cm.

Answer 7

4

Question 8

What can you use to help visualizer kidneys?

Answer 8

Colour and/or Power Doppler to see renal arteries

Question 9

The bladder can be seen as early as week _____.

Answer 9

11

Question 10

The bladder can definitely be seen by week _____.

Answer 10

13

Question 11

Fetal voiding excludes the possibility of: ________ _________ ____________.

Answer 11

Bladder Outlet Obstruction

Question 12

The fetal bladder fills and voids about ________ per _______.

Answer 12

Once per hour

Question 13

Bilateral renal dysfunction or agenesis and bilateral renal or ureteral obstruction can be ruled out by seeing the bladder _______.

Answer 13

Fill

Question 14

True or False: Amniotic fluid seen has a direct correlation to renal function

Answer 14

TRUE

Question 15

When does fetal urinary production begin?
When does it increase considerably?
When does urine make up about 90% of amniotic fluid?

Answer 15

9 Weeks
16 Weeks
20 Weeks

Question 16

We may suspect a malfunctioning urinary system if we see oligohydraminos after week ______.

Answer 16

16

Question 17

True or False: Unilateral renal agenesis is uncommon

Answer 17

False
(Unilateral is common, Bilateral is uncommon)

Question 18

Unilateral renal agenesis is often correlated with contralateral kidney anomalies such as ______ obstruction and ______ reflux .

Answer 18

UPJ: Ureteropelivc Junction obstruction
VUR: Vesicoureteral reflux

Question 19

True or False: In cases of unilateral renal agenesis, the existing kidney is usually small.

Answer 19

False: it is usually larger and hypertrophic to compensate

Question 20

True or False: Unilateral agenesis affects the amount of amniotic fluid produced

Answer 20

False: No change occurs

Question 21

Bilateral renal agenesis causes ____________, and an empty bladder from ______ weeks onward.

Answer 21

Anhydraminos
16

Question 22

True or False: A fetus can live with bilateral renal agensis

Answer 22

False: incompatible with life

Question 23

What is renal ectopia?

Answer 23

Kidney lies outside of renal fossa

Question 24

How do ecotpic kidneys differ in size?

Answer 24

Smaller than usual and irregular shaped

Question 25

Where do we usually find ectopic kidneys?

Answer 25

Pelvis

Question 26

Another name for a pelvic kidney is an _________ kidney

Answer 26

Unascended

Question 27

Crossed renal Ectopia is when the kidney is located on the __________ side from which the ureter inserts into the _________.

Answer 27

Opposite Bladder

Question 28

True or False: Crossed renal ectopia usually results in the kidneys being fused together

Answer 28

True

Question 29

Crossover in more common from the ___ side to the ____ side.

Answer 29

Left to Right

Question 30

What is the most common renal fusion anomaly?

Answer 30

Horseshoe kidney

Question 31

Horseshoe kidney is formed by the fusion of the _______ poles in most cases.

Answer 31

Lower

Question 32

__________ in the urinary system is one of the most common fetal anomalies detected on prenatal US.

Answer 32

Obstruction

Question 33

Pelvic dilation is more common in fetuses with trisomy ____.

Answer 33

21

Question 34

True or False: UT Dilation is most commonly mild

Answer 34

True

Question 35

Most kidneys iwth antenatal hydronephrosis of less than _______ mm prove to be normal at birth.

Answer 35

10

Question 36

In the second Trimester, hydronephrosis can range from Mild: ____ to ____ mm Moderate: _____ to ____mm Severe: Greater than ____ mm

Answer 36

4-7 mm 7-10 mm >10 mm

Question 37

In the third trimester, hydronephrosis can range from Mild: ____ to ____ mm Moderate: _____ to _____ mm Severe: greater than ____ mm

Answer 37

7-9 mm 9-15 mm >15 mm

Question 38

When hydronephrosis is detected in the second trimester (APRPD > or eqaul to ________ mm), a follow up US must be performed at _____ weeks.

Answer 38

4 mm 32 weeks

Question 39

What is a key factor for determining postnatal pathology?

Answer 39

Oligohydraminos

Question 40

When APRPD greater than ______ mm, oligohydraminos is predictive of chronic renal failure or death.

Answer 40

5

Question 41

UPJ obstruction is more common in this sex

Answer 41

Male

Question 42

Primary VUR is more common in this sex

Answer 42

Male

Question 43

Megaureter measures greater than ___ mm from ____ weeks onward

Answer 43

7 mm 30 weeks

Question 44

UVJ obstruction causes a _________, a cystic dilation of the distal ureter

Answer 44

Ureterocele

Question 45

The two most common causes of Lower Urinary Tract Obstruction (LUTO) is 1)_____________ 2)_____________

Answer 45

1) PUV (posterior urethral valves) -- key hole sign 2) Urethral Atresia

Question 46

PUV happens exclusively in this sex and is indicated by this sign

Answer 46

Males Key Hole sign

Question 47

MMIHS stands for and is more common in this sex

Answer 47

Megacystitis Microcolon Intestinal Hypoperistalsis Syndrome Female

Question 48

Prune Belly occurs mostly in this sex

Answer 48

Males

Question 49

Distension of the anterior abdominal wall without musculature, obstruction of the urinary tract, and bilateral cryptorchidsm is indicative of this syndrome

Answer 49

Prune Belly Syndrome

Question 50

ARPKD has cysts of ___ to ___ mm that are too small to be resolved as cysts on US

Answer 50

1 -2 mm

Question 51

ARPKD is seen in ______ while ADPKD is seen in ______

Answer 51

Infants Adults

Question 52

Structural disorganization of renal tissues resulting in multiple noncommunicating cysts of varying size, separated by dysplastic parenchyma is known as: ________

Answer 52

MCDK (multicystic dysplastic disease)

Question 53

The most common cause of nonhereditary renal cystic dysplasia and hyperechoic kidney is ________

Answer 53

Obstructive Cystic Dysplasia

Question 54

Neuroblastomas most commonly develop from the _______

Answer 54

Adrenal glands

Question 55

The most common congenital neoplasm is

Answer 55

Sacrococcygeal Teratoma

Question 56

The median umilical ligament is fromed from the ____

Answer 56

Urachus

Question 57

The cloaca divides into the 1) 2) 3)

Answer 57

1) rectum 2) bladder 3) genitalia

Question 58

The abnormal development of corpus spongiosum and cavernosa urethra due to incomplete fusion of the urogenital folds. "Tulip Sign"

Answer 58

Hypospadias

Question 59

True or False: Fluid in the scrotum at third trimester is abnormal

Answer 59

False: normal after teste decent

Question 60

The most common intraabdominal tumour in female fetuses and neonates are

Answer 60

Ovarian Cysts

Question 61

Any ovarian cyst greater than ___ mm is liekly to be complicated by torsion, hemorrhage or intestinal obstruction

Answer 61

5 mm

Question 62

Normal female phenotype at birth but amenorrhea at puberty and testes intraabdominally or in inguinal canal presents in ___________________ syndrome

Answer 62

Androgen Insensitivity Syndrome