Lesson 19b: Fetal Genitourinary System Flashcards
Urinary tract anomalies tend to show a predominance in this sex:
Male
Polycystic kidneys and horseshoe kidney has a predominance in this sex:
Male
In the first trimester the kidneys appear ___________ to the surrounding tissue
Isoechoic
What week is kidney evaluation optimal?
Week 20
(due to corticomedullary differentiation)
What week can the kidneys be easily identified and thoroughly evaluated in 95% of patients?
Week 22
In week 20, kidneys measure about _____cm.
2
By full term, kidneys measure nearly ____cm.
4
What can you use to help visualizer kidneys?
Colour and/or Power Doppler to see renal arteries
The bladder can be seen as early as week _____.
11
The bladder can definitely be seen by week _____.
13
Fetal voiding excludes the possibility of: ________ _________ ____________.
Bladder Outlet Obstruction
The fetal bladder fills and voids about ________ per _______.
Once per hour
Bilateral renal dysfunction or agenesis and bilateral renal or ureteral obstruction can be ruled out by seeing the bladder _______.
Fill
True or False: Amniotic fluid seen has a direct correlation to renal function
TRUE
When does fetal urinary production begin?
When does it increase considerably?
When does urine make up about 90% of amniotic fluid?
9 Weeks
16 Weeks
20 Weeks
We may suspect a malfunctioning urinary system if we see oligohydraminos after week ______.
16
True or False: Unilateral renal agenesis is uncommon
False
(Unilateral is common, Bilateral is uncommon)
Unilateral renal agenesis is often correlated with contralateral kidney anomalies such as ______ obstruction and ______ reflux .
UPJ: Ureteropelivc Junction obstruction
VUR: Vesicoureteral reflux
True or False: In cases of unilateral renal agenesis, the existing kidney is usually small.
False: it is usually larger and hypertrophic to compensate
True or False: Unilateral agenesis affects the amount of amniotic fluid produced
False: No change occurs
Bilateral renal agenesis causes ____________, and an empty bladder from ______ weeks onward.
Anhydraminos
16
True or False: A fetus can live with bilateral renal agensis
False: incompatible with life
What is renal ectopia?
Kidney lies outside of renal fossa
How do ecotpic kidneys differ in size?
Smaller than usual and irregular shaped
Where do we usually find ectopic kidneys?
Pelvis
Another name for a pelvic kidney is an _________ kidney
Unascended
Crossed renal Ectopia is when the kidney is located on the __________ side from which the ureter inserts into the _________.
Opposite
Bladder
True or False: Crossed renal ectopia usually results in the kidneys being fused together
True
Crossover in more common from the ___ side to the ____ side.
Left to Right
What is the most common renal fusion anomaly?
Horseshoe kidney
Horseshoe kidney is formed by the fusion of the _______ poles in most cases.
Lower
__________ in the urinary system is one of the most common fetal anomalies detected on prenatal US.
Obstruction
Pelvic dilation is more common in fetuses with trisomy ____.
21
True or False: UT Dilation is most commonly mild
True
Most kidneys iwth antenatal hydronephrosis of less than _______ mm prove to be normal at birth.
10
In the second Trimester, hydronephrosis can range from Mild: ____ to ____ mm
Moderate: _____ to ____mm
Severe: Greater than ____ mm
4-7 mm
7-10 mm
>10 mm
In the third trimester, hydronephrosis can range from
Mild: ____ to ____ mm
Moderate: _____ to _____ mm
Severe: greater than ____ mm
7-9 mm
9-15 mm
>15 mm
When hydronephrosis is detected in the second trimester (APRPD > or eqaul to ________ mm), a follow up US must be performed at _____ weeks.
4 mm
32 weeks
What is a key factor for determining postnatal pathology?
Oligohydraminos
When APRPD greater than ______ mm, oligohydraminos is predictive of chronic renal failure or death.
5
UPJ obstruction is more common in this sex
Male
Primary VUR is more common in this sex
Male
Megaureter measures greater than ___ mm from ____ weeks onward
7 mm
30 weeks
UVJ obstruction causes a _________, a cystic dilation of the distal ureter
Ureterocele
The two most common causes of Lower Urinary Tract Obstruction (LUTO) is
1)_____________
2)_____________
1) PUV (posterior urethral valves) – key hole sign
2) Urethral Atresia
PUV happens exclusively in this sex and is indicated by this sign
Males
Key Hole sign
MMIHS stands for and is more common in this sex
Megacystitis Microcolon Intestinal Hypoperistalsis Syndrome
Female
Prune Belly occurs mostly in this sex
Males
Distension of the anterior abdominal wall without musculature, obstruction of the urinary tract, and bilateral cryptorchidsm is indicative of this syndrome
Prune Belly Syndrome
ARPKD has cysts of ___ to ___ mm that are too small to be resolved as cysts on US
1 -2 mm
ARPKD is seen in ______ while ADPKD is seen in ______
Infants
Adults
Structural disorganization of renal tissues resulting in multiple noncommunicating cysts of
varying size, separated by dysplastic parenchyma is known as: ________
MCDK (multicystic dysplastic disease)
The most common cause of nonhereditary renal cystic dysplasia and hyperechoic kidney is ________
Obstructive Cystic Dysplasia
Neuroblastomas most commonly develop from the _______
Adrenal glands
The most common congenital neoplasm is
Sacrococcygeal Teratoma
The median umilical ligament is fromed from the ____
Urachus
The cloaca divides into the
1)
2)
3)
1) rectum
2) bladder
3) genitalia
The abnormal development of corpus spongiosum and cavernosa urethra due to incomplete fusion of the urogenital folds. “Tulip Sign”
Hypospadias
True or False: Fluid in the scrotum at third trimester is abnormal
False: normal after teste decent
The most common intraabdominal tumour in female fetuses and neonates are
Ovarian Cysts
Any ovarian cyst greater than ___ mm is liekly to be complicated by torsion, hemorrhage or intestinal obstruction
5 mm
Normal female phenotype at birth but amenorrhea at puberty and testes intraabdominally or in inguinal canal presents in ___________________ syndrome
Androgen Insensitivity Syndrome
