Lesson 4A (Part 4)

Question 1

What does supernumerary kidney look like on US?

Answer 1

An extra kidney will be found

- usually smaller

Question 2

Where is the supernumerary kidney located?

Answer 2

Found above, below in front of or behind the normal kidney

Question 3

What is the most common congenital anomaly?

Answer 3

Duplex collecting system

Question 4

Duplex collecting system

Answer 4

Two separate collecting systems, ureters and their own ureteral orifice

Question 5

Where do the ureters join and enter the bladder with an incomplete duplication?

Answer 5

Through a single ureteral orifice

Question 6

What do patients of an increase risk of with a incomplete duplication?

Answer 6

Increased incidence of UPJ obstruction and uterus didelphys-duplex uterus

Question 7

Incomplete duplication

Answer 7

Ureter draining the lower pole has a more perpendicular course through the bladder wall

Question 8

What are you more prone to with an incomplete duplication? (2)

Answer 8

1. Reflux

2. Obstruction

Question 9

What does obstruction of the ureter result in?

Answer 9

Cystic dilation of the intramural portion of the ureter

Question 10

What does cystic dilation of the intramural portion of the ureter give rise to?

Answer 10

Ureteroceles

Question 11

What are ureteroceles prone to?

Answer 11

Ureteral obstruction

- UTI’s

Question 12

What is the treatment for ureteroceles?

Answer 12

Surgical

Question 13

How do ureteroceles appear on US?

Answer 13

Round cyst like structure in the bladder

Question 14

What does colour doppler do with ureteroceles?

Answer 14

Assess both jets

Question 15

What may be present in the upper poles of ureteroceles?

Answer 15

Hydronephrosis

Question 16

What is a common anomaly that causes a kink?

Answer 16

Ureteropelvic junction obstruction

- UPJ

Question 17

Who is UPJ more common in?

Answer 17

Men

Question 18

What happens with UPJ obstructions? (3)

Answer 18

1. Stones
2. Infection
3. Impaired renal function

Question 19

What are 3 anomalies of bladder development?

Answer 19

1. Bladder agenesis
2. Bladder duplication
3. Bladder exstrophy

Question 20

Bladder agenesis

Answer 20

No bladder

Question 21

How are more infants with bladder agenesis?

Answer 21

Stillborn

Question 22

What gender is more likely to survive bladder agensis?

Answer 22

Females

Question 23

What are the 3 types of bladder duplication?

Answer 23

1. Complete/incomplete peritoneal fold separates 2 bladders
2. Complete/incomplete septum divides bladder
   - may be multiple septa
3. Transverse band of muscle divides the bladder into 2 unequal parts

Question 24

Bladder Exstrophy

Answer 24

Congenital absence of lower abdominal and anterior bladder wall

Question 25

What increases with bladder exstrophy?

Answer 25

The incidence of bladder carcinoma

Question 26

Aberrant vessels

Answer 26

During embryology, the kidney receives blood from the higher levels of the Aorta

Question 27

When will aberrant renal arteries be present?

Answer 27

If supply from lower levels persist

Question 28

Who is retrocaval ureter more common with?

Answer 28

Males

Question 29

Retrocaval ureter

Answer 29

If the infrarenal IVC does not develop from the usual Supracardinal vein, the ureter will pass posterior to the IVC
- may become compressed as the ureter takes an unusual path before entering the bladder

Question 30

How can urachal anomalies present as? (5)

Answer 30

1. Patent
   - associated with urethral obstruction
2. Cyst
   - urachus closes at umbilical and bladder ends
3. Sinus
   - closes at bladder, patent at umbilicus
4. Abscess in the abdominal wall
   - may form in the abdominal wall arising from the urachus
5. Diverticulum
   - closes at umbilicus,open at bladder

Question 31

Who is urachal anomalies more common with?

Answer 31

Males

Question 32

Where is urachal anomalies located?

Answer 32

Between the umbilicus and the bladder

Question 33

What increases with urachal anomalies?

Answer 33

Incidence of carcinoma and stone formation