Lesson 4B (Part 2) Flashcards
Xanthogranulomatous Pyelonephritis
Chronic suppurative renal infection with a destroyed parenchyma is replaced with lipid-laden macrophages
Is xanthogranulomatous pyelonephritis uni or bilatera?
Unilateral
- diffuse, focal or segmental
Who does xanthogranulomatous pyelonephritis commonly affect?
Middle aged diabetic women
What does xanthogranulomatous pyelonephritis look like on US? (3)
- Renal enlargement
- Lack of corticomedullary differentiation
- Focal masses
What does ischemia lead to?
Papillary necrosis
- lose of blood flow that leads to cell death
What are causative factors of papillary necrosis? (9)
- Analgesic abuse
- Diabetes
- UTI
- Renal vein
- Thrombosis
- Prolonged urinary tract obstruction
- Dehydration
- Sickle cell anemia
- Hemophilia
What does papillary necrosis look like on US? (5)
- Swollen pyramids
- Cystic papilla
- Clubbed calyx
- Hydronephrosis
- Debris in collecting system
TB
Tuberculosis
Who do tuberculosis affect?
The kidneys of 5-10 year olds after initial infection
What are the S/S of TB?
Frequency, dysuria, nocturia, urgency, gross or microscopic hematuria
What does TB look like on US? (3)
- Focal renal lesions
- Variable echotexture and size
- May involve bladder
- focal or diffuse wall thickening
What is the best way to asses TB? (2)
- CT
2. Urography
What is the most common fungal agent?
Candida Albicans
What are the patients who are at risk for fungal infections? (7)
- Diabetes mellitus
- Chronic indwelling catheters
- Malignancy
- Hematopoietic disorders
- Chronic antibiotic or steroid therapy
- Transplantation
- IV drug abuse
What do fungal infections look like on US? (2)
- Small cortical hypoechoic lesions
- small abscesses - Fungus balls in collecting system
- echogenic
What is the most common agent seen with parasitic infections?
Schistosomiasis
Schistosomiasis
Worms penetrate skin to liver via the portals
Hematuria
Eggs deposited in venules of bladder wall/ureter
Bladder stasis
Increased incidence of ureteral and bladder calculi and repeated infections
What is found in 2-5% of patients with hydatid disease?
Echinoccal hydatid Renal disease
What does echinoccal hydatid Renal disease affect? (3)
- Kidneys
- Ureters
- Bladder
Who do filiariasis affect?
Children between 10-12 years of age
How is filiariasis transmitted?
Mosquitos
Where do worms enter with filiariasis?
The lymphatic system through the kidneys
When do symptoms develop for filiariasis?
5- 20 years after infection
Is US the best modality for filiariasis diagnosis?
No - not helpful in diagnosis
HIV
An acquired immunodeficiency syndrome
What has decreased the incidence of opportunistic infections for HIV?
Antiviral therapy
What kind of disease is HIV associated nephropathy?
Chronic renal disease
What is US used for with HIV? (3)
- Exclude obstruction
- Determine renal size
- Cortical echogenicity
