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OBGYN 2 > M9: Fetal GU > Flashcards

M9: Fetal GU Flashcards

1
Q

which structure forms the renal collecting sys

A

ureteric buds from the wolffian ducts

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2
Q

which structure forms the nephrons (glomeruli and loop of henle)

A

metanephros

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3
Q

when does urine production start

what produced amniotic fluid before this

A

11 wks

membranes and lungs

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4
Q

where in the body are the primitive kidneys located

what happens if they fail to migrate

A

pelvis

ectopic kidney

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5
Q

name for the primitive kidneys

A

metanephros

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6
Q

in which plane do we image kidneys

A

TRX, only SAG if there’s pathology

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7
Q

norm kidney length

A

equal to gestational age in mm

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8
Q

upper limit of norm for renal pelvis dilation

20 wks and 20 + wks

A

5mm up to 20 wks

8mm from 20 wks- term

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9
Q

2 segments of the cloaca

A

cloaca is the terminal end of the hindgut….

segments:
urinary and rectal

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10
Q

what does the caudal end of the cloaca form

what does the allantois form

A

urethra and bladder neck

the rest of the bladder

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11
Q

another name for ureters

A

mesonephric ducts

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12
Q

when do the genitals form

A

8-10 wks. (prior to 8 wks they are ambiguous)

male genitals develop w/ testosterone present, w/o, female genitals develop due to maternal estrogen

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13
Q

bilateral renal genesis is associated w/ which other anomalies

risk factors for bilateral renal agenesis

A

GU, GI and cardiac abnormalities
sirenomelia syndrome

teratogens - warfarin, cocaine, maternal diabetes type 1

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14
Q

US appearance of unilateral renal agenesis

A

kidney thats present may be enlarged since its doing all the work… fetus may be asymp

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15
Q

US appearance of bilateral renal agenesis

A

absent bladder
oligohydramnios or anhydramnios
small AC and IUGR

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16
Q

describe potters syndrome

A

a sequence that refers to the consequence of severe oligohydramnios due to bilateral renal agenesis

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17
Q

describe the phenotype of potters syndrome

A

pulmonary hypoplasia
abnormal hand and foot positions
facial anomalies
IUGR

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18
Q

describe hydronephrosis

A

distention of the renal pelvis and calyces w/ urine due to obstruction
usually unilateral

accounts for most renal abnormalities and sometimes associated w/ other syndromes

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19
Q

causes of hydro

A

obstruction
reflux
ureterocele

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20
Q

which part of the urinary sys will be dilated w/ obstruction at the UPJ

A

kidneys/renal pelvis

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21
Q

which part of the urinary sys will be dilated w/ obstruction at the UVJ

A

kidneys/renal pelvis and ureters

22
Q

which gender does posterior uretheral valve obstruction effect

A

males only

23
Q

grading hydro in fetuses

A

grade 1: only renal pelvis dilated
grade 2: renal pelvis and calyces visible
grade 3: renal pelvis and calyces dilated
grade 4: parenchymal thinning

24
Q

whats the most common urinary obstruction in neonates

what should you look for

A

UPJ obstruction

dilated renal pelvis and calyces

25
Q

US appearance of unilateral UPJ obstruction

bilateral?

A

normal bladder and amniotic fluid

olihydromnios w/ hydro of varying degrees

26
Q

US appearance of severe UPJ obstruction

A

renal parenchyma may be destroyed

27
Q

false + for UPJ obstruction

A

extra-renal pelvis
prominent renal veins
reflux (dilation will come and go/be transient)

28
Q

most common cause of ureterovescial obstruction/UVJ

A

duplicated collecting sys w/ an ectopic ureter location from the upper pole of the kidney

29
Q

US appearance of UVJ obstruction w/ duplicated collecting sys

the ureter can mimic which structure

A

dilated upper pole of kidney w/ dilated ureter, lower pole is normal

bowel (but bowel is medial in the body, ureter is lateral)

30
Q

define ureterocele

A

cystic dilation of the intravesicular portion of the ureter, associated w/ dilation of upper pole of kidney in a duplicated collecting sys

31
Q

what are posterior urethral valves

A

membranes that occur in the prostatic urethra of a male fetus that obstruct retrograde flow of urine

32
Q

US appearance of posterior urethral valves

A

large distended bladder (keyhole)
oligohydramnious
hydro

33
Q

PUV may be a precursor to which syndrome

A

prune belly syndrome/eagle-barrett syndrome

34
Q

describe a bladder exstrophy

what causes it

A

failure of closure of the bladder, lower urinary tract, symphysis pubis, rectus muscles and skin

defect in development of cloacal membrane

35
Q

bladder exstrophy is associated w/ which condition

A

cloacal extrophy

36
Q

what is the OEIS complex

A

omphalocele
extrophy of the bladder
imperforate anus
spinal abnormalities

37
Q

describe infantile polycystic kidney disease (ARPKD)

US appearance/diagnostic criteria

A

autosomal recessive disorder primarily effecting the collecting ducts/cortex

  • bilaterally enlarged echogenic kidneys (many small cysts under 1-2 mm)
  • severe oligohydramnios
  • absent bladder
38
Q

ARPKD/IPKD is associated w/ which conditions

A

meckel Gruber syndrome
Roberts syndrome - IPKD, phocomelia, cleft palate
T13

39
Q

ddx for IPKD

A

benign glomerulosclerosis - large echogenic kidneys but hypo pyramids and norm fluid (diagnosed in a lab)

40
Q

what is phocomelia

A

hands and feet attached to trunk w/ single bone

41
Q

describe ADPKD

US appearance

A

-rarely seen antenatally but fetus is assessed if parents have the condition

enlarged kidneys w/ cysts, may be hyperechoic
norm amniotic fluid and bladder

42
Q

describe multi cystic dysplastic kidney (MCDK)

US appearance

A

multiple cystic lesions that arise from tubules of the cortex, cysts dont communicate

  • kidneys not reniform shape
  • unilateral usually
  • bilaterally - low fluid, associated w/ potters sequence, IS FATAL due to lack of fluid
43
Q

is MCDK a genetic condition

A

no

44
Q

2 types of renal tumors

A

nephroblastoma (wilm’s tumor) - solid mass, not commonly identified in utero

mesoblastic nephroma

45
Q

most common congenital renal tumor

A

mesoblastic nephroma

46
Q

2 adrenal pathologies

A

neuroblastoma

hemorrhage

47
Q

possible genital pathologies

A

Male:
hydrocele
cryptorchidism

Female:
hydrometrocolpos
ovarian cysts

Both:
ambiguous genitals
X linked syndromes - Turners, Noonan’s, hemophilia

48
Q

which structures can be mistaken for the kidneys if theres renal agenesis

A

adrenals since they will occupy the space of the kidney (laying down adrenals?)

49
Q

US appearance of bladder rupture

w/ which pathology can this occur

A

ascites
thick bladder wall
moderate hydro

PUV

50
Q

When gendering a male, which structure must be included

A

Penis

OBGYN 2 (15 decks)

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