Module 9: GU

Question 1

The ureteric buds form from what?

Answer 1

Wolffian ducts

Question 2

What do the ureteric buds become?

Answer 2

Ureters, renal pelvis, calyces, and collecting tubules

Question 3

The metanephros gives origin to what?

Answer 3

Nephrons

Question 4

When does fetal urine production begin?

Answer 4

Around 11 weeks LMP

Question 5

What is the metanephros also known as?

Answer 5

Primitive kidney

Question 6

Where is the primitive kidney located early on?

Answer 6

Pelvis

Question 7

What would cause an ectopic kidney?

Answer 7

Failure of primitive kidney migration

Question 8

What is a normal renal pelvis fullness in a fetus?

Answer 8

<3mm

Question 9

What renal pelvis fullness would require further investigation?

Answer 9

> 5mm

Question 10

What is the terminal end of the hindgut called?

Answer 10

Cloaca

Question 11

What compartments are the cloaca divided into?

Answer 11

Urinary and rectal

Question 12

The caudal end of the cloaca forms what?

Answer 12

Urethra and bladder neck

Question 13

The rest of the bladder is derived from what?

Answer 13

Allantois

Question 14

Where does the allantois end?

Answer 14

The urachus

Question 15

Where do the mesonephric ducts enter the bladder?

Answer 15

Posterior wall of the bladder at the trigone

Question 16

When are fetal genitals in an ambiguous state?

Answer 16

Prior to 8 weeks LMP

Question 17

When are normal male genitalia formed?

Answer 17

8-10 weeks when testosterone is present

Question 18

What is bilateral renal agenesis associated with?

Answer 18

Other GU abnormalities, GI abnormalities, cardiac abnormalities, sirenomelia-mermaid syndrome, and teratogens

Question 19

What kind of teratogens are bilateral renal agenesis associated with?

Answer 19

Warfarin, cocaine, and type 1 maternal diabetes

Question 20

What could be mistaken for kidneys with bilateral renal agenesis?

Answer 20

Adrenals that assume a discoid shape

Question 21

What would you expect to see sonographically with bilateral renal agenesis?

Answer 21

Absent bladder, IUGR, and oligohydramnios

Question 22

What does Potter’s syndrome refer to?

Answer 22

Bilateral renal agenesis

Question 23

What does Potter’s sequence refer to?

Answer 23

Consequence of severe oligohydramnios

Question 24

What are things you would see with Potter’s sequence?

Answer 24

Pulmonary hypoplasia, abnormal hand and foot positions, and facial anomalies

Question 25

What are some examples of abnormal foot and hand positions seen with Potter's sequence?

Answer 25

Bowed legs, clubbed feet, and hip dislocation

Question 26

What are some examples of abnormal facial features you'd expect to see with Potter's sequence?

Answer 26

Beaked nose, low set ears, prominent epicanthic folds, and hypertelorism

Question 27

75% of all renal abnormalities will be what?

Answer 27

Hydronephrosis

Question 28

What are three causes of hydronephrosis?

Answer 28

Obstruction, reflux, and ureterocele

Question 29

Where is the level of obstruction if there is only hydronephrosis with only dilated kidneys?

Answer 29

Ureteropelvic junction

Question 30

Where is the level of obstruction if there are dilated ureters with hydronephrosis?

Answer 30

Ureterovesical junction

Question 31

Where is the level of obstruction if there is a dilated bladder and keyhole appearance?

Answer 31

Posterior urethral valve

Question 32

What is Grade I hydronephrosis?

Answer 32

Involves renal pelvis only

Question 33

What is Grade II hydronephrosis?

Answer 33

Involves visible renal pelvis and calyces

Question 34

What is Grade III hydronephrosis?

Answer 34

Involves dilation of renal pelvis and calyces

Question 35

What is Grade IV hydronephrosis?

Answer 35

Involves parenchymal thinning

Question 36

What is the most common urinary obstruction in neonates?

Answer 36

Ureteropelvic junction obstruction

Question 37

What will you see with unilateral UPJ obstruction?

Answer 37

Normal bladder and amniotic fluid

Question 38

What will you see with bilateral UPJ obstruction?

Answer 38

Oligohydramnios with hydronephrosis of varying degrees

Question 39

What may be destroyed with severe UPJ obstruction?

Answer 39

Renal parenchyma

Question 40

An extra renal pelvis under 1.5cm may mimic what?

Answer 40

Small hydronephrosis

Question 41

What is UVJ obstruction usually due to?

Answer 41

Duplicated collecting system with an ectopic ureter location from the upper pole of the kidney

Question 42

A ureter may mimic bowel. How can you tell the difference?

Answer 42

Bowel is medial and ureter was lateral in the abdomen

Question 43

What is an ectopic ureter associated with?

Answer 43

Ureterocele in the bladder

Question 44

What is a ureterocele?

Answer 44

Cystic dilation of the intravesicular portion of the ureter

Question 45

What is a PUV?

Answer 45

Posterior urethral valve

Question 46

What membranes obstruct the retrograde flow of urine in a male fetus?

Answer 46

Posterior urethral valves

Question 47

Prune belly syndrome is also known as what?

Answer 47

Eagle-Barrett syndrome

Question 48

What is undescended testicles also known as?

Answer 48

Cryptorchidism

Question 49

What will you see sonographically with a fetus with infantile polycystic kidney disease?

Answer 49

Bilateral grossly enlarged echogenic kidneys, severe oligohydramnios, and absent bladder

Question 50

What is IPKD (infantile polycystic kidney disease) associated with?

Answer 50

Meckel-Gruber syndrome, Robert's syndrome, and trisomy 13

Question 51

What is a DDx of IPKD?

Answer 51

Benign glomerulosclerosis

Question 52

What does adult polycystic kidney disease look like on a fetus?

Answer 52

Enlarged kidneys with cysts

Question 53

Bilateral multicystic dysplastic kidney is associated with what?

Answer 53

Potter's sequence

Question 54

What is a Wilm's tumor also known as?

Answer 54

Nephroblastoma

Question 55

What is a nephroblastoma?

Answer 55

Solid mass not commonly identified in utero

Question 56

What is the most common congenital renal tumor?

Answer 56

Mesoblastic nephroma