Pediatric Kidney

Question 1

Ultrasound of the pediatric urinary tract should include

Answer 1

(KUB)
both kidneys
ureters
urinary bladder

Question 2

Exam of the pediatric patient should include bladder volume and post void images of both the kidneys and bladder

Answer 2

true

Question 3

How do infant renals differ from adults

Answer 3

1. central echo complex less prominent compared to renal parenchyma, due to less peripelvic fat
2. medullary pyramids are larger and more prominent
3. corticomedullary differentiation is greater
4. some ‘renal lobulations’ may remain
5. cortex of the infant kidney has similar echogenicity as liver parenchyma

Question 4

Where are the ureters visualized

Answer 4

posterior and laterally into bladder, maybe visualized as base of bladder

Question 5

where is the adrenal gland located

Answer 5

superior to upper pole of kidney

Question 6

the thin echogenic core of the adrenal gland is the

Answer 6

adrenal medulla

Question 7

the less echogenic ring surrounding the medulla is the

Answer 7

adrenal cortex

Question 8

initial diagnostic imaging method of choice when a renal or adrenal abnormality is suspected in the neonate

Answer 8

sonography

Question 9

List 5 indications for renal imaging in the newborn

Answer 9

flank masses
anuria
hematuria
sepsis
urinary tract infection

Question 10

The conditions usually indicated the renal study is for _______the kidneys with no particular renal symptoms present

Answer 10

screening

Question 11

accounts for the vast majority of palpable abdominal masses in the neonate

Answer 11

hydronephrosis

Question 12

list 3 possible causes of hydronephrosis

Answer 12

1. ureteropelvic junction obstruction
2. posterior urethral valves
3. ectopic ureterocele

Question 13

The best way to demonstrate the dilated ureters at the ureteropelvic junction is with a

Answer 13

coronal scan plane

Question 14

most common cause of bladder outlet obstruction in the male neonate

Answer 14

uteropelvic junction obstruction/posterior urethral valves

Question 15

results from an ectopic insertion and cystic dilation of the distal ureter of the upper pole of a completely duplicated renal collecting system. it is seen as a fluid mass within the urinary bladder

Answer 15

ectopic ureterocele

Question 16

has a classic appearance of a unilateral mass resembling a bunch of grapes, which represents a cluster of discrete non-communicating cysts, the largest of which are peripheral

Answer 16

multicystic dysplastic kidney

Question 17

bilateral occurrence is fatal. T or F

Answer 17

true

Question 18

most likely to occur in the dehydrated or septic infant and is more prevalent in infants of diabetic mothers

Answer 18

renal vein thrombosis

Question 19

when evaluating renal vein thrombosis, what helps the sonographer identify flow is present, reversed or obstructed

Answer 19

color doppler

Question 20

most common renal tumor of the neonate and young infant. the tumor is benign but is indistinguishable from a wilm’s tumor by any method of imaging and may invade adjacent structures, so nephrectomy is indicated

Answer 20

congenital mesoblastic nephroma

Question 21

congenital mesoblastic nephroma is seen in children

Answer 21

less than 1 year

Question 22

wilm’s tumor commonly occurs in children that are

Answer 22

more than 1 year

Question 23

abnormal persistence of fetal renal blastoma, which has the potential to develop into wilm’s tumor

Answer 23

nephroblastomatosis

Question 24

what may occur spontaneously and many pediatric laboratories will monitor both types of patients with ultrasound

Answer 24

wilm’s tumor

Question 25

sonography is valuable in detecting wilm’s tumor extension into

Answer 25

renal vein
IVC
right atrium

Question 26

malignant tumor that arises in sympathetic chain ganglia and adrenal medulla

Answer 26

adrenal neuroblastoma

Question 27

when neuroblastoma is found, what else should be evaluated sonographically? why?

Answer 27

liver because intraspinal extension may occur and ultrasound can successfully define the spinal canal in infants

Question 28

explain how a hemorrhagic adrenal gland can be differentiated from an adrenal neuroblastoma

Answer 28

decreases and does not enlarge

Question 29

What is the typical sonographic presentation of polycystic kidney disease in a neonate

Answer 29

enlarged and hyperechoic kidneys

Question 30

list the things that predispose a baby to adrenal hemorrhage

Answer 30

stress
hypoxia at delivery
septicemia
shock
difficult delivery
large size
infants of diabetic mothers

Question 31

most common childhood renal tumor

Answer 31

wilm’s tumor/nephroblastoma