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CNIH > peds- kidneys pt 1 > Flashcards

peds- kidneys pt 1 Flashcards

1
Q

kidney scan patient prep?

A
  • hydration is prefered

- no fasting needed

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2
Q

Normal Appearance of Kidneys in Neonates?

A
  • renal pyramids or medulla appear as hypoechoic, triangular, or rectangular structures
  • can be mistaken for cysts
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3
Q

Normal appearance of kidneys in neonates contour?

A
  • Renal lobulations account for the irregular kidney contour
  • normal in neonates and infants
  • disappear with age
  • aka fetal lobulations
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4
Q

Normal Appearance of Kidneys in Neonates cortex?

A

thin compared to medulla

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5
Q

Normal Appearance of Kidneys in Neonates renal sinus?

A

less fat filled in infants and young children

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6
Q

Normal Appearance of Kidneys in Neonates renal pelvis?

A

located within the renal sinus and should measure <10mm in the supine postition

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7
Q

Normal Pediatric Renal Echo Pattern newborn?

  • cortex
  • sinus
A

cortex:
- more echogenic than liver and spleen

sinus:
- poorly defined because of lack of fat in infants

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8
Q

Normal Pediatric Renal Echo Pattern 6-8 weeks? (cortex)

A

isoechoic to liver and spleen

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9
Q

Normal Pediatric Renal Echo Pattern 2-6 months (cortex)?

A

hypoechoic to liver and spleen

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10
Q

Normal Pediatric Renal Echo Pattern >6months (cortex)?

A

hypoechoic to renal sinus

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11
Q

unilateral renal agenesis?

A
  • Unilateral is rare 1/1000 newborn, but more common than bilateral
  • Males > females
  • Left kidney mostly
  • Right kidney undergoes compensatory
  • hypertrophy
  • Incidental if asymptomatic
  • Lying-down adrenal sign on ipsilateral side
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12
Q

Bilateral renal agenesis?

A
  • Incompatible with life
  • Most die shortly after birth
  • Bladder absent
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13
Q

bilateral renal agenesis is associated with?

A
  • oligohydramnios
  • pulmonary hypoplasia
  • low set eats, small mandible, flat nose, wide-set eyes (potters syndrome)
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14
Q

cross-fused ectopia?

A
  • one kindey displaced across the midline and fused to the other normally positioned kidney
  • prone to obstruction
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15
Q

Duplex Kidney child presents with?

A

UTI

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16
Q

duplex kidney sono features?

A
  • Duplex kidney is longer than the contralateral side
  • Upper pole ureter prone to obstruction
  • Dilated ureter
  • Lower pole dilates due to vesicoureteric reflux
  • Duplex kidneys are often bilateral
17
Q

what is Hydronephrosis?

A
  • dilation of the collecting system of the urinary tract
  • renal calyces
  • renal pelvis
  • ureters
18
Q

when is Hydronephrosis frequently diagnosed?

A
  • in utero
19
Q

common causes of Hydronephrosis?

A
  • UPJ obstruction (main cause)
  • UVJ/ disal urethral obstructions
  • duplication of the collecting system
20
Q

Hydronephrosis mild- grade 1?

A
  • minimal separation of sinus echoes

- fluid-filled calyces

21
Q

hydronephrosis moderate- grade 2?

A
  • anechoic separation of the entire central sinus

- calyces are enlarged

22
Q

hydronephrosis- severe: grade 3?

A
  • extensive separation of the sinus
  • parenchymal thinning
  • loss of normal kidney appearance
23
Q

Hydronephrosis -UPJ obstruction?

A
  • Most common site in infants
  • Multiple communicating cystic lesions are seen and are uniform and similar in size
  • Ureter appears normal, not seen on US
24
Q

hydronephrosis UVJ obstruction?

A
  • Distal stenosis or stricture, atresia
  • Ectopic insertion of ureter
  • In case of bilateral hydro cause might be in bladder or urethra
  • Must examine the bladder for obstructing masses or ureterocele
25
Q

Hydronephrosis: Duplicated collecting system?

A
  • Dilated upper pole and a separate dilated ureter which can be followed to the bladder
  • The ureter is dilated due to abnormal ectopic insertion into the bladder
26
Q

Hypoplasia of the Kidney?

A
  • Small but otherwise normal kidney

- Secondary to infection or vascular occlusion

27
Q

Dysplasia of the Kidney?

A

Kidneys are small or large
No corticomedullary junction
May have cysts
Pelvis may be dilated

28
Q

Dysplasia of the Kidney associated with?

A

Associated with urinary tract malformations in 90% of cases:

  • Obstruction
  • Ureterocele with hydroureter
  • Prune Belly Syndrome
  • PUV (posterior uretral valves)
  • Ectopic kidneys
29
Q

what is the most common cause of urethral obstruction in boys?

A

Posterior Urethral Valves (PUV)

30
Q

what is Posterior Urethral Valves (PUV)?

A
  • Most common cause of urethral obstruction in boys
  • A mucosal flap or fold or extra urethral tissue in posterior part of urethra
  • May be identified in utero
31
Q

PUV clinical presentation?

A
  • Palpable flank masses
  • Infection
  • Voiding abnormalities-decreased stream
  • Retention
32
Q

PUV sono features?

A
  • Thick, trabeculated bladder wall
  • Dilated posterior urethra
  • Dilated, tortuous ureters due to vesicoureteral reflux
  • In infants, the renal parenchyma is echogenic and becomes dysplastic due to long-standing reflux and obstruction
  • Incomplete voiding
  • Key hole sign
33
Q

Prune Belly Syndrome clinical presentation?

A
  1. Absent abdominal muscles
  2. Urinary tract abnormalities
  3. Cryptorchidism

CNIH (69 decks)

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