peds- kidneys pt 2 Flashcards
4 Cystic kidney diseases?
- Multicystic Dysplastic Kidney
- ARPKD
- ADPKD
- Medullary Cystic Disease
Multicystic Dysplastic Kidney cause?
- ureteral obstruction in utero
- as a result terminal tubules become cysts
- kidney loses function
sono apperance Multicystic Dysplastic Kidney?
- large mass at birth
- bunch of grapes appearance
- cysts do not communicate
- one or multiple cysts
Multicystic Dysplastic Kidney treatment?
- surgical removal
- follow up
Infantile PKD?
- Symmetrically enlarged kidneys
- Cysts are microscopic (tubular dilatation)
sono feature of PKD?
- Large kidneys
- Diffusely echogenic
- Poor cortico-medullary-sinus differentiation
- Associated with hepatic fibrosis
adult PKD?
- may occur in neonates
- 0.1- 5mm in size
- kidney size increases
- affects one or both kidneys
where might PKD be found?
- liver
- panc.
- lungs
- spleen
- gonads
2 medullary cystic diseases?
- medullary sponge kidney
2. juvenile nephronophthisis
medullary sponge kidney?
- echogenic pyramids caused by calcium deposits
4 Neoplasms of the Kidney?
Wilms Tumor
Nephroblastomatosis
Mesoblastic Nephroma
Angiomyolipoma
Three important things to determine when scanning abdominal mass?
- origin of mass
- extent of mass
- metastases
most common malignant renal tumor in pediatric patients?
wilms tumor
wilms tumor aka?
nephroblastoma
wilms tumor is most common in what age group?
3-4 years old
wilms tumor presentation?
- invades retroperitoneal, renal veins, IVC
- mets to liver and lungs
- may be bilateral
wilm’s tumor clinical signs?
- palpable mass
- pain
- fever
- malaise
- weight loss
- hematuria
- hypertension
Wims tumor sono apperance?
- large
- well-circumscribed
- homogeneous
- anechoic/cystic spaces (from necrosis/hemorrhage)
what is Nephroblastomatosis?
- Premalignant
- Precursor to Wilms tumor
- often found in patients with Wilms tumor
Nephroblastomatosis sono apperance?
Masses may be hypo, anechoic, or isoechoic
Detectable only if they alter renal contour or distort collecting system
What is Mesoblastic Nephroma?
- Benign
- composed of connective tissue
- aka benign Wilms Tumor
- Affects neonates
- Diagnosed prenatally
Mesoblastic Nephroma sono features?
- Can replace most of the parenchyma
- Resembles Wilms tumor
- Homogeneous or
- Heterogeneous with central areas of necrosis and hemorrhage
what is a Angiomyolipoma?
- benign hamartoma
- vessels-muscle-fat
Angiomyolipoma clinical presentation?
- associated with tuberous sclerosis
- TS patients present with seizures
- red papular rash over nose/ cheaks
sono apperance Angiomyolipoma?
- masses in renal cortex
- homogeneous
- hyperechoic
- with TS typically bilateral
acquired pathology of kidneys (3)
- pyelonephritis
- nephrolithiasis
- nephrocalcinosis
Pyelonephritis? on ultrasound
- enlargement of kidneys
- u/s is not sensitive for detection of acute inflammatory changes in renal cortex
renal stones?
- uncommon in children
renal stones causes? (3)
- Urinary tract infection
- Structural abnormalities
- Metabolic abnormalities
renal stones imaging?
- ultrasound used with plain radiography
- ureteric stones may be missed on US
what is Nephrocalcinosis?
- Deposit of Ca2+ in the kidney
- affects both kidneys
- focal increases in echogenicity in the renal pyramids
Pyelonephritis? on ultrasound
- enlargement of kidneys
- u/s is not sensitive for detection of acute inflammatory changes in renal cortex
