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Abdominal > Quiz 3 (urinary system) > Flashcards

Quiz 3 (urinary system) Flashcards

1
Q

what is the functioning unit of the kidney?

A

nephron

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2
Q

what is the arterial branching order?

A
  • segmental artery
  • interlobular/interlobular arteries
  • arcuate artery (cortex)
  • interlobular artery
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3
Q

what is the size of an adult kidney?

A

9-12 cm in length
4-5 cm in width
2.5-3 cm in height

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4
Q

what are some functions of the kidney?

A
  • produces hormones
  • absorbs nutrients, filters, and produces urine
  • balances water
  • blood pressure regulation
  • e.t.c
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5
Q

what are the lab values of the kidney?

A
  • creatinine
  • BUN
  • Hematuria
  • proteinuria
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6
Q

what is creatinine elevated in?

A
  • renal failure
  • chronic nephritis
  • urinary obstruction
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7
Q

what is creatinine?

A

a waste product produced from meat protein and normal wear ad tear on muscles in the body

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8
Q

BUN-blood urea nitrogen

A

produced from the breakdown of food proteins

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9
Q

wat is BUN elevated in?

A
  • urinary obstruction
  • renal dysfunction
  • dehydration
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10
Q

what is BUN decreased with?

A
  • overhydration
  • pregnancy
  • liver failure
  • decrease in protein intake
  • smoking
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11
Q

microscopic hematuria

A

microscopic red blood cells in the urine under the microscope

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12
Q

what is microscopic hematuria associated with?

A

early renal disease

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13
Q

Macroscopic hematuria

A

visible red blood cells seen with the naked eye

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14
Q

what is Macroscopic hematuria associated with?

A

infection and bladder neoplasms

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15
Q

proteinuria

A

abnormal amount of protein in the urine

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16
Q

what is proteinuria associated with?

A 
nephritis
nephrolithiasis
carcinoma
polycystic disease 
hypertension
diabetes mellitus
Increases the risk of developing progressive renal dysfunction
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17
Q

what are some indications for a renal US?

A 
Increase in creatinine ,BUN levels, proteinuria
Urinary tract infection
Flank pain
Hematuria
Hypertension
Decrease in urine output
Trauma
Evaluate mass from other medical imaging-CT
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18
Q

Hypertrophied column of Bertin-pseudotumor

A

renal cortex that is continuous with adjacent renal cortex

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19
Q

how big are renal pyramids in Hypertrophied column of Bertin-pseudotumor?

A

less than 3cm

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20
Q

Junctional Parenchymal(Cortical) Defect

A

Normal variant located at the point of fusion of the embryological upper and lower poles

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21
Q

where is Junctional Parenchymal(Cortical) Defect most commonly seen?

A

right kidney

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22
Q

what is Junctional Parenchymal(Cortical) Defect also known as?

A

interrenucular junction

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23
Q

extrarenal pelvis

A

renal pelvis lies partly outside of the kidney

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24
Q

what are the 3 sets of kidneys on embryo?

A
  • pronephros
  • mesonephros
  • metanephros
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25
Q

Pronephroi

A
  • Early in 4th week gestation

- Rudimentary and nonfunctioning

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26
Q

Mesonephroi

A
  • Late in 4th week

- Function as interim kidneys

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27
Q

Metanephroi

A

permanent kidneys

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28
Q

what are the abnormalities related to growth?

A
  • hypoplasia
  • fetal lobulation
  • compensatory hypertrophy
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29
Q

what are the abnormalities related to ascent?

A
  • ectopia
  • crossed renal ectopia
  • horseshoe kidney
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30
Q

Hypoplasia

A

too few nephrons in a smaller than normal size kidney

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31
Q

Fetal lobulation

A

Appears as infolding of the cortex without loss of cortical parenchyma

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32
Q

Compensatory hypertrophy

A

may be diffuse or focal

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33
Q

ectopia

A

pelvic kidney-failure of the kidney to ascend during embryology

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34
Q

what percent has decreased function is pelvic kidney?

A

50%

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35
Q

Crossed Renal Ectopia

A
  • both kidneys are found on the same side

- Upper pole of the ectopic kidney will be fused to lower pole of the other kidney

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36
Q

Horseshoe kidney

A

Fusion occurs prior to ascent usually at the lower poles

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37
Q

what should be measured in the horseshoe kidney?

A

isthmus

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38
Q

where does the isthmus in horseshoe kidney lie?

A

anterior to aorta

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39
Q

horseshoe kidney type a

A

inferior crossed fusion

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40
Q

horseshoe kidney type b

A

sigmoid kidney

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41
Q

horseshoe kidney type c

A

lump kidney

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42
Q

horseshoe kidney type d

A

disc kidney

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43
Q

horseshoe kidney type e

A

L-shaped kidney

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44
Q

horseshoe kidney type f

A

superiorly crossed fused

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45
Q

what are kidney anomalies related to ureteral bud?

A
  • Renal agenesis
  • Congenital Megacalicies
  • Congenital Megaureter
  • Supernumerary kidney
  • Duplex collecting system&Ureteroceles
  • Ureteropelvic Junction Obstruction
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46
Q

renal agenesis-unilateral or bilateral

A

could be uni or bi

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47
Q

is bilateral or unilateral renal agenesis rare and incompatible with life?

A

bilateral

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48
Q

Unilateral is an _________finding-with apparent _______________ of the single kidney

A

incidental finding, compensatory hypertrophy

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49
Q

what is renal agenesis associated with?

A

genital tract anomalies

HBP

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50
Q

Megacalyces-Puigvert’s disease

A

Unilateral nonobstructive enlargement of the calyces

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51
Q

what can occur with Megacalyces-Puigvert’s disease?

A

infection and stones

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52
Q

describe Megacalyces-Puigvert’s disease

A
  • congenital and non-progressive
  • normal parenchyma and renal function
  • on US numerous clubbed calyces seen
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53
Q

how does Megaureter appear?

A

Appears as fusiform dilation of distal third

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54
Q

what is megaureter?

A
  • functional uretic obstruction
  • distal ureter segment is aperistaltic
  • progressive hydroureter and hydronephrosis
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55
Q

who does megaureter mostly affect?

A

men

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56
Q

supernumerary kidneys

A

-extra kidney found on sonography an dis usually smaller with a few calyces

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57
Q

what is the most common congenital anomaly?

A

duplex collecting system

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58
Q

what is COMPLETE duplex collecting system?

A

2 separate collecting systems and ureters

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59
Q

what is INCOMPLETE duplex collecting system?

A

ureters join and enter the bladder through a single ureteral orifice

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60
Q

what is increased in duplex collecting system?

A

increased incidence of UPJ obstruction and uterus didelphys-duplex uterus

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61
Q

what is incomplete duplex collecting system prone to?

A

ureter from the upper pole is prone to

  • obstruction
  • reflux
  • or both
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62
Q

what does incomplete duplex collecting system give rise to?

A

ureteroceles

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63
Q

how may ureteroceles appear?

A
  • unilateral
  • bilateral
  • normal ureters
  • duplicated ureters
  • ectopic ureters
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64
Q

what is ureteroceles prone to?

A

ureteral obstruction-UTI’s

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65
Q

how do ureteroceles appear on US?

A

round cyst like structure in bladder

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66
Q

what common anomaly causes a kink?

A

ureteropelvic junction obstruction

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67
Q

who does ureteropelvic junction mostly affect?

A

men

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68
Q

UPJ obstructions

A
  • stones
  • infection
  • impaired renal function
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69
Q

what are some anomalies related to bladder development?

A
  • bladder agenesis
  • bladder duplication
  • bladder exstrophy
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70
Q

what happens to most infants with bladder agenesis?

A

most infants are still born

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71
Q

what are the 3 types of bladder duplication?

A

1-complete/incomplete peritoneal fold separates
2-complete-incomplete septum divides bladder (may be multiple septa)
3-transverse band of muscle divides bladder into 2 unequal parts

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72
Q

who does bladder exstrophy mostly affect?

A

male

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73
Q

what is bladder exstrophy?

A

Congenital absence of lower abdominal and anterior bladder wall

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74
Q

Aberrant vessels

A

During embryology, the kidney receives blood from the higher levels of Aorta

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75
Q

when will aberrant renal arteries be present?

A

if supply from lower levels persist

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76
Q

what will happen if the infrarenal IVC does not develop from the usual Supracardinal vein?

A

the ureter will pass posterior to the IVC

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77
Q

how may urachal anomalies be present as?

A
  • patent
  • cyst
  • sinus
  • abscess in the abdominal wall and diverticulum
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78
Q

where are urachal anomalies located?

A

between umbilicus and bladder

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79
Q

what does urachal anomalies increase?

A

incidence of carcinoma and stone formation

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80
Q

Acute pyelonephritis

A

UTI begins in bladder and ascends to kidney parenchyma

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81
Q

who does acute pyelonephritis affect?

A

women age 15-35

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82
Q

what is the sonographic appearance of Acute pyelonephritis?

A
  • renal enlargement
  • compression of sinus
  • abnormal echotexture
  • loss of corticomedullary differentiation
  • poorly marginated mass
  • gas within renal parenchyma
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83
Q

Acute pyelonephritis colour flow

A

focal or diffuse absence of colour due to swollen inflamed areas

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84
Q

how may Acute pyelonephritis focal masses appear?

A
  • poorly marginated
  • echogenic
  • hypoechoic
  • mixed
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85
Q

Chronic pyelonephritis

A

Interstitial nephritis (swelling between the tubules)associated with vesicoureteric reflux

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86
Q

who is Chronic pyelonephritis more common in?

A

women

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87
Q

what is Chronic pyelonephritis caused by?

A

Caused by incompetent papillary duct orifice(where pyramids empty urine into minor calyces)

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88
Q

Chronic pyelonephritis sonographic appearance

A
  • dilated blunt calix

- cortical scar and atrohy

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89
Q

Renal and perinephric abscess

A

Untreated pyelonephritis may lead to necrosis and abscess formation

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90
Q

what are some risk factors for Renal and perinephric abscess?

A
  • diabetics
  • compromised immunity
  • chronic diseases
  • UT obstruction
  • IV drug abuse
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91
Q

Renal and perinephric abscess sonographic appearance?

A
  • An abscess appears as round,thick-walled,complex masses
  • Debris&septations
  • Gas –dirty shadowing
  • Posterior enhancement
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92
Q

Pyonephrosis

A

Purulent material in obstructed collecting system

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93
Q

Pyonephrosis in young

A

UPJ obstruction and calculi is the cause usually

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94
Q

Pyonephrosis in elderly

A

malignant ureteral onstruction is usually the cause

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95
Q

Pyonephrosis sonogrpahically

A
  • mobile collecting system debris
  • gas and stones
  • fluid/debris level
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96
Q

Emphysematous pyelonephritis

A

characterized by gas formation, usually E-Coli

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97
Q

who does Emphysematous pyelonephritis mostly affect?

A
  • women (55 yrs)

- diabetics

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98
Q

what does Emphysematous pyelonephritis present as?

A
  • extremely ill
  • flank pain
  • acidosis
  • hyperglycemia
  • dehydration
  • electrolytes off
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99
Q

what is the treatment of choice for Emphysematous pyelonephritis?

A

emergency nephrectomy is treatment of choice

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100
Q

why is Emphysematous pyelonephritis sonographic image confusing?

A

appears confusing due to gas formation

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101
Q

Emphysematous Pyelitis

A

Refers to gas localized within collecting system-pelvis and calyces

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102
Q

where does Emphysematous Pyelitis usually occur?

A

in women with diabetes or obstructing stone disease

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103
Q

Xanthogranulomatous Pyelonephritis

A

chronic suppurative renal infection

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104
Q

is Xanthogranulomatous Pyelonephritis typically unilateral or bilateral?

A

typically unilateral

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105
Q

where is Xanthogranulomatous Pyelonephritis commonly seen?

A

middle aged diabetic women

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106
Q

what leads to papillary necrosis?

A

ischemia

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107
Q

what could cause papillary necrosis?

A
  • analgestic abuse
  • diabetes
  • UTI
  • renal vein
  • thrombosis
  • prolonged urinary tract obstruction
  • dehydration
  • sickle cell anemia
  • hemophilia
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108
Q

what are the sonographic findings of papillary necrosis?

A
  • swollen pyramids
  • cystic papilla
  • clubbed calyx
  • hydro nephrosis
  • debris in collecting system
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109
Q

what are signs/symptoms of TB?

A
  • dysuria
  • nocturia
  • urgency
  • gross or microscopic hematuria
  • unilateral typically
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110
Q

what is TB sonographically?

A
  • focal renal lesions (variable echotexture and size)

- may involve bladder (diffuse wall thickening)

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111
Q

what is the most common fungal agent?

A

candida albicans

112
Q

patients with a fungal infection have a risk if what?

A
  • diabetes mellitus
  • chronic indwelling catheters
  • malignancy
  • hematopoietic disorders
  • chronic antibiotic or steroid therapy
  • transplantation
  • IV drug abuse
113
Q

what are fungal infections on US?

A

small cortical hypoechoic lesions-small abscesses

Fungus balls in collecting system-echogenic

114
Q

what is the most common parasitic infection seen?

A

schistosomiasis

115
Q

schistosomiasis

A

Worms penetrate skin to liver via the portals

116
Q

Hematuria

A

eggs deposited in venules of bladder wall/ureter

117
Q

Bladder stasis

A

increased incidence of ureteral and bladder calculi and repeated infections

118
Q

what does Echinoccal hydatid Renal disease affect?

A

kidneys
ureters
bladder

119
Q

how do Echinoccal hydatid Renal disease cysts look like?

A
  • floating membranes
  • daughter cysts
  • thick double walls
120
Q

who does filariasis affect?

A

10-12 years of age

121
Q

what is transmitted by mosquitos?

A

filiariasis

122
Q

when do symptoms for filariasis develop?

A

post infection

123
Q

which disease is US not helpful in diagnosing?

A

filariasis

124
Q

HIV associated ______-_______ renal disease

A

HIV associated nephropathy-chronic renal disease

125
Q

what is sonography used for in HIV?

A
  • exclude obstruction
  • determine renal size
  • cortical echogencity
126
Q

who is more at risk for bladder infection-cystitis?

A

women because if a short urethra

127
Q

what is the cause of bladder infection-cystitis?

A

colonization of rectal flora

128
Q

what is the most common pathogen for cystitis?

A

E-Coli

129
Q

what are signs of cystits?

A

bladder irritability and hematuria

130
Q

what is the sonographic sign of cystitis?

A

diffuse wall thickening

131
Q

Emphysematous cystitis

A

gas present in lumen and wall of bladder

132
Q

who does Emphysematous cystitis affect?

A

diabetic females

133
Q

Malacoplakia

A

Rare granulomatous infection

134
Q

what is brunna epithelial nests associated with?

A

chronic cystitis

135
Q

cystitis cystica

A

Cysts may develop in nests

136
Q

cystitis glandularis

A

may be a precursor of adenocarcinoma-cysts/solid masses in wall

137
Q

what are causes of bladder fistulas?

A
  • congenital
  • trauma
  • inflammation
  • radiation
  • neoplasm
138
Q

where may bladder fistula occur from?

A

bladder to:

  • vagina
  • gut
  • skin
  • uterus
  • ureter
139
Q

Vesicovaginal fistula

A

most often related to gynecological or urological surgery,carcinoma of the bladder or cervix

140
Q

vesicoenteric fistula

A

complication of diverticulitis or Crohn’s disease

141
Q

Vesicocutaneous fistula

A

surgery or trauma may be the cause

142
Q

Vesicoureteral fistula

A

rare occurrence after hysterectomy

143
Q

what are predisposing factors to Nephrolithiasis-renal calculi?

A
  • dehydration
  • urinary stasis
  • hyperericemia
  • hyperparathyroidism
  • hypercalciuria
144
Q

____ of stones from calculi under 5mm pass spontaneously

A

80%

145
Q

______ in patients with calculi with flank pain

A

77-93%

146
Q

in calculi what are the 3 areas of narrowing?

A

1-UPJ-just past this junction
2-where the ureter crosses the iliac vessels
3-UVJ at ureter vesicular junction

147
Q

what is high sensitivity for calculi?

A

ultrasound

148
Q

what demonstrates twinkle artifact?

A

calculi

149
Q

what does calculi look like sonographically?

A
  • echogenic foci with sharp distal acoustic shadowing

- 83% of stones demonstrate twinkle artifact?

150
Q

why may ureteral calculi be difficult to see?

A

bowel gas and deep retroperitoneal position

151
Q

Hydrourete

A

A dilated ureter will be seen as a tubular hypoechoic structure entering the bladder obliquely

152
Q

what will hydroureter demonstrate?

A

anechoic ureter on either side of stone

153
Q

Hydronephrosis

A

Obstructing ureteral calculus causes hydronephrosis of collecting system

154
Q

what happens to urine in hydronephrosis?

A

urine is being produced but cannot flow from kidney to bladder

155
Q

what are the sign and symptoms of hydronephrosis?

A
  • flank pain
  • hematuria
  • fever
  • leukocytosis
156
Q

what are some causes of hydronephrosis?

A
  • infection
  • tumor extensions from bladder, ureter, or kidney
  • thrombus
  • kink in ureteropelvic junction
  • enlarged prostate
  • pregnancy
157
Q

what is grade 1 hydro nephrosis grading?

A

small fluid filled separation of renal pelvis

158
Q

what is grade 2 hydronephrosis grading?

A

dilation of some but not all calyces

159
Q

what is grade 3 hydronephrosis grading?

A

marked dilation of renal pelvis and all calyces and echogenic line separates the collecting system

160
Q

what is grade 4 hydronephrosis grading?

A

prominent dilation of collecting system, cortical thinning, unable to separate collecting system and parenchyma

161
Q

what does bladder caluli cause?

A
  • migration of stone from kidney

- stasis related to bladder outlet obstruction, cystocele, neurogenic bladder, or foreign body

162
Q

staghorn calculi

A

large, jagged coral shaped calcification

163
Q

who is staghorn calculi most common in?

A

women

164
Q

what are the symptoms for staghorn calculi?

A
  • fever
  • hematuria
  • flank pain
165
Q

extrarenal pelvis

A

normal variant

pelvis lies partly outside of kidney

166
Q

Nephrocalcinosis

A

renal parenchymal calcification

167
Q

Dystrophic

A

occurs in tumors,abscess or hematomas

168
Q

Metastatic

A

occurs with hypercalcemic states-hyperparathyroidism, renal failure,acidosis

169
Q

what is seen sonographically with nephrocalcinosis?

A

medullary pyramids are surrounded with calcium deposits exhibiting acoustic shadowing

170
Q

Renal failure-chronic

A

A medical condition of impaired kidney function in which the kidneys fail to adequately filter metabolic wastes from the blood

171
Q

what are the causes of renal failure-chronic?

A 
Glomerulonephritis
Hypertension
Vascular disease
Diabetes mellitus
Chronic hydronephrosis
172
Q

what are the clinical findings of renal failure?

A 
Elevated BUN and creatinine
Proteinuria
Polyuria
Headaches
Fatigue
Weakness
Anemia
173
Q

what is the sonographic finding of renal failure?

A

Renal atrophy
Hyperechoic parenchyma
Thin renal cortex <1cm
Difficult to distinguish the kidney from surrounding structures

174
Q

what are some Genitourinary Tumors?

A

renal cell carcinoma (RCC)
transitional cell carcinoma (TCC)
bladder tumors
angiomyolipoma

175
Q

what is the most common type of genitourinary tumors?

A

renal cell carcinoma

176
Q

what is a risk factor for RCC?

A

acquired cystic kidney disease

177
Q

RCC is _______ of all primary malignant renal parenchymal tumors

A

86%

178
Q

describe RCC

A

more common in males
50-70 years of age
etiology is unknown

179
Q

what the symptoms of RCC?

A

CLASSIC TRIAD

  • flank pain
  • gross hematuria
  • palpable renal mass
180
Q

what are the symptoms of RCC as more advanced?

A
  • anorexia
  • weight loss
  • some are found incidentally
181
Q

what is the most common type of RCC?

A

clear cell

182
Q

what are the types of RCC?

A
  • clear cell
  • papillary RCC
  • cystic
183
Q

what does RCC look like sonographically?

A
  • most are solid
  • majority are isoechoic
  • MRI or CT needed to characterize
184
Q

how do you distinguish RCC from bengin renal tumors

A

angiomyolipoma-CT and MRI

not possible with imaging test

185
Q

medullary cancer

A

sickle cell trait

186
Q

transitional cell carcinoma

A

occurs in central kidney

187
Q

what is the staging criteria for RCC?

A

11-Tumor confined within renal capsule
2-Tumor invasion of perinephric fat
3-Tumor involvement of regional lymph nodes
4-Invasion of adjacent organs or distal metastasis

188
Q

Juxtaglomerular tumor

A

Extremely rare kidney tumor generally considered bengin

189
Q

what does Juxtaglomerular tumor cause?

A

severe hypertension

190
Q

Renal sinus lipomatosis- pseudotumor

A

increased fat in the renal sinus

191
Q

what does Renal sinus lipomatosis- pseudotumor occur secondary to?

A

renal parenchyma atrophy or destruction of parenchyma

192
Q

what is Renal sinus lipomatosis- pseudotumor associated with?

A

obesity and steroid therapy

193
Q

Renal cell carcinoma

A

Cancer that originates in the lining of the proximal convoluted tubules-most

194
Q

Transitional Cell Carcinoma

A

Cancer that forms in the transitional cells in the lining of the bladder ,ureter or renal pelvis

195
Q

TCC

A
  • multifocal

- bilateral nature

196
Q

who is TCC more common in?

A

men

197
Q

where does TCC rarely invade?

A

renal vein

198
Q

what is the differential diagnosis for TCC?

A
  • blood clots
  • sloughed papillae
  • fungus balls
199
Q

where is TCC-ureteral mostly found?

A

lower third of ureter

200
Q

what is a common malignant tumor?

A

TCC of bladder

201
Q

what does TCC-bladder look like?

A

trigone and lateral and posterior walls

202
Q

what are the S/S of TCC bladder

A

Hematuria
Frequency
Dysuria
Suprapubic pain

203
Q

the sonographic detection of polyploid tumors is excellent with what?

A

full bladder

204
Q

what can colour demonstrate on TCC bladder?

A

vascular stalk

205
Q

what is TCC sonographically?

A
  • non mobile focal mass
  • may calcify
  • turn patient into semi decubitus position-if the mass moves it is probably clot
206
Q

what is the differential diagnosis for TCC?

A 
Cystitis
Wall thickening
Postradiation change   
Blood clot
Invasive prostatic carcinoma
Lymphoma,
Metastasis
Endometriosis 
Neurofibromatosis
207
Q

is bladder TCC or renal pelvic TCC more common?

A

bladder TCC is 50x’s more common than renal pelvic TCC-because of its large surface area

208
Q

Bladder outlet obstruction

A

Blockage at the base of the bladder

Reduces or prevents the flow of urine into the urethra

209
Q

what are the causes of bladder outlet obstruction

A

Enlarged prostate
Stones
Tumors
Scar tissue

210
Q

what is the second most common malignant tumor after TCC?

A

Squamous cell carcinoma-SCC

211
Q

how does SCC appear on US?

A
  • diffusely enlarge kidney

- stones often seen

212
Q

Adenocarcinoma

A

Rare in the pelvis,ureter and bladder
History of chronic UTI
Staghorn calculi present

213
Q

what is adenocarcinoma on ultrasound?

A

Pelvic,ureteric or bladder mass is seen

Calcification/stones

214
Q

what does oncocytoma look like?

A

RCC

215
Q

what is the most common benign renal tumor?

A

renal adenoma

216
Q

what is the sonographic appearance of renal adenoma?

A

mimics renal cell carcinoma

217
Q

which disease is associated with smoking?

A

renal adenoma

218
Q

Angiomyolipoma-AML

A

Benign renal tumors

  • Adipose tissue
  • smooth muscle
  • blood vessels
219
Q

Angiomyolipoma-unilateral or bilateral

A

unilateral

220
Q

what may happen with growth of a Angiomyolipoma?

A

may hemorrhage

221
Q

what are the symptoms for Angiomyolipoma?

A
  • hematuria
  • flank pain
  • palpable flank mass
222
Q

where is Angiomyolipoma located?

A

parachyma or exophytic

223
Q

lymphoma of kidney

A

no lymphoid tissue is in the kidney normally

224
Q

what does lymphoma of ureter result in?

A

Results in dilation of intrarenal collecting system/ureter to the level of the mass

225
Q

what is seen on lymphoma of bladder on US?

A

bladder wall is seen

226
Q

what are rare tumors of the kidney?

A 
Juxtoglomerular
Leiomyomas
Carcinoid tumor
Lipomas,hemangiomas
Liposarcomas
Sarcomas
Leiomyosarcomas
Hemangiopericytoma
227
Q

what are rare tumors of bladder?

A 
Mesenchymal  
Leiomyoma
Neurofibromas
Cavernous hemangioma
Pheochromocytomas
Leiomyosarcomas
Rhabdomyosarcomas
228
Q

Cortical cysts

A

Simple cysts:

Benign and fluid filled

229
Q

Sonographic criteria to confidently characterize as simple cyst

A

Anechoic
Sharply defined back wall
Round or ovoid
Posterior enhancement

230
Q

what do complex cysts contain?

A
  • internal echoes
  • Septations
  • Calcifications
  • Mural nodularity
231
Q

what are considered benign septations?

A

Thin,smooth septa attached to thin wall

232
Q

what are ominous signs of septations?

A

Complex cysts with thick septa >1cm and thick wall attachment

233
Q

what suggests a complicated cyst rather than malignancy for calcifications?

A

Thin wall or septal calcification

234
Q

what is more worrisome for calcifications?/

A

Thick irregular amorphous calcification

235
Q

what excludes malignancy for calcifications?

A

Only surgical removal

236
Q

what does milk of calcium cyst show?

A

Bright echogenic foci with ringdown artifact

237
Q

do parapelvic cysts communicate with collecting system?

A

no

238
Q

what do you need to show for parapelvic cysts?

A

Mimics hydronephrosis so take care to show noncontinuity with collecting system

239
Q

what is the most common hereditary renal disorder?

A

Polycystic kidney disease-ADPKD

240
Q

what does Polycystic kidney disease-ADPKD result in?

A

Results in a large number of bilateral cortical and medullary renal cysts

241
Q

if you have this disease you are at risk for RCC

A

Polycystic kidney disease-ADPKD

242
Q

what are complications of Polycystic kidney disease-ADPKD?

A 
infection
hemorrhage
stones
obstruction 
cyst rupture
243
Q

what does ADPKD look like on US?

A

Very enlarged kidneys (>20cm)
Multiple bilateral cysts of varying sizes
Little cortex is visible

244
Q

Medullary Sponge Kidney

A

dilated ecstatic collecting tubules

245
Q

Multicystic dysplastic

A

Nonhereditary developmental anomaly

246
Q

what does the kidney look like for multicystic dysplastic?

A

kidney is small, malformed with multiple cysts

247
Q

multicystic dysplastic-bilateral or unilateral?

A

unilateral-asymptomatic

248
Q

how do you get Medullary cystic kidney disease-MCKD1

A

inherited condition

249
Q

what does Medullary cystic kidney disease-MCKD1 lead to?

A

scarring of the kidney and cyst formation

250
Q

what does Medullary cystic kidney disease-MCKD1 result in?

A

kidney failure

251
Q

Multilocular cystic nephroma

A

Uncommon & benign neoplasm

252
Q

what does Multilocular cystic nephroma look like?

A

Multiseptated,exophytic complex cystic mass with noncommunicating locules

253
Q

which disease is biopsy not recommended?

A

Multilocular cystic nephroma

254
Q

Localized cystic disease

A
  • rare
  • benign
  • Mimics Autosomal Dominant Polycystic Kidney Disease
255
Q

what aids in diagnosis of localized cystic disease?

A

No family history of ADPKD & lack of cysts in other kidney aids in diagnosis

256
Q

VonHippel -Lindau disease

A

Usually multifocal and bilateral

Renal cysts are a common finding

257
Q

Tuberous sclerosis

A
  • Multiple cysts from microscopic to 3 cm in size
  • Appears similar to ADKPD
  • Associated with AML and RCC
258
Q

what are the renal Injuries with trauma?

A
  1. minor injury
  2. major injury
  3. catastrophic injury
  4. ureteropelvic junction avulsion
259
Q

what is the most common etiology for Renal vein thrombosis?

A

membranous glomerulonephritis-50%

260
Q

Acute RVT sonographically

A

Large edematous hypoechoic kidney

261
Q

Chronic RVT sonographically

A

Appears as small end stage echogenic kidney

262
Q

what is the most common cause of acute reversible renal failure?

A

acute tubular necrosis

263
Q

Acute tubular necrosis

A

Deposition of cellular debris within renal collecting tubules

264
Q

Acute cortical necrosis

A

Rare cause of acute renal failure

Ischemic necrosis of cortex

265
Q

Acute Glomerulonephritis

A

Necrosis and mesangial cell proliferation of the glomerulus

266
Q

Acute Glomerulonephritis, what kidney is affected?

A

both kidneys are affected

267
Q

Acute Glomerulonephritis chronic disease

A

Profound,global symmetrical parenchymal loss occurs

Small smooth echogenic kidneys

268
Q

Acute interstitial nephritis

A

Acute hypersensitivity reaction of the kidney to drugs

269
Q

what is acute interstitial nephritis on US?

A

enlarged echogenic kidneys

270
Q

what is the most common cause of chronic renal failure?

A

diabetes mellitus

271
Q

what does amyloidosis present with?

A

renal failure

272
Q

Interstitial Cystitis

A

chronic inflammation of bladder wall

273
Q

interstitial cystitis on US

A

small capacity

thick walled bladder

274
Q

Neurogenic Bladder

A
  • smooth large capacity, thin walled bladder on sonography

- a large post void residual will be seen

275
Q

Bladder Diverticula

A
  • acquired
  • previous bladder outlet obstruction
  • post void residual images-detect change

Abdominal (11 decks)

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