Renal Flashcards
What is the most common pathological cause of prenatal hydronephrosis? How can you detect it?
Congenital ureteropelvic obstruction.
Detected by ultrasound.
Say the 3 phases of renal embryology and their weeks of development.
Pronephros - week 4
Mesonephros - week 4
Metanephros - weeks 5-36
Tell me the POTTER sequence symptoms (associated with the acronym)
Pulmonary hypoplasia
Oligohydramnios
Twisted face
Twisted skin
Extremity defects
Renal failure
What’s an oligohydramnios?
It’s the lack of amniotic fluid, which causes the compression of the fetus and the potter sequence deformities
What are the causes of the potter sequence?
- Mother: Cronic placental insufficiency
- Fetus: Reduced renal output (includes ARPKD and obstructions)
Where is horseshoe kidney trapped?
Under the inferior mesenteric artery. It remains low in the abdomen.
What is horseshoe kidney associated with? (5)
- Hydronephrosis
- Ureteropelvic junction obstruction
- Renal stones
- Infection
- Higher risk of cancer
Horseshoe kidney has higher incidence in…
Chromosomal aneuploidy:
- Turner
- Some trisomies
Multicystic dysplastic kidney
The ureteric bud is developed but there’s no differentiation of the metanephric mesenchyme.
Usually nonhereditary
Usually unilateral
What is duplex collecting system associated with? (4)
- Vesico-ureteral reflux
- Ureteral obstruction
- Higher risk of UTI
- Hydronephrosis
What’s the posterior urethral valve?
It’s a membrane remnant in prostatic urethra in males. It can cause obstructions and leads to HYDRONEPHROSIS and DILATED BLADDER.
What’s the most common cause of bladder outlet obstruction in male infants?
Posterior urethral valve
Primary vesicoureteral reflux is due to…
A defficiency in the uretero-vesical junction
Secondary vesicoureteral reflux is due to…
High bladder pressure
Vesicoureteral reflux is commonly associated with…
High risk of UTI
Which part of the kidney is more sensible to hypoxia?
The medulla, because it receives less blood flow.
Left renal vein receives…
Two additional veins:
- Left suprarrenal vein
- Left gonadal vein
Which kidney is taken during a living Donnie transplantation?
Left kidney is taken because it has a longer renal vein.
The ureter course goes over and under…
Over the common iliac artery.
Under the uterine and gonadal arteries or vas deferens
Proximal ureter blood supply:
Renal arteries
Middle ureter blood supply:
Gonadal artery
Aorta
Common iliac artery
Internal iliac artery
Distal ureter blood supply:
Internal iliac artery
Superior vesical artery
Resume the ureter blood supply:
PROXIMAL:
- Renal arteries
MIDDLE:
- Gonadal artery
- Aorta
- Common iliac artery
- Internal iliac artery
DISTAL:
- Internal iliac artery
- Superior vesical artery
3 common points of ureteral obstructions:
- Ureteropelvic junction
- Ureterovesical junction
- Pelvic inlet
