renal embryo

Question 1

where are the kidneys derived from ?

Answer 1

mesoderm

Question 2

what are the different structures made in utero for the kidney ?

Answer 2

propnephros
mesonephros
metnanephros

Question 3

what does the mesonephros contribute to ?

Answer 3

vas deferens in males

Question 4

which of the primitive parts of the kidney forms the permanent kidney?

Answer 4

metanephros

Question 5

what are the key structures associated with kidney formation ?

Answer 5

key structure : ureteric bud
key structure : metanephric mesenchyme

Question 6

what is the ureteric bud an outgrowth of ?

Answer 6

the mesonephric or wolffian duct

Question 7

what is the basis of kidney malformation ?

Answer 7

when there is aberrant interaction between the ureteric bud and the metanephric mesenchyme

Question 8

what is the most common renal cancer of children ?

Answer 8

wilms tumor

Question 9

what is the pathlogy associated with wilms tumor ?

Answer 9

proliferation of the metanephric blastema
associated with WT1 gene mutation

Question 10

what is the cause of renal agensis ?

Answer 10

failure of development of the ureteric bud
lack of signals to mesenchyme

Question 11

what risk is associated with unilateral kidneys ?

Answer 11

development in focal segmental glomerular sclerosis

Question 12

if both kidneys fail to develop what happens ?

Answer 12

development of potter syndrome

Question 13

what is the cause of multicystic dysplastic kidney ?

Answer 13

abnormal ureteric bud mesenchyme interaction
where the kidney is replaced with cysts

Question 14

what is the problem with uretropelvic junction obstruction ?

Answer 14

common cause of single kidney obstruction
narrowing of the proximal ureter
leading to hydronephrosis

Question 15

what is a duplex collecting system and what is the associated pathology ?

Answer 15

where there are two ureteric buds on either one of the kidneys , or bifurcation of the ureteric bud

Question 16

what other abnormality is often associated with duplex collecting system ?

Answer 16

vesicoureteral reflux

Question 17

what is vesicoureteral reflux ?

Answer 17

it is the backward flow of urine back into the kidneys

Question 18

what are the two types of vesicoureteral reflux ?

Answer 18

primary - abnormal closure of the UVJ
secondary - associated with high bladder pressure , where the urine is pushed backwards - seen with poterior urethral valves

Question 19

what is the main clinical consequence of vesicoureteral reflux ?

Answer 19

recurrent UTIs

Question 20

what is potter’s syndrome ?

Answer 20

fetus is exposed to decreased amniotic fluid
if there is a kidney problem in the fetus this will cause a decrease in the amniotic fluid levels , leading to a loss of cushioning

this leads to compression and abnormal face and limb formation
as well as abnormal lung formation

Question 21

what are the signs associated with potter syndrome ?

Answer 21

limb deformities
flat face
pulmonary hypoplasia
often leads to fetal death

Question 22

what is the main cause of oligohydraminous in the second trimester ?

Answer 22

usually associated decreased formation of fetal urine

Question 23

what are the causes of potters syndrome ?

Answer 23

1- bilateral renal agenesis
2- posterior urethral valve
3- autosomal recessive polycystic kidney disease

Question 24

what are the features associated with posterior urethral valve?

Answer 24

occurs only in males
where the tissue valve obstructs the bladder outflow
this results in affection of both kidneys

Question 25

what is the most probable diagnosis in a male fetus with bilateral hydronephrosis ?

Answer 25

posterior urethral valve

Question 26

what are the two forms of polycystic kidney disease ?

Answer 26

autosomal dominant - adult onset autosomal recessive - children cysts develop from normal renal tubules

Question 27

what is the anomaly associated with horseshoe kidney ?

Answer 27

inferior poles fuse , so the kidney cannot ascend in the pelvisw

Question 28

what artery is associated with horse shoe kidney ?

Answer 28

they become trapped by the inferior mesenteric artery

Question 29

what other kidney abnormality is associated with horseshoe kidney ?

Answer 29

vesicouretral reflux

Question 30

what genetic disorders are associated with horse shoe kidney ?

Answer 30

turner and down syndrome

Question 31

what is the urachus and what is the fate of it ?

Answer 31

an embryological structure that connects the dome of the bladder to the umbilicus , it is eventually obliterated and forms the median umbilical ligament

Question 32

what pathology is associated with the urachus ?

Answer 32

incomplete obliteration may cause the formation of a cyst may cause adenocarcinoma of the bladder

Question 33

what is the classic presentation associated with adenocarcinoma of the bladder ?

Answer 33

adult with painless hematuria tumor of the dome of the bladder pathology shows adenocarcinoma.

Question 34

how is a diagnosis of posterior urethral valve made ?

Answer 34

a male neonate that still hasnt peed perform an ultrasound followed by cystourethrogram

Question 35

what are the causes of vesicouretral reflux in pregnancy ?

Answer 35

1- due to a larger uterus in pregnancy in the third trimester 2- progesterone causes a decrease in ureteral peristalsis