Renal Pathology 2

Question 1

What is associated with prune belly syndrome?

Answer 1

anterior wall defect; mostly males; hydroureteronephrosis, vesicoureteral reflux (VUR), renal dysplasia, cryptorchidism, UTIs, decreased ability to cough, decreased valsalva

Question 2

if unilateral renal agenesis occurs, why is the solitary kidney enlarged?

Answer 2

because of an adaptation–> hypertrophy

Question 3

true renal hypoplasia is usually observed in what patients?

Answer 3

in low birth-weight infants

Question 4

how can you identify truly hypoplastic kidneys?

Answer 4

there will be no scars and it will have a reduced number of renal lobes and pyramids

Question 5

how does an ectopic kidney come to be?

Answer 5

during normal embryological development, there is cephalic migration of the kidneys to their normal retroperitoneal location, and an ectopic location is the result of arrested ascent

Question 6

where are some common places ectopic kidneys can be found?

Answer 6

in the pelvis, iliac fossa, abdominal or thoracic cavities, or contralateral positions

Question 7

what is a horseshoe kidney?

Answer 7

fusion of the upper or lower poles of the kidneys produces a horseshoe-shaped structure that is continuous across the midline anterior to the great vessels. Usually found incidentally

Question 8

what are 4 congenital anomalies of the ureters?

Answer 8

vesicoureteral reflux, double or bifed ureters, UPJ obstruction, diverticula

Question 9

what is vesicoureteral reflux?

Answer 9

when urine flows in both directions from the kidney to the bladder and from the bladder to the kidney

Question 10

what is the most common cause of hydronephrosis in infants and children?

Answer 10

ureteropelvic junction (UPJ) obstruction

Question 11

how does UPJ present?

Answer 11

hydronephrosis, UTI, hematuria, FTT, sepsis, azotemia

Question 12

if you have signs of UPJ, what sites should be evaluated for obstruction?

Answer 12

1. at the ureteropelvic junction 2. crossing the external iliac artery and/or pelvic brim 3. as the ureter traverses the bladder wall

Question 13

what is the etiology of acquired diverticula in the bladder?

Answer 13

when there is increased intraluminal pressure secondary to obstruction and some area of weakness that leads to a diverticula

Question 14

what is exstrophy of the bladder?

Answer 14

a developmental failure in the anterior wall of the abdomen and the bladder

Question 15

what are the consequences of exstrophy of the bladder?

Answer 15

the exposed bladder mucosa may undergo colonic glandular metaplasia that is subject to chronic infection that often spread to the upper urinary tract

Question 16

what is a urachal cyst?

Answer 16

the urachal canal connects the fetal bladder with the allantois and is normally obliterated at birth; rarely it remains fully or partially patent

Question 17

what is a malformation of the urethral groove and what are the two types?

Answer 17

it may create an abnormal opening either on the ventral surface of the penis (hypospadias) or on the dorsal surface (epispadias)

Question 18

what is cryptorchidism?

Answer 18

a complete or partial failure of the intra-abdominal testes to descend into the scrotal sac