Renal retro test review

Question 1

UPJ obstruction

Answer 1

(Ureteropelvic junction)- This is called a congenital condition (present from birth). The blockage is caused when there is a narrowing of area between the ureter and the part of the kidney called the renal pelvis. Urine can build up and damage the kidney as a result.

Question 2

Ureterocele

Answer 2

a swelling at the bottom of one of the tubes (ureters) that carry urine from the kidney to the bladder. The swollen area can block urine flow.

Question 3

PUV

Answer 3

posterior urethral valve is an obstructing membrane in the posterior male urethra as a result of abnormal in utero development (keyhole bladder)

Question 4

Bladder diverticulum

Answer 4

an area of weakness in the bladder wall through which some of the lining of the bladder is forced out and creates a pouch where urine can collect and may not come out.

Question 5

Common normal variants

Answer 5

column of bertin
 dromedary hump,
 junctional parenchymal defect,  
fetal lobulation, 
lobar dysmorphism, 
duplex collecting system, 
bifid renal pelvis (incomplete duplex),
 extrarenal pelvis, 
horseshoe kidney

Question 6

Echogenicity of the kidney cortex

Answer 6

Cortex- darker than the inner medulla because of the increased perfusion of blood.

Question 7

Echogenicity of the kidney sinus

Answer 7

echogenic an intense area of echoes.

Question 8

Echogenicity of the kidney Medullary and pyramids

Answer 8

hypoechoic calyces is anexchoic when dilated such as hydronephrosis-otherwise not seen

Question 9

Most common pediatric renal mass

Answer 9

Nephroblastoma aka wilms tumor. Most common tumor age 1-8, 90 % found under 5 years old. 2-8 times higher found in horseshoe kidneys. Clinically presents as flak mass, hematuria, fever, and anorexia

Question 10

location of renal cysts/prevalence

Answer 10

Exophtic: cyst projects outward away from the kidney,

Cortical: lies within renal cortex,

Parapelvic: originates in renal parenchyma and protrude into renal sinus,

Peripelvic: originates in the renal sinus, 50% 50 years of age
(renal path slide 4-5)

Question 11

Flow of urine

Answer 11

nephron-collecting duct-minor calyces-major calyces-renal pelvis-ureter-bladder-urethra
(slide 13)

Question 12

Location of kidneys

Answer 12

in the retroperitoneal cavity, on both the right and left sides of the body

Question 13

Neuroblastoma

Answer 13

(slide 30-31 pg 457)
a.50% arise from the adrenal medulla, and tumors have been found in the neck, mediastinum, retrperitoneum, and pelvis,

b. Clinical symptoms, depend on location of tumor. If adrenal- enlarged abdomen,HTN,diarrhea,bone pain if metastasized,
c. 2nd most common abdominal tumor in childhood, Arises in the sympathetic chain ganglia and adrenal medulla,
d. Normally seen between 2 months to 2 years,
e. Neuroblastoma-common in children < 5 years old. Weight loss, decrease in energy, abd protusion,fever. Rapid metastasis to the lymph nodes, lungs, bone and liver

Question 14

Metastasis to the adrenal glands come from what primary tumors

Answer 14

(slide 26 pg, pg 455)
 lung 33%, 
breast 30%,
 melanoma, 
gastric, 
colon, 
kidney, 
thyroid

Question 15

Hormones of the adrenal glands

Answer 15

Sex hormone (Androgen-male sex hormone. Estrogen-female sex hormone)

epinephrine and norepinephrine

Aldosterone

Cortisol

Question 16

Sex hormone

Answer 16

Androgen-male sex hormone. Estrogen-female sex hormone. Secretes both regardless of gender. Secreted in minute quantities, almost insignificant effects. Controlled by ACTH from the pituitary gland. Hypofunction is termed Addison’s Disease.

Question 17

epinephrine and norepinephrine

Answer 17

Responsible for flight or fight- pg 448 Adrenal Medulla produces them Both hormones are amines, referred to as catecholamines.

Question 18

Aldosterone

Answer 18

Steroid hormone (mineralcorticoid) produced by outer section of adrenal cortex in the adrenal gland. Excessive secretion (Conn’s Syndrome-aldosteronism) due to adenoma of glomerulosa cells or less common adrenal hyperplasia or adrenal carcinoma.

Question 19

Cortisol

Answer 19

Steroid hormone (glucocorticoid) produced by zona fasciculate of adrenal cortex. Excessive secretion of cortisol (cushing’s syndrome) normally from an adenoma or carcinoma of the adrenal gland or a pituitary tumor.

Question 20

R. Renal artery

Answer 20

arises from the posterolateral wall of the aorta, travels POSTERIOR to the IVC to supply the Kidney

Question 21

L. Renal artery

Answer 21

arises from the posterolateral wall of the aorta DIRECTLY into the hilus of the kidney.

Question 22

R. Renal vein

Answer 22

leaves the renal hilus to enter the lateral wall go the IVC. Shorter than L. Renal vein

Question 23

L. Renal vein

Answer 23

leaves the hilum , travels anterior to the aorta and posterior to the SMA to enter the lateral wall of the IVC.

Question 24

Vascular supply to kidney

Answer 24

Aorta- renal arteries - segmental- interlobar – Arcuate

Question 25

Blood supply to nephrons

Answer 25

Renal arteries- afferent arteriole - Bowmans capsule- Glomerulus- efferent arteriole - renal veins Cleaned blood back into the circulatory system.

Question 26

Most common location for kidney stone to be found

Answer 26

ureterovesical junction

Question 27

Staghorn calculus

Answer 27

stone that fills entire kidney lots of shadowing pg 402

Question 28

Renal fungal infections Most commonly affects patients

Answer 28

Immunocompromised Diabetis mellitus drug abusers Infants with longstanding indwelling catheters

Question 29

Renal fungal infections, Most common form of fungal urinary tract infection is......

Answer 29

Candida albicans

Question 30

Renal fungal infections, Clinical symptoms

Answer 30

Flank pain Fever Chills

Question 31

Renal fungal infections, Sonographic findings

Answer 31

ungal balls will be echogenic, mobile, nonshadowing structures within the renal collecting system

Question 32

column of bertin

Answer 32

location-medulla indention of the renal sinus similar to renal parenchyma and contiguous with cortex

Question 33

dromedary hump

Answer 33

location-lateral border of the kidney identical to renal cortex

Question 34

junctional parenchymal defect

Answer 34

location-upper pole of renal parenchyma echogenic triangular area best seen in sagittal scan

Question 35

fetal lobulation

Answer 35

location-surface of kidney indentations between the calyces best seen on sagittal scan

Question 36

lobar dysmorphism

Answer 36

location-middle and upper calyces elongation of upper and middle calyces best seen on sagittal scan

Question 37

duplex collecting (complete) system

Answer 37

location-central renal sinus two echogenic regions separated by moderately echogenic parenchymal tissue best seen on sagittal scan

Question 38

bifid renal pelvis (incomplete duplication)

Answer 38

location- central renal sinus middle calyces, two echogenic regions one ureter entering the bladder on each side of the bladder

Question 39

extrarenal pelvis

Answer 39

location-long renal pelvis that extends outside the renal bladder central cystic region that extends beyond medial renal border best seen on transverse view at the level of the midpole

Question 40

horseshoe kidney

Answer 40

location-kidneys seen more medial anterior to the spine fusion of the polar region, usually the lower poles

Question 41

Lab tests that indicate renal failure

Answer 41

Urinalysis, Urine pH, Specific Gravity, Blood, Hematocrit, Hemoglobin, Protein, Creatinine Clearance, Blood Urea Nitrogen (BUN), Serum Creatinine