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Small Parts > Renal & Urinary > Flashcards

Renal & Urinary Flashcards

1
Q

What is azotemia?

A

Elevated blood urea nitrogen and creatinine

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2
Q

What is uremia?

A

Elevated blood urea nitrogen

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3
Q

What is nocturia?

A

Frequent urination at night

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4
Q

What is pyuria?

A

Pus in urine

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5
Q

What is polyuria?

A

Excessive volume of urine

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6
Q

What is oliguria?

A

Abnormally small volume of urine

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7
Q

What is cystitis?

A

Inflammation of the bladder

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8
Q

What are S&S of cystitis?

A
  • pain
  • frequency, urgency
  • hematuria
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9
Q

What is the sono app of cystitis?

A
  • normal
  • focal/diffuse wall thickening
  • lumen echoes- layering
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10
Q

The bladder wall is considered thickened when it is over

A

3 mm

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11
Q

What are causes of bladder wall thickening?

A
  • muscular hypertrophy
  • tumor
  • infection
  • under distended bladder
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12
Q

What is the sono app of bladder wall thickening?

A

Focal/diffuse increased thickness

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13
Q

What is bladder diverticulum?

A
  • bladder wall defect
  • pouch, pocket or sac that protrudes out of the bladder
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14
Q

What is the typical cause of bladder diverticulum?

A

Outlet obstructions

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15
Q

What are S&S of bladder diverticulum?

A
  • retention
  • UTI
  • hematuria
  • abdominal distention
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16
Q

What is the sono app of bladder diverticulum?

A
  • solitary or multiple areas of discontinuity of wall
  • anechoic fluid filled pocket outside of bladder wall
  • cystoscopy
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17
Q

What is a lower tract calculi?

A

Focal calcification in the collecting system

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18
Q

What are the S&S of lower tract calculi?

A
  • asymp
  • obstructing: pain, hematuria
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19
Q

What is the sono app of lower tract calculi?

A
  • focal, echogenic mass
  • shadowing
  • obstructive hydro, distended ureter
  • mobile if in bladder
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20
Q

What is a urinary hematoma?

A

Localized collection of blood within lower urinary tract

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21
Q

What is the sono app of urinary hematoma?

A
  • low-level echoes
  • focal, mass like
  • layering dependent on gravity
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22
Q

What is urinary adenoma?

A

Benign growth of glandular tissue, AKA bladder polyp

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23
Q

What are S&S of adenoma?

A
  • asymp
  • painless hematuria
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24
Q

What is the sono app of adenoma?

A
  • focal lumen mass
  • irregular wall thickening
  • variable size/echogenicity
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25
Q

What is transitional cell carcinoma?

A

Primary malignant epithelial tumor

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26
Q

Where does transitional cell carcinoma originate?

A

Collecting system

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27
Q

What are S&S of transitional cell carcinoma?

A
  • asymp
  • painless hematuria
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28
Q

What is the sono app of transitional cell carcinoma?

A
  • focal lumen mass
  • irregular wall thickening
  • echogenic ureteral mass
  • variable echogenicity
  • obstructive hydro
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29
Q

How does metastatic disease to the bladder typically occur?

A

By direct extension to the bladder

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30
Q

What are S&S of metastatic disease to the bladder?

A
  • asymp
  • with obstruction: pain, oliguria
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31
Q

What is the sono app of metastatic disease?

A
  • focal lumen mass
  • irregular wall thickening
  • echogenic ureteral mass
  • variable echogenicity
  • obstructive hydro
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32
Q

What is Column of Bertin?

A
  • continuity of renal cortex
  • inward extension of cortex between renal pyramids
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33
Q

What is the sono app of Column of Bertin?

A
  • no change in sinus fat composition
  • prominent cortical tissue in medulla
  • easily mistaken for cortical mass
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34
Q

What is dromedary hump?

A
  • lateral cortical thickening
  • typically midpole
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35
Q

What is the sono app of dromedary hump?

A
  • normal vascularity
  • normal echogenicity/comp
  • bulging from outer border of cortex
  • easily mistaken for cortical mass
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36
Q

What is junctional parenchymal defect?

A

Results from partial fusion of the embryonic parenchymatous structues

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37
Q

What is the sono app of junctional parenchymal defect?

A
  • triangular or linear hyperechoic structure
  • anterosuperior or posteroinferior surface of kidney
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38
Q

What is persistent fetal lobulation?

A

Contour lobulations past 5 years old

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39
Q

What is the sono app of persistent fetal lobulation?

A
  • multiple smooth cortical lobulations
  • anterior surface
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40
Q

What is horseshoe kidney?

A

Lower poles of bilateral kidneys are fused

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41
Q

What is horseshoe kidney associated with?

A

Improper ascent and malrotation, stones

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42
Q

What is the most common fusion anomaly?

A

Horseshoe kidney

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43
Q

What is the midline connection of horseshoe kidneys called?

A

Isthmus

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44
Q

What is the sono app of horseshoe kidney?

A
  • lies lower than normal kidneys
  • mistaken for lymphadenopathy
  • renal pelvis anteriorly rotated
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45
Q

What is renal agenesis?

A

Total failure of kidney and ureter to develop in utero

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46
Q

Renal agenesis is more common in

A

Males

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47
Q

Bilateral vs unilateral renal agenesis

A

Bilateral: incompatible with life
Unilateral: more common, normal prognosis

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48
Q

What is supernumerary kidney?

A
  • Abnormal division during embryology
  • Complete duplication of kidney
  • Separate vascular supply, collecting system & parenchyma
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49
Q

What is the sono app of supernumerary kidney?

A
  • lower than typical kidneys
  • normal echogenicity and vascularity
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50
Q

What is duplex collecting system?

A

Two separate collecting systems with 2 separate ureters

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51
Q

What is extrarenal pelvis?

A
  • Chamber where urine forming ducts meet before ureter
  • Dilation of extra renal pelvis
  • Calyces are unaffected
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52
Q

What is the most common congenital renal anomaly?

A

Extrarenal pelvis

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53
Q

What is the sono app of extrarenal pelvis?

A
  • Cystic like region within pelvis
  • Does not extend into ureter or calyces
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54
Q

What can extrarenal pelvis be mistaken for?

A

Hydronephrosis or cyst

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55
Q

What is ectopic kidney?

A
  • Kidney fails to ascend
  • Congenital shortening of ureter
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56
Q

When does kidney ascent occur?

A

Between 12-15 weeks gestation

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57
Q

What can ectopic kidney result in?

A

Infections, blockage, failure

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58
Q

What is the sono app of ectopic kidney?

A

Normal appearance but located in pelvis

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59
Q

What is crossed fused renal ectopia?

A

Bilateral kidneys are fused and located on one side, kidneys fuse in pelvis before ascent

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60
Q

Who is crossed fused renal ectopia more common in?

A

Males

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61
Q

What is renal malrotation?

A
  • Renal hilum faces wrong direction
  • Uni or bilateral
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62
Q

What is the normal direction of the renal hilum?

A

Anteriomedial

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63
Q

What is the sono app of renal malrotation?

A
  • normal echogenicity
  • hilum not orientated anteriomedially
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64
Q

What is kidney hypoplasia?

A
  • Abnormally small
  • Renal function proportional to renal size
  • Small collecting system
  • Narrowed ureters/vessels
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65
Q

What are S&S of unilateral hypoplasia?

A
  • asymp
  • hypertension
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66
Q

What are S&S of bilateral hypoplasia?

A
  • severe clinical symptoms
  • renal insufficiency
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67
Q

What is the sono app of hypoplasia?

A

Small, hyperechoic

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68
Q

What is unilateral multicystic dysplastic kidney?

A
  • Non-hereditary, pedi condition
  • Cysts grow instead of renal tissue, non-functional
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69
Q

What is the MC form of cystic disease and the MC palpable mass in neonates?

A

Unilateral multicystic dysplastic kidney

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70
Q

Bilateral multicystic dysplastic kidney is

A

Incompatible with life

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71
Q

What are S&S of unilateral multicystic dysplastic kidney?

A
  • polyuria
  • HTN
  • infection
  • assoc with risk of malignancy
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72
Q

What is the sono app of unilateral multicystic dysplastic kidney?

A
  • multiple cysts of varying size
  • no renal parenchyma surrounding cysts
  • enlarged kidney in childen
  • small kidney in adults
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73
Q

What is medullary sponge kidney?

A
  • Rare, non-hereditary disease
  • Small cysts form either on tubules or the collecting ducts
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74
Q

Who is medullary sponge kidney MC in?

A

Children

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75
Q

What are S&S of medullary sponge kidney?

A
  • asymp
  • hematuria
  • infections
  • pain
  • hydronephrosis
76
Q

What is the sono app of medullary sponge kidney?

A
  • Normal/small kidneys, echogenic parenchyma (cysts too small on US)
  • Small cysts in medulla & cortex with echogenic parenchyma
77
Q

What is medullary cystic disease?

A
  • Autosomal recessive disease
  • Small cysts result in fibrosis/scarring of parenchyma & tubules
78
Q

Who does medullary cystic disease commonly affect?

A

Young adults

79
Q

What are the S&S of medullary cystic disease?

A
  • normal renal function, can lead to failure
  • anemia
  • salt loss
  • azotemia
  • polyuria
  • pain
  • infection
80
Q

What is the sono app of medullary cystic disease?

A
  • Normal or small echogenic kidneys with small cysts (<2 cm)
  • widening of renal sinus
81
Q

What is infantile polycystic kidney disease?

A
  • Autosomal recessive
  • Rare
  • Dilation of collecting tubules which leads to renal failure
82
Q

What are the 4 types of IPCKD?

A
  • perinatal
  • neonatal
  • infantile
  • juvenile
83
Q

What are S&S of IPCKD?

A
  • renal insufficiency
  • lung hypoplasia
  • portal HTN
  • hepatic fibrosis
  • GI bleed
84
Q

What is the sono app of IPCKD?

A
  • enlarged, echogenic kidneys
  • small cysts not visualized
  • no corticomedullary differentiation
85
Q

What is adult polycystic kidney disease?

A
  • autosomal dominant
  • Bilateral disease with multiple cysts in cortex & medulla
86
Q

What are S&S of adult polycystic kidney disease?

A
  • 40s-50s, by 60 end stage renal disease
  • HTN
  • renal failure
  • pain, fever, chills
  • uremia
  • palp mass
  • polycythemia
  • hematuria
87
Q

What is the sono app of adult polycystic kidney disease?

A
  • enlarged kidneys
  • multiple cysts varying size
  • loss of reniform shape
  • atypical cysts due to hemorrhage/infection
  • cysts also in liver, panc, spleen
88
Q

What is the genetic difference between infantile and adult polycystic kidney disease?

A

Infantile: autosomal recessive
Adult: autosomal dominant

89
Q

What is acute pyelonephritis?

A

Acute inflammation of renal tissue

90
Q

What are S&S of acute pyelonephritis?

A
  • flank pain
  • fever
91
Q

What is the sono app of acute pyelonephritis?

A
  • normal appearance
  • focal or diffuse:
    - increase in size
    - areas of
    increased/decreased echogenicity
    - absence of perfusion with doppler
  • loss of corticomedullary differentiation
  • compression of renal sinus
  • uni or bilateral
92
Q

What is emphysematous pyelonephritis?

A

Life-threatening infection of renal parenchyma with gas formation in tissue or collecting system

93
Q

What are S&S of emphysematous pyelonephritis?

A
  • fever
  • flank pain
  • dehydration
  • acidosis
  • electrolyte imbalance
94
Q

What is the sono app of emphysematous pyelonephritis?

A

Echogenic gas within parenchyma and collecting system

95
Q

What is chronic pyelonephritis?

A

Interstitial nephritis from ongoing or recurring UTIs
- swelling between tubules

96
Q

What are S&S of chronic pyelonephritis?

A
  • asymp
  • renal failure
97
Q

What is the sono app of chronic pyelonephritis?

A
  • uni or bilateral
  • focal area of cortical thinning and increased echogenicity
98
Q

What is acute tubular necrosis?

A
  • Damage and/or necrosis of renal tubules
  • Bilateral condition
99
Q

What are S&S of ATN?

A
  • AKI
  • oliguria
  • uremia
  • electrolyte imbalance
100
Q

What is the sono app of ATN?

A
  • normal appearance
  • bilateral enlargement
  • increased parenchyma echogenicity
101
Q

What is pyonephrosis?

A

Pus within collecting system

102
Q

What are S&S of pyonephrosis?

A
  • fever
  • flank pain
103
Q

What is the sono app of pyonephrosis?

A
  • hydronephrosis
  • mobile echogenic debris within collecting system
104
Q

What is acute glomerulonephritis?

A
  • Accumulation of inflammatory elements
  • Necrosis of glomeruli
105
Q

What are the S&S of acute glomerulonephritis?

A
  • hematuria
  • HTN
  • azotemia
106
Q

What is the sono app of acute glomerulonephritis?

A
  • Normal/enlarged kidneys
  • Variable echogenicity of cortex
  • Normal medulla
107
Q

What is renal candidiasis?

A
  • Fungal infection
  • Immunocompromised patients
108
Q

What are S&S of renal candidiasis?

A

Worsening symptoms of chronically ill patients

109
Q

What is the sono app of renal candidiasis?

A
  • multiple focal abscesses of varying echogenicity throughout parenchyma
  • focal echogenic masses within collecting system
110
Q

What is renal schistosomiasis?

A

Parasitic infection

111
Q

What are S&S of schistosomiasis?

A

Hematuria

112
Q

What is the sono app of schistosomiasis?

A
  • normal
  • hydronephrosis
  • bladder wall thickening/calcs
  • bladder wall granuloma
113
Q

What is renal abscess?

A

Focal collection of purulent material

114
Q

What are S&S of abscess?

A
  • fever
  • pain
  • localized tenderness
115
Q

What is the sono app of abscess?

A
  • variable echogenicity
  • acoustic enhancement/shadowing
  • central fluid with peripheral hyperemia
116
Q

What is cortical cyst?

A

Benign serous filled sac

117
Q

What are complications of cortical cyst?

A
  • hemorrhage
  • infection
118
Q

What are S&S of cortical cyst?

A
  • asymp
  • pain
  • palp mass
  • fever, elev WBC
119
Q

What is the sono app of cortical cyst?

A
  • typically in cortex
  • enhancement
  • layering
  • wall calcs
120
Q

What is the sono app of simple cortical cyst vs complex cortical cyst?

A

Simple: anechoic, smooth walls, no calcs/nodules/septations

Complex: varying echogenicity, septations

121
Q

What is parapelvic cyst?

A

Benign, serous filled sac in renal hilum

122
Q

What are S&S of parapelvic cyst?

A
  • asymp
  • HTN
  • hematuria
  • hydro
123
Q

What is the sono app of parapelvic cyst?

A
  • hilar/sinus location
  • anechoic
  • well-defined walls
  • enhancement
  • possible internal echoes
124
Q

What is acquired cystic kidney disease?

A

Patients undergoing dialysis develop multiple cysts in native and allograft kidneys

125
Q

What are S&S of acquired cystic kidney disease?

A
  • asymp
  • increased risk of tumor development
126
Q

What is the sono app of acquired cystic kidney disease?

A
  • multiple cysts of varying size
  • variable echogenicity of kidney
  • bilateral
  • cortical thinning
127
Q

What is angiomyolipoma?

A

AKA renal hamartoma
Tumor composed of fat, blood vessels, and smooth muscle tissue

128
Q

What are S&S of angiomyolipoma?

A
  • asymp
  • hematuria
  • HTN
  • flank pain
129
Q

Who is angiomyolipoma more common in?

A

Females

130
Q

Angiomyolipoma are more likely to hemorrhage at what size?

A

> 4 cm

131
Q

What is the sono app of angiomyolipoma?

A
  • hyperechoic mass in parenchyma
  • variable echogenicity if hemorrhaged
  • variable size
132
Q

What is renal adenoma?

A

Tumor derived from glandular epithelium

133
Q

What are S&S of adenoma?

A
  • asymp
  • painless hematuria
134
Q

What is the sono app of adenoma?

A
  • well-defined
  • iso/hypoechoic cortical mass
135
Q

What is oncocytoma?

A
  • Benign tumor composed of oncocyte & epithelial cells
  • May be premalignant with increased risk of malignancy
136
Q

Who is more likely to develop an oncocytoma?

A

Males later in life

137
Q

What is the sono app of oncocytoma?

A
  • solid
  • variable size/echogenicity
  • difficult to differentiate from malignancies
138
Q

What is mesoblastic nephroma?

A
  • Pedi tumor composed of mesoderm tissue
  • Benign counterpart of nephroblastoma
139
Q

What are S&S of mesoblastic nephroma?

A
  • palp flank mass
  • HTN
140
Q

What is the sono app of mesoblastic nephroma?

A
  • variable echogenicity
  • possible areas of cystic degeneration
  • possible calcs
141
Q

What is renal cell carcinoma?

A

Cancerous tubular cells of renal parenchyma

142
Q

What is renal cell carcinoma AKA?

A

hypernephroma

143
Q

What are S&S of RCC?

A
  • pain
  • hematuria
  • palp mass
144
Q

What is the sono app of RCC?

A
  • solid mass of variable echogenicity
  • partially exophytic
  • calcs
  • possible echogenic mass in RV, IVC, and contralateral kidney
  • hypervascular
145
Q

What is nephroblastoma?

A

Pediatric malignancy composed of embryonal elements

146
Q

What is nephroblastoma AKA?

A

Wilm’s tumor

147
Q

What are S&S of nephroblastoma?

A
  • fever
  • hematuria
  • HTN
  • palp flank mass
148
Q

What is the sono app of Wilm’s tumor?

A
  • homogenous, echogenic mass
  • may be hypoechoic or cystic
  • large
  • calcs
149
Q

What pathology is nephroblastoma associated with?

A

horseshoe kidney

150
Q

What is the sono app of metastatic disease to kidneys?

A
  • hypo/hyper masses
  • single/multiple
  • diffusely hypoechoic
151
Q

What is hydronephrosis?

A

Dilation of renal pelvis and calyces due to obstruction of outflow of urine

152
Q

What are the causes of hydronephrosis?

A

Congenital: anatomic variants, abnormal position, PCKD, etc

Intrinsic: stones, tumors

Extrinsic: trauma, infections

153
Q

What is the sono app of hydronephrosis?

A
  • mild to sever fluid filled pelvocaliectasis
  • hydroureter
  • cortical thinning
  • non-vis of affected urinary jet
  • increased resistive index
154
Q

What is grade I hydro?

A

slight blunting of calyceal fornices

155
Q

What is grade II hydro?

A

Blunting and enlargement of calyceal fornices but easily seen shadows of papillae

156
Q

What is grade III hydro?

A

Rounding of calyces with obliteration of papillae

157
Q

What is grade IV hydro?

A

Extreme calyceal ballooning

158
Q

What is renal calculi?

A
  • Focal concentrations of calcium, struvite, uric acid, or cystine
  • Renal parenchyma or collecting system
159
Q

Who are renal calculi more common in?

A

Males

160
Q

What are S&S of calculi?

A
  • asymp
  • acute pain
  • hematuria
161
Q

What is the sono app of calculi?

A
  • hyperechoic foci
  • shadowing
  • twinkle artifact
  • obstructive hydro
  • mobile in bladder
  • echogenic focus in dilated distal ureter
162
Q

What is a staghorn calculus?

A

Occupies entire collecting system

163
Q

What is nephrocalcinosis?

A
  • Increased calcium levels in blood and/or urine
  • Deposits within kidney parenchyma
  • Occurs bilaterally
164
Q

Who is nephrocalcinosis common in?

A

Infants

165
Q

What is trauma to kidneys?

A

Assault to urinary tract from blunt force, penetrating trauma or rupture of neoplasm

166
Q

What does renal trauma result in?

A
  • Rupture of kidney and capsule
  • Subcapsular hematoma
  • Parenchymal laceration
  • Urinoma
167
Q

What are S&S of renal trauma?

A
  • Pain
  • Decreased hematocrit
  • Hematuria
  • Oliguria
  • HTN
168
Q

What is the sono app of trauma to kidneys?

A
  • Free fluid within abdomen
  • Hematoma located along surface
  • Diffusely heterogenous parenchyma
169
Q

What is renal infarction?

A

Necrosis of tissue due to occlusion of arterial supply

170
Q

What are S&S of renal infarction?

A
  • asymp
  • localized pain
171
Q

What is the sono app of infarction?

A
  • Focal or diffuse
  • Acute: hypoechoic
  • Chronic: hyperechoic, small size, capsular retraction or scarring
172
Q

What is renal artery stenosis?

A
  • Luminal narrowing of renal artery
  • Usually caused by plaque
173
Q

What are S&S of renal artery stenosis?

A

HTN

174
Q

What is the sono app of renal artery stenosis?

A
  • normal
  • decreased size of affected kidney
  • increased cortical echogenicity
175
Q

What is renal artery occlusion?

A

Obstruction of arterial lumen

176
Q

What are S&S of renal artery occlusion?

A
  • asymp
  • flank pain
  • hematuria
177
Q

What is the sono app of renal artery occlusion?

A
  • decrease in kidney size after acute phase
  • increase in cortical echogenicity
  • absence of doppler flow distal to occlusion
178
Q

What is renal vein thrombosis?

A

Presence of obstructive or non-obstructive thrombus in renal vein

179
Q

What are S&S of renal vein thrombosis?

A
  • asymp
  • flank pain
180
Q

What is the sono app of renal vein thrombosis?

A
  • increase size during acute phase
  • decrease size after acute phase
  • varying echogenicity of kidney
  • echogenic material within vein
  • possible IVC involvement
  • absence of flow in vein
181
Q

What is the sono app of cortical calcium deposit?

A
  • diffuse or focal increased cortical echogenicity
  • shadowing
182
Q

What is acute kidney injury/chronic renal failure?

A
  • Impairment of kidney function
  • Inability to maintain normal physiologic processes
183
Q

What are the types of AKI?

A

prerenal, renal, postrenal

184
Q

What are S&S of AKI?

A
  • oliguria
  • increased BUN & creatinine
  • proteinuria, uremia
  • anemia
  • HTN
185
Q

What is the sono app of AKI?

A
  • Starts with normal appearance, then decreased size, cortical thinning, hyperechoic
  • Hydronephrosis

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