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Case Studies > TEST 1---ALL POWERPOINTS > Flashcards

TEST 1---ALL POWERPOINTS Flashcards

1
Q

When a patient has increased creatine, what are we looking for?

A
  1. nonfunctioning kidneys VS hydro.
  2. mechanical-such as obstruction VS medical cause
  3. Surgicial VS Non-Surgical
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2
Q

What is the column of bertin?

A

a lateral indentation of renal sinus

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3
Q

Where is a column of bertin typically located?

A

At junction of upper and middle thirds

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4
Q

What must be present to say a kidney has hydro?

A

Pelvicaliectasis (Pelvicaliectasis means that both the pelvis and renal calyces are dilated)

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5
Q

What are some causes of hydronephrosis?

A
  • stones in ureter
  • tumors in or near ureter
  • narrowing of ureter
  • Neurogenic bladder
  • Cancer of bladder
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6
Q

What are the symptoms of acute hydronephrosis?

A

excruciating intermittent flank pain.

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7
Q

What is the column of bertin?

A

a lateral indentation of renal sinus

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8
Q

Where is a column of bertin typically located?

A

At junction of upper and middle thirds

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9
Q

What must be present to say a kidney has hydro?

A

Pelvicaliectasis (dilation of pelvic and calcyces.

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10
Q

What are some causes of hydronephrosis?

A
  • stones in ureter
  • tumors in or near ureter
  • narrowing of ureter
  • Neurogenic bladder
  • Cancer of bladder
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11
Q

What are the symptoms of acute hydronephrosis?

A

excruciating intermittent flank pain.

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12
Q

What are some symptoms of chronic hydronephrosis?

A

asymptomatic or dull, aching discomfort in the flank of affected side.

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13
Q

TRUE OR FALSE

UTIS, a fever, and N/V are all associated with hydro.

A

TRUE

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14
Q

When suspecting hydro, what else should we look for that may be dilated?

A

Ureter

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15
Q

If the ureter is dilated, we should try to follow it to the level of obstruction

T/F

A

True

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16
Q

Sonographically, what should we do when fiinding a dilated ureter with hydronephrosis?

A

Put on color to r/o prominent vessels

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17
Q

Is UPJ obstruction more often found in men or women?

A

Men

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18
Q

What is the most common cause of pediatric hydronephrosis?

A

Uteropelvic junction obstruction (UPJ)

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19
Q

True or False

The right kidney is affected twice as often as left in UPJ obstruction?

A

FALSE

The LEFT kidney is affected twice as much.

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20
Q

What are some symptoms of UPJ obstruction?

A

chronic back or flank pain

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21
Q

What are some causes of UPJ Obstruction?

A
  • renal stones
  • compression of ureter
  • tumor
  • kinking of ureter
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22
Q

Where is a UVJ obstruction usually located?

A

at the junction of ureter and bladder

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23
Q

Describe what Infantile Polycystic Kidney disease would look like on ultrasound?

A

multiple tiny cysts and an echogenic kidney!

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24
Q

Is multicystic dysplastic kidney usually unilateral or bilateral?

A

unilateral

it is fatal if bilateral.

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25
Q

Is acute renal failure reversible?

A

yes

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26
Q

Is chronic renal failure reversible?

A

no

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27
Q

What exactly is acute renal failure?

A

the sudden loss of the kidneys ability to concentrate urine, excrete wastes, or conserve electrolytes.

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28
Q

What lab values will be increased with Acute Renal Failure?

A

creatinine and BUN

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29
Q

What are a few causes of Acute Renal Failure?

A
  • dehydration
  • burns
  • septic shock
  • Urinary tract obstruction
  • malignant HTN
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30
Q

What are the symptoms of acute renal failure?

A
  • decreased urine output
  • swelling of various types
  • N/V
  • Mental Status changes
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31
Q

What will acute renal failure look like on US?

A

normal or enlarged echogenic kidneys with possible hydro

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32
Q

What is the most common cause of Chronic Renal Failure?

A

diabetes and hypertension

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33
Q

What are some symptoms of Chronic Renal Failure?

A
  • Weightloss
  • N/V
  • Fatigue
  • Hypotension
  • Hyerkalemia (potassium levels)
  • Drowsiness, confusion and delirium
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34
Q

What is the sonographic findings of Chronic Renal Failure over time?

A
  • Kidneys become smaller

- Increased echogenicity

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35
Q

With ________ disease, the kidneys cannot function enough to sustain daily life and are

A

ESRD (end-stage renal disease)

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36
Q

When a patient has hematuria, what should we look for?

A
  • mass
  • stone
  • severe infection
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37
Q

What is the common cause of a patient over 40 years of age with hematuria?

A

Urinary tract cancer or prostatis disease

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38
Q

What is a common cause of a patient under 40 years of age with hematuria?

A

GU infection or stones and calcifications

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39
Q

What are some common causes of someone with hematuria and PAIN?

A

stones, renal vein thrombosis, or renal cancer.

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40
Q

If we see a bladder mass what should we do???

A
  • determine the side

- have the patient roll up to see if it moves

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41
Q

Give some examples of obstructive hydronephrosis?

A
  • stones
  • masses
  • decreased ureteral jet
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42
Q

Give some examples of nonobstructive hydronephrosis?

A
  • infection
  • distended bladder
  • pregnancy
  • normal jet
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43
Q

Sonographically, what would a stone look like on ultrasound?

A
  • echogenic foci
  • posterior shadowing
  • TWINKLE ARTIFACT
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44
Q

What can we do to better image the shadowing of a stone?

A

higher frequency and harmonics

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45
Q

Where are the lower poles of a horshoe kidney used joined at?

A

midline of the abdomen

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46
Q

If there are cysts in the kidney where else should we check for cysts?

A

in the liver.

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47
Q

If we come across something that looks like a cyst with septations, what is important to note about the mass?

A

Tell the thickness of the septations and if there is a presence of blood flow.

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48
Q

T/F

It isn’t necessary to put color on a complex renal cyst.

A

FALSE FALSE FALSE!

Always put color.

49
Q

What is a common finding with a ruptured renal cyst?

A

pericystic fluid.

50
Q

What is papillary necrosis?

A

destruction of cells at the apex of pyramids

that is the ducts that empty the kidneys

51
Q

A patient with that has been diagnosed with ______ or __________ is at risk for papillary necrosis

A

sickle cell or diabetes

52
Q

Sonographically what does papillary necrosis look like?

A

cystic spaces at corticomedullary junction.

53
Q

What will Autosomal Recessive Polycystic Kidney Disease look like on ultrasound?

A

Large echogenic kidney with small cysts and splenomegaly.

54
Q

What will Autosomal Dominant Polycystic Kidney Disease look like in adults on ultrasound?

A

Bilateral large kidneys with cysts

at risk for hemorrhage

55
Q

What will Autosomal Dominant Polycystic Kidney Disease look like in fetus’ on ultrasound?

A

enlarged and echogenic kidneys

56
Q

What decade is Autosomal Dominant Polycystic more commonly found in?

A

4th or 5th decade

57
Q

With Multicystic Dysplastic Kidney Disease is usually bilateral or unilateral?

A

unilateral

58
Q

What will Multicystic Dysplastic Kidney Disease look like on ultrasound?

A

echogenic kidney filled with cysts

59
Q

What does nephrocalcinosis look like on ultrasound?

A

echogenic renal medulla.

60
Q

What is the most common cause of nephrocalcinosis?

A

hyperparathyroidism and medullary sponge kidney

61
Q

What does a renal cell carcinoma look like on ultrasound?

A
  • iso-hypoehoic mass that seems to blend in.
  • vascularity
  • calcification
62
Q

what is a tumor of the collecting system called?

A

transitional cell carcinoma

63
Q

What will a squamous cell carcinoma look like on ultrasound?

A

a large mass in the renal with hydronephrosis

64
Q

Will an angiomyolipoma have blood flow?

A

yes, it is composed of fat cells and vessels

65
Q

What will an angiomyolipoma look like on ultrasound?

A

hyperechoic (from the fat cells) with posterior enhancement. Usually in the cortex

66
Q

People with ___________ are also known have multiple angiomyolipomas

A

tuberous sclerosis

67
Q

Angiomyolipomas are at risk for ____ and hemorrhage.

A

rupture

68
Q

What will lipomas look like on ultrasound??

hint=lipo indicates fat cells

A

hyperechoic and well defined

69
Q

An oncocytoma can often mimic a ___________ carcinoma

A

renal cell carcinoma

this is because they have the same appearance and both have blood flow

70
Q

Is an oncocytoma benign or malignant?

A

benign.

71
Q

Sonographicallly what will an oncocytoma look like on ultrasound?

A
  • central scar
  • variable size
  • bulls-eye look
  • blood flow
72
Q

With hypertensive Nephropathy what will the kidney look like?

A

small with internal scarring from infection

73
Q

What is the telescoping of segments of bowel into each other called?

A

intussusception

74
Q

Who is at risk for intussusception?

A

between 6 months-2 years

75
Q

What is the most common cause of small bowel obstruction in children?

A

intussusception

76
Q

Where is the most common location for intussusception to occur?

A

ileocolic junction where the small intestines meet large intestines

77
Q

What are some symptoms of intussusception?

A
  • abdominal pain
  • RED JELLY-LIKE STOOL
  • palpable sausage shaped abdominal mass

50% of patients will have these symptoms

78
Q

What will intussusception look like on ultrasound?

A

bulls-eye target sign, echogenic center.

*it can have a psuedo kidney appearance.

79
Q

What scanning plane is best to image intussusception?

A

an oblique sagittal plane

80
Q

Name some predictors of intussesception.

A
  • free fluid
  • dilated fluid filled bowel (small bowel obstruction)
  • fluid trapped in wall of colon
  • vascularity
81
Q

Where is the pylorus in relation to the other surrounding organs??

A

between right kidney and gallbladder

82
Q

What happens when the pylorus becomes stenotic?

A

it becomes enlarged and restricts movement of food from stomach to duodenum

83
Q

True or False

It is common to get pyloric stenosis over 6 months of age

A

False!

84
Q

When is pyloric stenosis usually diagnosed?

A

between 6-8 weeks but accuracy decreases before 21 days

85
Q

True/false

First born males are the most at risk for pyloric stenosis

A

True

86
Q

What are some symptoms for pyloric stenosis?

A
  • projective vomiting
  • dehydration
  • weight loss
  • excessive hunger
87
Q

What are some questions you would ask of a patient having a pyloric stenosis scan done?

A
  • symptoms and duration of symptoms
  • any weight loss
  • whens the last time the baby threw up or ate
88
Q

In transverse the pyloric will look like a cervix

T/F

A

true

89
Q

What is the correct measurements of a pyloric scan?

A

3-4 mm wall thickness

14-17 mm length

90
Q

What is a staghorn calculi and what is it associated with?

A

a stone that fills the renal pelvis

associated w/ nephrolithiasis

91
Q

Cigarette smoking is a definite risk factor for which malignant neoplasm?

A

Renal Cell Carcinoma

92
Q

What would the lab values show in a patient with RCC?

A

elevated creatinine and BUN

93
Q

What is the sonographic appearance of a Renal Cell Carcinoma?

A

hypo-iso- or hyper echoic to the renal parenchyma

large ones are heterogenous and hypoechoic to renal parenchyma

94
Q

What is the most common malignant mass of the bladder in the United States?

A

Transitional Cell Carcinoma

95
Q

What is the most common malignant mass of the bladder in the world?

A

Squamous Cell Carcinomas

96
Q

What is common symptoms of someone with a angiomyolipoma?

A

palpable abdominal mass with hematuria or flank pain.

97
Q

What is a mass in the liver that consists of blood vessels?

A

hemangioma

98
Q

What are possible causes of a hematoma?

A

post-renal biopsy, trauma, RCC, hemorrhagic cyst, absess…

99
Q

Hematomas varies in appearance.

New Blood appears______

A

New Blood = anechoic right as it happens then becomes echogenic.

100
Q

Prolonged hydro destroys the tubules in the cortex resulting in renal parenchymal atrophy, scarring, or _____________,.

A

Irreversible kidney damage

101
Q

What is an inflammation of the renal glomeruli?

A

Acute Glomerulonephritis

102
Q

What are some symptoms of acute golmerulonephritis

A

foggy urine, recent fever, sore throat, joint pain, naueous ,

103
Q

Papillary necrosis is commonly found around the ________ of the kidney

A

apex—-point of pyramids that point to the sinus

104
Q

True / False

Pyelonephritis can turn into pyonephritis

A

TRUE

105
Q

What does a fungal ball (ew……) look like on ultrasound?

A

echogenic, non shadowing, soft tissue mass in the renal collecting system

106
Q

What is the most significant life threatening hepatobiliary disorder in children?

A

biliary atresia

107
Q

What is the narrowing or obliteration of the bile ducts?

A

biliary atresia

108
Q

What is the triangular cord sign associated with?

A

Biliary Atresia

109
Q

What is the most common cause of hydro in babies is?

A

UPJ obstruction

110
Q

What is the name for the junction between the bladder and ureter>

A

UVJ - uterovesicular juntion

111
Q

Does renal failure come with a increase or decrease in BUN and Creatinine

A

increased

112
Q

What is the difference in clinical symptoms between a patient who has a stone in the kidney versus a patient who has a stone in the ureter at the level of bladder?

A

stone in distal ureter- back pain

stone in kidney- asymptomatic

113
Q

Can an angiomyolipoma have internal blood flow and why?

A

it is made of arterial vessels

114
Q

What is the most common bladder malignancy in US?

A

Transitional Cell carcinoma

115
Q

What might be the cause of hematuria in a patient with increased white blood count?

A

pyonephritis

116
Q

The diagnosis of pyelonnephritis will include hydro

T/F

A

false

117
Q

What is the most common cause of chronic renal failure?

A

Diabetes

118
Q

What will a dilated ureter at the level of the bladder look like in transverse?

A

circular structure at the base of bladder

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