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OB 2 > The GU system > Flashcards

The GU system Flashcards

1
Q

How many weeks for optimal kidney evaluation vs. being able to thoroughly identify kidneys?

A
  1. Optimally at 20 weeks
  2. Thorough evaluation at 22 weeks
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2
Q

Kidney length?

A
  1. 2cm at 20 weeks
  2. 4cm at term
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3
Q

When can the bladder be seen on US?

A

11 weeks and definitely by 13 weeks

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4
Q

T or F? Unilateral renal agenesis is considered common?

A

TRUE

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5
Q

What may fill the place of the kidney in cases of agenesis?

A

Adrenal gland

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6
Q

Sonographic features of an ectopic kidney?

A
  1. Smaller
  2. Malrotated
  3. Irregular shape
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7
Q

In crossed renal ectopia, what kidney is more likely to cross over?

A

Left to right crossover - where the upper pole of the left crossed kidney fuses to the lower pole of the right kidney

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8
Q

US finding in crossed renal ectopia?

A
  1. Hydronephrosis
  2. Dilated calyces
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9
Q

What is the isthmus in a horseshoe kidney?

A

The connecting piece to each kidney and is the key feature in diagnosing horseshoe kidney

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10
Q

T or F? The horseshoe kidney is associated with other non-urologic abnormalities?

A

True

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11
Q

What can pelvic dilation depend on?

A
  1. Fetal bladder filling
  2. Hydration
  3. Patient position
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12
Q

When hydronephrosis is detected, at how many weeks GA would a follow-up be?

A

32 weeks

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13
Q

What does APRPD stand for?

A

Anterior-posterior renal pelvic diameter

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14
Q

What is the most common cause of congenital obstructive hydronephrosis?

A

UPJ

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15
Q

Difference in sonographic findings of UPJ vs. UVJ

A

UPJ will have dilated calyces and renal pelvis but not a dilated ureter or bladder

UVJ will have dilation including the ureter without bladder dilation

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16
Q

What measurement is classified as megaureter?

A

> 7mm from 30 weeks onward

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17
Q

What are ureteroceles most commonly associated with?

A

Duplicated collecting system

Ectopic ureter insertion

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18
Q

What does LUTO stand for?

A

Lower urinary tract obstruction

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19
Q

What sonographic features are seen in bilateral renal agenesis? (2)

A
  1. Anhydramnios
  2. Empty bladder
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20
Q

What are the most common causes of LUTO?

A
  1. PUV
  2. Urethral atresia
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21
Q

What is urethral atresia characterized by?

A
  1. Anhydramnios
  2. Largely distended bladder
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22
Q

Adults with unilateral renal agenesis are shown to have increased rates of?

A

Chronic kidney disease and end-stage renal disease (ESRD) by 30 yrs.

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23
Q

What does MMIHS stand for?

A

Megacystitis microcolon intestinal hypoperistalsis syndrome - is lethal within the first year of life

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24
Q

What abnormality demonstrates the “keyhole” sign?

A

PUV

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25
Q

What are associated findings with PUV?

A
  1. Hydronephrosis
  2. Hydroureter
  3. Thickened bladder wall
  4. Dilated posterior urethra
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26
Q

Prune Belly Syndrome Triad

A
  1. Distended abdominal wall (absence of abdominal wall musculature)
  2. Urinary obstruction - megacystitis
  3. Bilateral cryptorchidism
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27
Q

What syndrome presents laxity/distention of the abdominal wall?

A

Prune Belly Syndrome

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28
Q

What is the most common cause of perinatal death?

A

Pulmonary hypoplasia due to oligohydramnios

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29
Q

ARPKD is also known as?

A

Infantile PKD

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30
Q

ADPKD is also known as?

A

Adult PKD and usually asymptomatic for 30-40 years

31
Q

What is the most common cystic disease in pregnancy?

A

ARPKD/infantile PCKD

32
Q

Sonographic finding of ARPKD and ADPKD

A
  1. Bilateral enlargement
  2. Echogenic kidneys

Cannot see the cysts on ultrasound as they are only 1-2mm

33
Q

What is the most common inherited kidney disease?

34
Q

What is LUTO characterized by?

A
  1. Bilateral hydronephrosis
  2. Enlarged bladder
35
Q

What kidney anomaly has multiple non-communicating cysts with dysplastic parenchyma surrounding it?

36
Q

Sonographic features of MCDK

A

Multiple, large anechoic cysts of varying size

37
Q

In what renal anomaly is the affected kidney reported to involute?

38
Q

Most common cause of hyperechoic kidneys?

A

Obstructive cystic disease

39
Q

Sonographic findings of obstructive cystic dysplasia?

A
  1. Oligohydramnios
  2. Moderately enlarged kidneys
  3. Small cysts
  4. Thinned walls
  5. Echogenic cortex
40
Q

T or F? Simple renal cysts communicate with the renal pelvis

A

False: No communication

41
Q

T or F? Simple renal cysts tend to spontaneously resolve

42
Q

Most common benign renal neoplasm?

A

Congenital mesoblastic nephroma

43
Q

Sonographic features of mesoblastic nephroma

A
  1. Very large
  2. Solid or cystic
  3. Well-defined
44
Q

T or F? Mesoblastic nephromas occur exclusively in the second trimester?

A

False: They occur exclusively in the third trimester

45
Q

Mesoblastic nephromas are commonly associated with?

A
  1. Polyhydramnios
  2. Premature labour
46
Q

In what trimester are adrenal glands best visualized?

A

Third trimester

47
Q

Sonographic findings of adrenal glands?

A

Hyperechoic medulla with a hypoechoic cortex

48
Q

Where do neuroblastomas originate?

A

Adrenal glands

49
Q

Why do neuroblastomas have a good prognosis?

A

They tend to spontaneously regress

50
Q

What are the most common abnormalities seen in the pelvis?

A
  1. Internal pelvic masses
  2. Sacrococcygeal teratoma
51
Q

What is the most common neoplasm in the fetal pelvis?

A

Sacrococcygeal teratoma

52
Q

What abnormality can cause dystocia?

A

Sacrococcygeal teratoma

53
Q

The urachus connects the urinary bladder to the what?

54
Q

What does the urachus eventually become after obliteration?

A

Median umbilical ligament

55
Q

What are the most common urachal abnormalities?

A

Urachal cyst and sinus

56
Q

What is the leading complication of urachal anomalies?

57
Q

The two cancers of adenocarcinoma and TCC are associated with what GU anomaly?

A

Urachal anomalies

58
Q

Sonographic features of bladder exstrophy?

A
  1. Wide pubis
  2. Low umbilicus
  3. Small genetalia
  4. Exterior bladder
59
Q

What does the cloaca divide into?

A

Bladder, rectum, genetalia

60
Q

What is the OEIS complex?

A

AKA cloacal extrophy

O - omphalocele

E - exterior bladder

I - imperforate anus

S - spinal anomalies

61
Q

If the genital nub is facing at a caudal angle, is it male or female?

62
Q

If the genital nub is facing at a cranial angle, is it male or female?

63
Q

What structure is seen on ultrasound when determining a female?

64
Q

Can repeat exams be scheduled for determining gender?

A

No, not for that sole purpose

65
Q

Assessment of genetalia is examined in what trimester?

A

Second trimester routine exam

66
Q

Sonographic findings of hypospadias

A
  1. Penile shortening
  2. Ventral urinary stream
  3. “Tulip sign” - small, ventrally curved penis
67
Q

What abnormality is seen with the “Tulip sign”?

A

Hypospadias

68
Q

On what side do inguinoscrotal hernias occur on primarily?

69
Q

What is the most common intraabdominal tumor in female fetuses and neonates?

A

Ovarian cysts

70
Q

Why may fetal ovarian cysts develop?

A
  1. Response to maternal hormones
  2. Hypothyroidism
  3. Diabetes
71
Q

What does DSD stand for?

A

Disorders of sex development

72
Q

What does AIS stand for?

A

Androgen insensitivity syndrome

73
Q

What is the chromosomal makeup in AIS?

A

46 XY - resulting in a normal female phenotype

74
Q

Pt comes in for an ultrasound at 18 weeks GA. SF show anhydramnios and no detection of the bladder. What is the most likely diagnosis?

A

Bilateral renal agenesis

OB 2 (20 decks)

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