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MIDS 127 - abdo > The Kidneys > Flashcards

The Kidneys Flashcards

1
Q

Are the kidneys retroperitoneal or peritoneal organs?

A

Retroperitoneal

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2
Q

What is the average kidney length?

A

10-12cm long

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3
Q

What should the size difference between the two kidneys be?

A

Within 2cm of each other

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4
Q

What are the 3 supportive tissues of the kidney?

A

Fibrous Renal Capsule, Perirenal Fat Layer, and the Renal (Gerota) Fascia

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5
Q

‘Innermost layer covering the surface of the kidney, continuous with the outer layer of the ureter at the renal hilum and barrier against trauma and infection’ is which layer?

A

Fibrous Renal Capsule

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6
Q

What is the perirenal fat layer?

A

The middle layer composed of fat tissue

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7
Q

What is the outer layer that has fibrous connective tissue surrounding the kidneys and adrenal glands called?

A

Renal Gerota Fascia

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8
Q

How much lower down does the right kidney sit?

A

2-8cm lower

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9
Q

Where do the RENAL ARTERIES begin?

A

Arise from lateral aspects of the Aorta, just inferior to the SMA.

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10
Q

Which renal artery is longer - right or left? Why?

A

Right. It courses behind the IVC, RRV, pancreatic head and inferior portion of the duodenum

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11
Q

Describe the course of the left renal artery.

A

Courses posterior to the LRV, SV, and pancreatic body

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12
Q

What renal vessel drains into the IVC?

A

The main renal vein

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13
Q

Which renal vein is longer - right or left? Why?

A

The left renal vein - it courses anteriorly to the left renal artery, crosses over the AO anteriorly, the SMA posteriorly, before entering the medial aspect of the IVC

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14
Q

Describe the course of the right renal vein

A

It is the shorter vein. It courses anterior to the right renal artery and enters the right lateral aspect of the IVC slightly lower than the left renal vein

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15
Q

Describe the vascular pathway of the kidney (the big long one- 15 steps)

A 
Aorta
Renal Artery
Segmental/Lobar Arteries
Interlobar Arteries 
Arcuate Arteries
Interlobular Arteries
Afferent arterioles
Glomerulus
Efferent arterioles
Peritubular capillaries
Interlobular veins
Arcuate Veins
Interlobar Veins
Unite to form Single Renal Vein
IVC
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16
Q

What is a kidney nephron?

A

Histologic and functional unit - it filters blood and produces urine

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17
Q

What does a nephron consist of?

A

Renal Corpuscle, renal tubule, and a vascular component.

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18
Q

Name the functions of the nephron.

A

Controls blood concentration and volume by removing selected amounts of water and solutes, assists in regulating blood pH, removes the gross toxic stuff from the blood

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19
Q

What does metabolic waste contain?

A

Water, carbon dioxide, and nitrogenous wastes

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20
Q

Name 3 nitrogenous wastes

A

Urea, uric acid, creatinine

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21
Q

What is an antidiuretic hormone?

A

Responsible for maintaining the body’s fluid balance

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22
Q

What does ADH increase with?

A

Water loss or reduced blood volume or blood pressure

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23
Q

What is Aldosterone?

A

Increases the rate of resorption of sodium and produces a concurrent loss of potassium

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24
Q

An excess of potassium promotes _______.

A

secretion

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25
Q

Name the 5 most common renal function tests.

A 
Blood urea nitrogen (BUN)
Creatinine clearance rate (Cr, CrCl)
Uric acid (UA)
Red Blood Cell (RBC) count
Total white blood cell (WBC) count
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26
Q

Describe BUN (blood urea nitrogen) test and its variations/clinical indications.

A

Measures amount of urea nitrogen in blood, measures renal function.

Increased: acute or chronic disease of damaged kidneys
Decreased: over hydration, liver failure, smoking

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27
Q

Describe the CrCl (creatinine clearance rate) and its variations/clinical indications.

A

Creatinine is the end product of breakdown of creatinine phosphate in skeletal muscles. Removed via Glomerular Filtration.

Increased: decrease in renal function
Decreased: muscle weakness or dystrophy

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28
Q

Describe Uric Acid (UA) and its variations/clinical indications.

A

End product of purine metabolism (comes from dietary sources and breakdown of proteins)

Increased: Gout, arthritis, metastatic CA, DM, renal failure, stress, leukemias, liver disease
Decreased: liver atrophy, renal disease

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29
Q

What does an increased RBC count mean?

A

Renal cysts

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30
Q

What does an increased and decreased value of Total White Blood Cell Count mean?

A

Increased: infection or inflammation
Decreased: toxic reactions, chemotherapy, radiation therapy

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31
Q

What are the Columns of Bertin?

A

Cortical extensions between renal pyramids

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32
Q

Describe the echo properties of a renal cortex

A

Contour should be smooth, homogenously echogenic (less echogenic than liver, spleen, renal sinus)

Neonates: isoechoic/hyperechoic compared to liver/spleen
Children: similar to adults

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33
Q

Describe the sonographic apperance of the Renal Medulla

A

Hypoechoic cone shaped tissue deep to the cortex, broader base faces the cortical area with apex towards center. Larger in children than adults.

More hydrated individuals have a more hyperechoic medulla.

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34
Q

What is the corticomedullary junction?

A

Where the cortex/medulla meet in the kidney, comma shaped specular echoes and inward extension of the column of Bertin. Can be difficult to see in large patients

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35
Q

Is the medulla larger in children than adults?

A

Yes

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36
Q

What is the renal sinus?

A

The fat containing area of the kidney

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37
Q

What should be suspected if two lobulations of renal sinus fat are idenified?

A

Bifid renal pelvic or duplex collecting system

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38
Q

What does the renal pelvic do?

A

Collects urine from the papillae

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39
Q

How long is the proximal ureter?

A

25-30cm, 6mm diameter

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40
Q

Are the ureters visible sonographically?

A

No

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41
Q

Cortical thickness should be >___cm.

A

> 1cm

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42
Q

Renal enlargement following removal of the other kidney is called…

A

Compensatory renal hypertrophy

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43
Q

What is a common variant, usually , affects the left kidney,and shows as a lateral cortical bulge of kidney tissue of the same echogenicity as the rest of the tissue? Often mistaken for a neoplasm.

A

Dromedary Hump

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44
Q

What is a common variant that is a remnant due to incomplete fusion of the upper and lower poles, and commonly affects the right kidney?

A

Junctional Parenchymal Defect (aka junctional cortical defect, interpenduncular junction defect)

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45
Q

What has the SF of: wedge-shaped hyperechoic defect on anterior aspect near function of upper/mid kidney?

A

Junctional Parenchymal Defect/Junctional Cortical Defect, Interpenduncular Junction Defect

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46
Q

What is a common variant, double layer of cortical tissue folded toward the center of the kidney and most commonly affects the left kidney in the middle third?

A

Hypertrophied Column of Bertin

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47
Q

What is the Sonographic Appearance of a Hypertrophied Column of Bertin?

A

Lateral indent of renal sinus by continuous cortical tissue with the same echogenicity and is less than 3cm

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48
Q

What is the other name for Renal Sinus Lipmatosis?

A

Renal Sinus Fibrolipomatosis

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49
Q

What is Renal Sinus Fibrolipmatosis? What is it most common with (age and body state)

A

Fatty infiltration of therenal pelvic, most common in 6th-7th decade of life. Associated with obesity and diseases that cause parenchymal atrophy/destruction

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50
Q

What is a renal pelvic outside of the renal sinus called?

A

Extrarenal Pelvis

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51
Q

What is the SA of an extrarenal pelvic?

A

Central cystic area partially or entirely outside the kidney. Does not continue like a dilated ureter would, more oval/circular shaped. Fluid does NOT extend into the kidney.

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52
Q

Duplicated Collecting System (Most common/what it is/SA)

A

Most common congenital anomaly of the GU tract. Most common in women.
Complete duplication of the ureter.

SA: Separation in the renal sinus echodensities, may see 2 separate dilated ureters and or 2 ureteric jets in the urinary bladder

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53
Q

Where is the most common location for an ectopic kidney?

A

The pelvis

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54
Q

What is Cross Fused Renal Ectopia? Complications?

A

When the kidneys are on the same side.

Increased risk of obstruction and infection (prone to rotating)

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55
Q

Horseshoe Kidney (Definition, SS, SA, complications)

A

Fusion of the upper or lower poles during fetal development

SS: asymptomatic, often have pulsating abdo mass
SA: Continuous kidney tissue across midline and anterior to the great vessels connecting the two kidneys
Complication: Hydronephrosis, infection, stone formation, obstruction

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56
Q

Hydronephrosis (Definition, SS, etiology)

A

Urine dilation in renal pelvic, calyceal structures, and infundibula

SS: Asymptomatic, abdo/back/flank pain, decreased urine output
Etioloy: Associated with pregnancy (right kidney most commonly affected)

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57
Q

Name the two types of Hydronephrosis etiologies.

A

Intrinsic (inside the kidney) and extrinsic (outside the kidney).

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58
Q

What are the four grades of Hydronephrosis?

A 
Grade I (mild): 2mm separation of sinus echoes
Grade II (mild): dilation of renal pelvic and some but not all calyces
Grade III (moderate): complete pelvocaliectasis
Grade IV (severe): extreme dilation of renal pelvic and all calyces with loss of borders between, thinning renal parenchyma
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59
Q

What are the sonographic appearances of Hydronephrosis?

A

Splaying/spreading/ballooning of central echo complex

Anechoic filling of renal pelvic (possible extension to calyces depending on severity)

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60
Q

What other organs must be evaluated when pt has Hydronephrosis?

A

Ureters, urinary bladder, urethra and pelvic structures (prostate, uterus, ovaries)

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61
Q

What is the most common DD of Hydronephrosis?

A

Extrarenal pelvic (this is more oval shaped)

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62
Q

What is Pyonephrosis?

A

Pus in the collecting system (ew)

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63
Q

What is Pyonephrosis associated with?

A

Severe urosepsis

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64
Q

What are the SS/SA of Pronephrosis?

A

SS: renal insufficiency, hematuria
SA: Low level echoes with a fluid debris level (may also appear anechoic)

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65
Q

Describe Urolithiasis.

A

Stone formation anywhere in the urinary tract.

66
Q

What are the types of Urolithiasis?

A

Calcium oxalate, calcium phosphate, or a combo of the both (MOST COMMON)

Struvite or magnesium ammonium

Staghorn calculus (stone filling entire renal pelvic)

Uric acid, caused by a high concentration of uric acid

Cystine formation in acid urine due to inherited defect affecting absorption of urine amino acids

67
Q

What is oxalate, calcium phosphate, or a combo of both most associated with?

A

Increased blood and urinary concentration of calcium, bone disease, renal tubular acidosis, hyperparathyroidism, medullary sponge kidney

68
Q

What is Struvite or Magnesium Ammonium associated with?

A

Bacteria

69
Q

What is Staghorn Calculus associated with?

A

UTIs, persistent alkaline urine (or both)

70
Q

What is Uric Acid (a type of urolithiasis) associated with?

A

Gout and dehydration

71
Q

What is nephrolithiasis?

A

Stones within the kidney

72
Q

Who is most commonly affected by nephrolithiasis?

A

Men in their 20’s-50’s

73
Q

Nephrolithiasis (SS, SA)

A

SS: Hematuria, oliguria (low urine output), renal colic
SA: Dense echogenic echo pattern with strong acoustic shadow, twinkle artifact posterior to calcification with CD

74
Q

Nephrocalcinosis (Cortical): (Etiology/SA)

A

Calcium deposits within the kidney

Etiology: Hypercalcemic states
SA: Hyperechoic foci within renal cortex, loss of definition of the cortical medullary junction, kidney may appear small and more echogenic, typically bilateral and diffuse

75
Q

Nephrocalcinosis (Medullary): (Etiology/SA)

A

Calcium deposits in the renal medullas

Etiology: Metaboic abnormality identified in hypercalciuria and hypercalcemic states, associated with medullary sponge kidney and papillary necrosis in situ

SA: echogenic renal pyramids with shadowing

76
Q

What are the five stages of the Bosniak classification of cysts?

A

I - simple, no f/u
II - less than or equal to 3cm, one or two thin (less tham 1mm) septations, wall is still less than 1mm. no f/u
IIF - minimally complicated, weird features that require f/u in 6 mo
III - wall thickening, nodularity. biopsy/surgery for further eval
IV - wall thickening all over, large nodules, vascular components, considered a malignancy, removal of kidney required

77
Q

What is the most common renal lesion?

A

Simple renal cyst

78
Q

Is a hemorrhagic cyst common? What does the risk increase with?

A

No, but increases with PKD

79
Q

What has a complex echo pattern with gravity-dependent material floating around within, necrotic exudate can stick to the wall and look like a hyperechoic mass? Often mistaken for hemorrhagic cysts?

A

Infected cyst

80
Q

What is a clue of malignancy in the kidney?

A

Thick septa/loculations less than 1cm with vascularity

81
Q

What’s the margin of measurement for a benign septated or multilocular cyst?

A

Septations are less than 1cm

82
Q

Cysts with Calcified Walls are often associated with malignancy. True or false?

A

True

83
Q

What is a Milk of Calcium cyst? SS/SF/DD

A

Occurs after a low grade inflammation and partial/complete obstruction to urine flow with stasis, is then deposited in calyceal diverticula

SS: asymptomatic
SF: linear band of hyperechoic echo with reverb artifact and acoustic shadowing (may be mobile)
DD: renal calculi, AML

84
Q

What do parapelvic and peripelvic cysts have in common?

A

They do not communicate with the collecting system

85
Q

Parapelvic cysts originate from renal _______ and protrude into the ______.

A

Parenchyma & sinus

86
Q

Peripelvic Cysts are…

A

True sinus cysts. Typically small and multiple with irregular outlines along the calyceal infundibula or around renal pelvic.

87
Q

ADPKD stands for:

A

Autosomal Dominant Polycystic Kidney Disease

88
Q

When does ADPKD typically present and what is the biggest SS?

A

In the 4th decade, most commonly is kidney failure.

89
Q

ADPKD is more prone to complications. What are a few?

A

Infection, renal calculi, cyst rupture, hemorrhage, obstruction.

90
Q

What is medullary sponge kidney? Associations, SS, complications, SA

A

Multiple cystic dilatations of collecting ducts in the medulla.
Associated with: Beckwith-Wiedemann syndrome, ADPKD, Caroli disease, and congenital hepatic fibrosis.
SS: Asymptomatic but can cause pain, hydronephrosis, and infection
Complications: Calcifications in cysts, infection, urinary stones
SA: Echogenic medullary pyramids without shadowing (very echogenic medulla pyramids that don’t shadow)

91
Q

Nephronophthisis is also called…

A

Uremic Medullary Cystic Disease

92
Q

Uremic Medullary Cystic Disease (Definition, SS, complications, SA)

A

Variable amount of cysts in medulla - rare hereditary disorder
Associated with: cortical tubular atrophy and interstitial fibrosis
SS: Anemia, salt wasting, increased BUN or creatinine, polyuria
Labs: Elevated alk phos
Complications: Renal insufficiency and renal failure
SF: Multiple small cysts confined in the medulla, loss of corticomedullary differentation, increased parenchymal echogenicity, small kidneys

93
Q

Describe Tuberous Sclerosis.

A

Associated with renal cyst formation and neoplasms.

Associated with multiple bilateral AML’s and renal cysts.

94
Q

What is the most common BENIGN kidney tumour?

A

Adenoma

95
Q

Adenoma is most common in…

A

Males, 6th to 7th decade

96
Q

Adenoma (SS/association/SA)

A

SS: Asymptomatic unless larger, may present with PAINLESS hematuria

Associated with RCC
SA: Usually 1-3cm, echogenic (hyperechoic) hypervascular tumour with sound attenuation

97
Q

Oncocytoma (CP, SS, complications, SA, DD)

A

More common in men.
SS: Asymptomatic unless large, causes pain/hematuria
Complications: Infarcation, hemorrhage, necrosis
SA: Well defined smooth hypoechoic homogenous tumour, central stellate scar, can be BIG (up to 26cm)
Can be mistaken for RCC

98
Q

Angiomyolipoma (AML) - Most in common in, association, SS, complications

A

Most common in WOMEN.
Associated with tuberous sclerosis complex
SS: Asymptomatic unless hemorrhage, causes flank pain/hematuria, serious hemorrhage can cause renal failure
Complications: Hemorrhage, necrosis, cystic degeneration, calcification

99
Q

Sonographic Features of AML (Angiomyolipoma)

A

Homogenous, hyperechoic cortical tumour. Hypervascular. Most commonly affects RIGHT kidney.

100
Q

Lipoma (Most commonly affects, SS, SA)

A

Fatty tissue tumour.
Most common in females.
SS: Asymptomatic
SF: Well defined hyperechoic mass, typically less than 5mm

101
Q

Leiomyoma (Definition, SA)

A

Originates from smooth muscle of the kidney, uniquely complex in comparison to other benign neoplasms

SA: Hyperechoic complex mass

102
Q

Reninoma (juxtaglomerular tumour) - Definition, most common in, SS, SA

A

Rare tumour that secrets renin
Most common in women
SS: hypertension, elevated renin
SA: solid hypovascular encapsulated tumour arising from near corticomedullary junction

103
Q

Fibroma (most common, SA)

A

Fibrous mass in the medulla.

Most commonly female
SA: Hyperechoic mass in medulla aprox 2-3mm

104
Q

Multilocular Cystic Nephroma (most common in, SA, DD)

A

YOUNG men and OLDER women.
SA: large anechoic space (up to 10cm)
DD: cystic RCC or cystic Wilms tumour

105
Q

Is a solid mass is present, it is considered malignant, even if fat is present.

A

False

106
Q

Indicators of malignancy are… (4 items)

A

Calcification, wall thickness greater than 1mm, irregularity at the base of a cyst, thick and/or vascular septations

107
Q

What else should be evaluated if a mass is seen in the kidney?

A

Renal vein and IVC for thrombus/tumour extension

Entire abdo for mets

108
Q

RCC (most common, SS, associations)

A

Most common MALIGNANT tumour of the kidney. Most common in MALES.
SS: Hematuria
Associated with: von Hippel-Lindau disease, ADPKD, tuberous sclerosis

109
Q

Abnormal cells in RCC frequently produce _______.

A

hormones

110
Q

What is the most common mets location for RCC?

A

Lungs

111
Q

What is the sonographic appearance of RCC?

A

Can be any echogenicity, has mass effect (normal vasculator splays around the mass), hypervascular, calcifications, needto assess entire abdo for possible mets

112
Q

Is RCC complex, simple, or cystic?

A

Complex

113
Q

Urothelial Carcinoma are commonly _____ ____ _____ (three words).

A

Transitional cell carcinomas (TCC)

114
Q

Urothelial Carcinoma (SS)

A

Hematuria, palpable hydronephrosis

115
Q

What is TCC? (Transitional Cell Carcinoma) - most common in, SS, SA, DD

A

Most common of primary renal pelvis tumours.

Most common in MALES.

SS: painless hematuria, flank pain, weight loss, fatigue
SA: Intraluminal polypouid mass, urothelium thickening, solid mass, splitting or seperation of central echo complex, bulky hypoechoic mass
DD: blood clots, fungus ball

116
Q

Lymphoma (most common, SS, SA)

A

More commonly secondary form (caused by haematogenous spread)
Non-Hodgkin Lymphoma is more common than Hodgkin Lymphoma
SS: non specific kidney enlargement
SA: Enlarged kidneys (bigger kidneys) with anechoic or hypoechoic mass(es) with NO acoustic enhancement

117
Q

Met renal tumours commonly come from ____ & _____, or _________.

A

Lung and breast, RCC of the opposite kidney

118
Q

Met Renal Tumours are ____echoic masses with renal enlargement.

A

hypo

119
Q

Etiology of Posttraumatic INTRArenal hematomas

A

Bleeding diathesis (anticoag drugs), renal infarcts

120
Q

Etiology of rare spontaneous hemorrhage

A

RCC, AML’s, segmental renal infarction, AVM (arteriovenous malformation), hemorrhagic cyst, abscess, idiopathic

121
Q

What are the SS of renal hematomas?

A

Palpable mass, unilateral flank pain, decreased hematocrit

122
Q

What are the SA of renal hematomas?

A

Always avascular, but varied appearance depending on age.

Acutely will be echogenic. Will appear anechoic after liquefying and becoming a seroma. A chronic hematoma may calcify.

123
Q

Where do subscapular hematomas lie?

A

Between the kidney cortex and capsule; which can flatten or distort the renal cortex.

124
Q

Renal Infarction (Definition, SS, SA)

A

Loss of blood supply.

SS: hypertension, loss of lower extremity pulses, elevated LDH (lactate dehydrogenase), hematuria
SA: Starts echogenic/normal appearance, then becomes hypoechoic, and then echogenic again

125
Q

What group does renal infection/inflammatory processes usually happen in?

A

Women aged 15-24 (child bearing)

126
Q

Why do renal infections/inflammation generally occur in women?

A

Shorter urethra

127
Q

Acute pyelonephritis (APN) is associated most with…?

A

Ascending UTI

128
Q

Acute pyelonephritis (APN) is most common in…

A

Females (age 15-35)

129
Q

Acute Pyelonephritis (SS, SA)

A

SS: Dysuria, frequency, urgency, pyuria
SA: Varied non-specific findings

130
Q

Is Emphysematous Pyelonephritis life threatening?

A

Yes. Mortality rate is high.

131
Q

Emphysematous Pyelonephritis is ______ within the parenchyma or sinus.

a) air
b) pus
c) blood
d) gas

A

D, gas.

132
Q

Emphysematous Pyelonephritis is common in ________. Describe SA.

A

Diabetic patients, immunosuppressed pts, women with urinary tract obstruction
SA: Hyperechoic foci with sharp flat margins and reverb artifact with dirty shadows/ringdown. Kidneys may be enlarged and hypoechoic.

133
Q

_________ _________ contrubites to the progression of chronic pyelonephritis.

A

Severe hypertension

134
Q

Chronic Pyelonephritis (CPN) - SS, SA

A

SS: polyuria, nocturia, mild proteinuria
SA: small kidney with increased echoes in involved area from fibrosis, loss of kidney tissue, one or more calyces retracted and not distended

135
Q

What is Xanthogranulomatous Pyelonephritis?

A

The replacement of normal renal parenchyma with lipid-laden macrophages, plasma cells, and multinucleated giant cells

136
Q

Xanthogranulomatous Pyelonephritis (Most common,SS, complications, SA)

A

Most commonly women (correlation with diabetes)
SS: malaise,flankpain, mass, weight loss
Complications: Papillary necrosis
SA: Anechoic/hypoechoic masses (debris filled)

137
Q

What is the classic SA triad for Xanthogranulomatous Pyelonephritis?

A

Renal Calculi, renal enlargement, and decreased renal function

138
Q

How do renal and perinephric abscesses occur?

A

Infected cysts, CPN, TB, renal trauma, or obstruction

139
Q

What are the SS/SA of renal and perinephric abscesses?

A

SS: Unilateral flank pain, chills, fever, point tenderness
SA: Anechoic to hypoechoic complex mass with irregular borders, possible mass effect, possible sludge in collecting system
(If chronic, may contain septa, air, or microbubbles)

140
Q

What is Pyonephrosis?

A

Presence of pus (gross, purulent) material in a dilated renal collecting system.

141
Q

Pyonephrosis (SA, complication)

A

SA: Variable, but possible enlarged kidney with hydro. Sludge that doesn’t move when the patient moves, air may be present, gotta examine for cortical thickness.
If chronic, can lead to xanthogranulomatous pyelonephritis

142
Q

What is the most common fungal infection in the kidneys?

A

Candida Albicans

143
Q

What is the SA of Candida Albicans in the kidney?

A

Fungal balls, echogenic cortical tissue, hyperechoic non shadowing mass.

144
Q

Tuberculosis (SA)

A

Kidney can appear normal but may look like ‘Putty kidney’. Looks like parenchymal destruction and results in small, calcified, non functioning kidney. Increased echogenicity.

145
Q

What is Malakoplakia and who is it most common in?

A

Rare granulomatous inflammatory disease. Most common in middle-aged women with recurrent UTI’s.

146
Q

What are the general things to look for in a parenchymal renal disease evaluation?

A 
Renal Size
Renal Contour
Cortical echogenicity
Distinctness of the corticomedullary junction
Detectability of the renal pyramids
Size of the renal pyramids
Appearance of the renal sinus
147
Q

AIDS (most common spread, cause of renal dysfunction, SA)

A

Spread by sexual activity and infected needles.
Causes acute tubular necrosis, nephrocalinosis
SA: Increased cortical echogenicity, decreased definition of the CMJ, and decreased renal sinus fat. Also enlarged kidneys, potential punctate renal calcifications

148
Q

What is the leading cause of CKD/CRF?

A

Diabetic nephropathy

149
Q

Diabetic Nephropathy (SS, SA)

A

Diabetic pt with persistent proteinuria, elevated blood pressure without UTI, other renal diseases or heart failure
SA: evaluate with doppler

150
Q

Papillary Necrosis (risk factors, SS, SA)

A

Risk factors: analgesic abuse, sickle cell disease, diabetes
SS: hematuria, flank pain, dysuria
SA: hypoechoic medullary rims with anechoic spaces, calcifications within pyramids

151
Q

Systemic Lupus Erythematosus (most common in, SS, SA)

A

Most common in women. Kidneys involved in half of cases.
SS: Hematuria, proteinuria, hypertension
SA: Increased cortical echogenicity, small or large renal size

152
Q

ARF/AKI stands for:

A

Acute renal failure, acute kidney injury

153
Q

AKI (definition, SS)

A

Acute decrease in renal function, high mortality rate
Possibly reversible
SS: Severe oliguria, elevated BUN

154
Q

What is the most common renal disease to result in AKI?

A

Acute Tubular Necrosis (ATN)

155
Q

Acute Tubular Necrosis (definition, SS, SA)

A

Cell damage and death of renal tubules. Reversible
SS: renal insufficiency, hematuria
SA: Bilaterally enlarged kidneys with hyperechoic pyramids

156
Q

What are the differences between Acute Tubular Necrosis and Nephrocalcinosis?

A

ATN: Most common renal disease to result in AKI. Reversible. Bilaterally enlarged kidneys with hyperechoic pyramids.

Nephrocalcinosis: Echogenic renal pyramids with shadowing, hyperechoic foci within renal cortex, loss of definition of CMJ, typically bilateral and diffuse involvement

157
Q

CKD (definition, most common in, SS, SA)

A

Irreversible condition with diminished renal function
Most common in diabetics and hypertension-related nephropathies
SS: Renal failure, hypertension
SA: Atrophied echogenic kidney

158
Q

Name the two types of Dialysis

A

Hemodialysis and Peritoneal dialysis

159
Q

Blood moves through an artificial kidney unit - which dialysis is this?

A

Hemodialysis

160
Q

Abdominal catheter is placed and dialysis takes 1.5-5 hours - which dialysis is this?

A

Peritoneal dialysis

MIDS 127 - abdo (14 decks)

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