Ultrasound of the Urogenital Tract Flashcards

1
Q

Indications for ultrasound of the Urinary Tract?

A
Hematuria
Dysuria
Palpable mass
Guided biopsy/cystocenteisis
Monitor Therapy
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2
Q

*View ultrasound urogenital lecture; slide 3

A

Left kidney.
Long axis and short axis
*Looks like tomato

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3
Q

*View ultrasound urogenital lecture; slide 5

A

Right kidney lives in the renal fossa of the liver.

*Observe mild pelvic dilation.

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4
Q

Renal pelvis dilation..

Mild

A

Physiologic
Acute pyelonephritis
Early obstruction

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5
Q

Renal pelvis dilation..

Moderate or severe dilation..

A

Pyelonephritis or obstructive nephropathy.

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6
Q

Are the ureters normally seen on ultrasound?

A

NO

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7
Q

*View ultrasound urogenital lecture; slide 7

A

Pyelectasia (dilation of the renal pelvis)

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8
Q

*View ultrasound urogenital lecture; slide 9 + 10

A

Hydronephrosis

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9
Q

If both of the ureters are dilated.. the problem is in the..

A

bladder!

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10
Q

*View ultrasound urogenital lecture; slide 11

A

Severe hydronephrosis

Dilated pelvis of the right kidney.

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11
Q

Renal disease can be… (3)

A

Focal, multifocal or diffuse.

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12
Q

Diffuse disease of the kidney…

Hyperechoic renal cortex due to..

A

Hyperechoic renal cortex due to..
Lymphoscarcoma or Ethylene Glycol toxicity (acute tubular necrosis)
*View ultrasound urogenital lecture; slide 13

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13
Q

Diffuse disease of the kidney…
Hyperechoic renal cortex due to..
Differentials?

A
Glomerulonephritis, 
Interstitial nephritis (leptospirosis)
Pyelonephritis
Acute tubular necrosis 
Toxic nephrosis (ethylene glycol, Easter lily)
End stage kidney
Nephrocalcinosis
Nephrosclerosis 
Amyloidosis
Leukemic infiltrate
Cats: Lymphoma, FIP + Fat deposits
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14
Q

What are differentials for hypoechoic renal cortex?

A

Lymphoscarcoma
Congestion
Inflammation
*View ultrasound urogenital lecture; slide 15

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15
Q

Indistinct corticomedullary junctions..

A
Difficult to assess..
Pyelonephritis 
Chronic renal disease (end stage)
May be seen normally in 5-6 year olds.
*View ultrasound urogenital lecture; slide 16
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16
Q

Focal/multifocal kidney disease..

A

Nodules and cysts (nodules look the same as in the spleen/liver)
Neoplasia (may be hyper or hypo echoic)
Abscesses
Benign cortical cysts (insignificant) older patients

*View ultrasound urogenital lecture; slide 17

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17
Q

*View ultrasound urogenital lecture; slide 18

A

Renal infarcts

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18
Q

*View ultrasound urogenital lecture; slide 19

A

Polycystic kidneys

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19
Q

Polycystic kidneys:

A

Autosomal dominant inheritable condition primarily in long haired cats (especially Persians)
Appearance from single to multiple cysts to foamy cortices
May not be symptomatic.

20
Q

*View ultrasound urogenital lecture; slide 20

A

Urinary bladder on ultrasound.

*Hard feces can shadow

21
Q

How to ultrasound the bladder

A

Evaluate the bladder including apex, body and trigone in both planes.
Moderate bladder filling is the best: need urine to interface with the wall and contents. Over distended difficult to manipulate.
*View ultrasound urogenital lecture; slide 21

22
Q

What can be in the lumen of the bladder?

A

Sand, mucus, calculi, blood clots and suspended debris.

23
Q

Ultrasound of bladder calculi

A

*View ultrasound urogenital lecture; slide 23

With ultrasound both mineral and soft tissue calculi are visible; may or may not be distinguishable from each other.

24
Q

*View ultrasound urogenital lecture; slide 24

A

Sand in the bladder

25
Q

*View ultrasound urogenital lecture; slide 25

A

View blood clots in the bladder, move the patient around to differentiate from a mass.

26
Q

*View ultrasound urogenital lecture; slide 26

A

Neoplasia and inflammatory polyps.

27
Q

What are focal and diffuse masses in the urinary bladder?

A

Neoplasia and inflammatory polyps.

May see normal ureteral papillae***

28
Q

Do you want to get samples of neoplasia with cystocenteiss?

A

NO

29
Q

Can you differentiate between neoplasia and cystitis of the bladder?

A

NO
Both are equally, diffuse/focal, irregular, obstructive (non obstructive; cystitis).
Neoplasia will cause lymphadenopathy.

30
Q

Normal wall thickness of the bladder?

A

<2 mm.
Bladder must be adequately distended.
Undistended bladder wall will appear thicker.

*View ultrasound urogenital lecture; slide 28

31
Q

*View ultrasound urogenital lecture; slide 29

A

Diffuse thickening of the bladder.

32
Q

Prostate gland enlargement differentials:

A
BPH
Cyst
Prostatitis
Abscess
Neoplasia
33
Q

*View ultrasound urogenital lecture; slide 30

A

Prostate gland enlarged

34
Q

*View ultrasound urogenital lecture; slide 31

A

Prostate gland on ultrasound.

Likely to be cancer if mineralized.

35
Q

*View ultrasound urogenital lecture; slide 32

A

Uterine stump

36
Q

Uterine diseases:

A

Pyometra
Endometrial hyperplasia
Metritis

37
Q

Normal uterus thickness

A

20 mm max thickness.

38
Q

*View ultrasound urogenital lecture; slide 34

A

Large fluid filled uterus, lots of echoes, fluid pus mucus

39
Q

Pregnancy diagnosis on ultrasound..

A

Yes vs no

Number exact and at least, easier to count on radiograph.

40
Q

*View ultrasound urogenital lecture; slide 36

A

Pregnancy
Gestational sac -20 days
Gestational sac with embryo (23-25 days)
Look for heartbeat with Doppler

41
Q

Pregnancy

Gestational sac at what day..

A

20 days

42
Q

Pregnancy

Gestational sac with embryo at what days:

A

23 to 25 days

43
Q

Normal fetal circulation..

A
The head of the fetus is to the left of the image. Umbilical vein (UV) and umbilical artery (UA) extended cranially to the liver (L).
The heart (H) is visible cranial to the diaphragm.
44
Q

*View ultrasound urogenital lecture; slide 38

A

Pregnancy

45
Q

Pregnancy

Mandible and skull can be seen at what day..

A

46

46
Q

Pregnancy

Ribs can be seen at what day..

A

45-53

47
Q

Can ovaries be identified on ultrasound?

A

Ovaries are difficult but can be identified and evaluated caudal to the kidneys?