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ABDOMINAL I21 > URINARY PATHOLOGY > Flashcards

URINARY PATHOLOGY Flashcards

1
Q

tuberous sclerosis looks like adult polycystic kidney disease

A

(ADPKD) adult polycystic kidney disease

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2
Q

In cases of_______, calcium deposits are usually located in the medulla

A

nephrocalcinosis

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3
Q

pyelonephritis or chronic renal disease appearance

A

the kidneys appear diffusely enlarged with a loss of normal anatomy.

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4
Q

____ ___ ___may demonstrate renal vein thrombosis or tumor extension into the renal vein

A

Renal cell carcinoma

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5
Q

_____ is in urine when major damage or destruction of (RBC) erythrocytes occurs. This condition injures the kidney and can cause acute renal failure

A

Hemoglobin

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6
Q

_____ can invade the renal vein and IVC w/ tumor or thrombosis

A

Renal cell carcinoma

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7
Q

_____ occurs when pus is in obstructed renal system

A

Pyonephrosis

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8
Q

Autosomal dominant polycystic kidney characteristics:

A

1 latent until the fourth or fifth decade of life. 2 The severity varies, depending on the genotype. 3 may have cysts in the liver, pancreas, and spleen. 4 kidneys are small and extremely echogenic.

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9
Q

most common renal ectopia:

A

The pelvic kidney (sacral kidney), (looks like pelvic tumor)

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10
Q

true or false? An extrarenal pelvis appears as a central cystic region that may extend beyond the confines of the renal sinus.

A

true

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11
Q

____ ___ are one of the most common kidney problems that can occur, may cause obstruction that is very painful

A

kidney stones (nephrolithiasia)

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12
Q

stones that are large and fill the collecting system are called:

A

staghorn calculi

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13
Q

urolithiasis

A

calculous of urinary system

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14
Q

nephrolithiasis

A

calc of the kidney

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15
Q

Most ___ are formed in kidney, course down urinary tract and are made of chemicals that precipitate out of urine

A

kidney stones -urolithiasis

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16
Q

true or false? Most urolithiasis are small and can travel through the urinary system with increased hydration and without treatment, but some may obstruct the ureter in the constricted areas

A

true

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17
Q

sonographic findings urolithiasis:

A
  • Very echogenic foci with posterior acoustic shadowing
  • Scanning is done along the lines of the renal fat; stones less than 3 mm may not shadow.
  • Prominent renal sinus fat, mesenteric fat, and bowel have high attenuation; they may appear as an indistinct echogenic focus with questionable posterior acoustic shadowing, making it difficult to differentiate from stones
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18
Q

describe what you see:

a midpole echogenic foci w/ posterior shadowing

(clean shadowing from a midpole right kidney stone (nephrolithiasis)

A

describe what you see:

a midpole echogenic foci w/ posterior shadowing

(clean shadowing from a midpole right kidney stone (nephrolithiasis)

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19
Q

Majority (95%) of bladder tumors in adults are ______.

Usually not detected until they have become advanced

Patients typically have gross hematuria, dysuria, urinary frequency, or urinary urgency.

A

TCC Transisitional cell carcinoma

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20
Q

Sonographic findings of bladder tumors (masses):

  • Appearance varies
  • Commonly appear as a focal bladder wall thickness
  • Intravesical lesions are as small as 3 to 4 mm.
  • US can NOT see a perivesical extension and pelvic wall involvement.
  • Transrectal approach to detect intravesicular involvement.
A
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21
Q

_____ tumors are typically hypoechoic compared with malignant bladder tumors but may have the same echogenicity.

A

benign

22
Q

true or false?

Any bladder mass may cause outflow obstruction; the kidneys should be evaluated for hydronephrosis.

A

true

23
Q

____bladder tumors include squamous cell carcinoma, adenocarcinoma, and rhabdomyosarcoma in children.

This just depends on what cells turn cancerous

A

primary

24
Q

bladder tumor

carcinoma of the urinary bladder with blood flow seen within the mass

A
25
Q

normal renal blood flow

Low resistance

Flow to vital organs

A

Low resistance

Flow to vital organs

26
Q

All _____bladder tumors have the same sonographic appearance: an irregular echogenic mass that projects into the lumen of the bladder.

A

primary

27
Q

normal intrarenal vessels with vascular flow throughout the renal cortex

A

normal arcuate arteries

a rapid systolic rise w/ RI of 0.56. gradual decrease into dystole.

28
Q

diagram of normal renal artery spectral waveform with early systolic peak (ESP) and rapd systolic upstroke followed by peak systole (PS) and gradual decrease into diastole

A

abnormal renal artery spectral waveform w/ absence of early systolic peak and a long systolic upstroke

29
Q

The most common correctable cause of hypertension.

A

(RAS) renal artey stenosis

30
Q
A
31
Q

Most common causes of the renal artery stenosis:

A

atherosclerosis and fibromuscular dysplasia

32
Q

sonographic characteristics RAS (renal artery stenosis)

A

Overall waveform shape: “tardus” and “parvus” waveform

Resistive index: RI = (S-D) ≥ 0.70 S

33
Q

what occurs when part of the tissue undergoes necrosis after the cessation of the blood supply (usually arterial occlusion), and renal function is usually normal

A

renal infarction

34
Q

renal infarction may result from:

A
  • thrombus
  • tumor infiltration
  • obstruction
  • or be iatrogenic
35
Q

renal infarction sonographic findings:

A
  • irregular areas, somewhat triangular in shape, and along the periphery of the renal border.
  • Irregular area may be more echogenic than renal parenchyma.
  • Renal contour “lumpy-bumpy.”
36
Q

renal failure:

A
  • failure of the kidneys to remove metabolites from blood.
  • can be acute or chronic
  • chronic- long term disease, shrunken kidney w/ increased echogenicity
37
Q

end stage renal disease

may not even be able to id kidneys because they blend in w/ sinus fat and are so shrunken

A
38
Q

Arteriovenous Fistula
and Pseudoaneurysm

A
39
Q

bladder imaging:

A
  • U.S. not modality of choice, masses of approx. 5 mm. can be seen
  • Bladder should always be examined with upper urinary system
  • Bladder must be distended to examine walls for tumors, diverticulum, thickening
  • Cystoscopy diagnoses early neoplasms
40
Q

bladder imaging:

A

Cystoscopy is usually used to examine the bladder because it can diagnose early neoplasms.

Transabdominal sonography will allow visualization of most lesions greater than 5 mm.

Transurethral intravesicular sonographic approach has been used to evaluate bladder tumors.

41
Q

bladder US technique:

A
  • Bladder is distended.
  • Right or left lateral decubitus position is recommended.
  • TGC is adjusted to reduce anterior wall artifacts.
  • Bladder wall should be smooth and measure 3 to 6 mm.
  • Look for asymmetry in the walls.
  • Evaluate residual volume.
  • Ureteral jets
42
Q

Ureters: Congenital Anomalies: stricture

  • Ureteral narrowing a result of fibrosis is a common form of ureteral stricture.
A
  • Ureteral narrowing a result of fibrosis is a common form of ureteral stricture.
  • Ureteral strictures may also result from inflammatory disease, tuberculosis, localized periureteral fibrosis, impacted ureteral stone, schistostomiasis, iatrogenic ureteral injury, or radiation therapy.
  • Other causes include amyloidosis, adjacent malignancies, metastases, extrinsic compression caused by primary retroperitoneal tumors, enlarged lymph nodes, and medial lower pole renal masses.
43
Q

sonographic evaluation of transplant (allograft)

A

Sonographic evaluation:

  • Renal size
  • hydronephrosis
  • perirenal fluid collections
  • Hematomas
  • Urinomas
  • Lymphoceles
  • Adequate perfusion: Doppler RI > .7 may indicate rejection
44
Q

double ureter jet

A

single ureteral jet

45
Q

what pathology is shown?

where is this bladder calc located?

A

nephrolithiasis

calc at base of bladder - ureterovesicle junction

ureter dialates all the way up to the bladder

46
Q

Ureters: Congenital Anomalies: ureterocele

  • Cystlike enlargement of the lower end of the ureter
  • Caused by congenital or acquired stenosis of the distal end of the ureter
A
  • Cystlike enlargement of the lower end of the ureter
  • Caused by congenital or acquired stenosis of the distal end of the ureter
  • Ectopic ureteroceles are rare; are usually associated with complete ureteral duplication.
47
Q

***ureterocele***

A
48
Q

true or false?

the most sensitive and specific way to evaluate the presence of stones is the intravenous urogram and the helical CT scan

A

true

49
Q

bladder diverticula

2 bladder diverticula; one on each side of the bladder

A
50
Q

T or F? flank pain caused by urolithiasis is a common prob. in pt. coming to ER

A

true

51
Q

what do you see?

2 stones causing hydronephrosis

2 echogenic foci wth posterior shadowing

A

ABDOMINAL I21 (11 decks)

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