Urinary System - Part 7 Flashcards
What is the cause of a renal abscess?
Infection
What are the clinical findings of a renal abscess? (3)
- Flank pain
- Fever or chills
- Leukocytosis
What is the US appearance of a renal abscess? (3)
- Hypo echoic or complex mass
- Thick irregular wall margins
- Shadowing associated with gas
formation
What are 4 differential diagnosis for renal abscess?
- Neoplasm
- Focal pyelonephritis 3. Complicated cyst
- Resolving hematoma
ATN
Acute tubular necrosis
What is ATN caused by? (5)
- Toxic drug exposure 2. Hypotension
- Trauma
- Surgery of the heart or aorta
- Sepsis
What are the clinical findings for ATN? (3)
- Asymptomatic
- Renal failure
- Oliguria
- small amounts of urine
What is the US appearance for ATN? (3)
- Bilateral enlarged kidneys
- Hyper echoic renal pyramids
- Normal renal cortex
What are 4 differential diagnosis ATN?
- Renal sinus lipomatosis
- Chronic pyelonephritis
- Renal failure
- Nephrocalcinosis
What is the cause of chronic renal failure? (5)
- Glomerulonephritis
- Hypertension
- Vascular disease
- Diabetes mellitus
- Chronic hydronephrosis
What are the clinical findings for chronic renal failure? (7)
- Elevated BUN and creatinine
- Proteinuria
- Polyuria
- Headaches
- Fatigue
- Weakness
- Anemia
What is the US appearance for chronic renal failure? (4)
- Renal atrophy
- Hyper echoic parenchyma
- Thin renal cortex
- Difficult to distinguish the kidney
from surrounding structures
What are 2 differential diagnosis for chronic renal failure?
- Renal sinus lipomatosis
2. Hypoplastic kidney
What causes glomerulonephritis? (6)
- Immune diseases 2. Infection
- Strep throat
- Lupus
- Chronic hepatitis C
- Vasculitis
What are the clinical findings of glomerulonephritis? (7)
- Asymptomatic
- Proteinuria
- Oliguria
- Hypertension
- Hematuria
- Fatigue
- Edema
What is the US appearance of glomerulonephritis? (2)
- Hyper echoic renal cortex
2. Enlarged kidney(s)
What is a differential diagnosis for glomerulonephritis?
Renal sinus lipomatosis
What causes pyelonephritis?
Bacteria ascends from the bladder
What are clinical findings for pyelonephritis? (5)
- Flank pain
- Fever or chills
- Dysuria
- Pyuria
- Leukocytosis
What is the US appearance for pyelonephritis? (3)
- Generalized or focal swelling of the kidney(s)
- Well-defined renal pyramids
- Loss of corticomedullary
definition
What are 2 differential diagnosis for pyelonephritis?
- Renal abscess
2. Neoplasm
What causes hydronephrosis?
Obstruction of the urinary tract
What are the clinical findings of hydronephrosis? (4)
- Flank pain
- Hematuria
- Fever
- Leukocytosis
What is grade 1 hydronephrosis?
Small fluid-filled separation of the renal pelvis
What is grade 2 hydronephrosis?
Dilation of some but not all calyces
What is grade 3 hydronephrosis? (2)
- Marked dilation of renal pelvis and all calyces
2. Echogenic line separating the collecting system from the parenchyma can be demonstrated
What is grade 4 hydronephrosis? (4)
- Prominent dilatation of collecting system
- Cortical thinning
- Unable to separate collecting system
and renal parenchyma - Regardless of the grade evaluate bladder for ureteral jets using colour Doppler
What are 5 differential diagnosis for hydronephrosis?
- Extrarenal pelvis
- Parapelvic cyst
- Polycystic disease
- Reflux
- Over-distended urinary bladder
What are the causes of hydroureter?
Obstruction of the UPJ, UVJ, or region where the ureter crosses the pelvic brim
What are the clinical findings of hydroureter? (2)
- Asymptomatic
2. Flank pain
What is the US appearance of hydroureter? (2)
- Anechoic tubular structure connecting the renal pelvis to the urinary bladder
- No internal blood flow
What is a differential diagnosis of hydroureter?
Fluid filled bowel
Nephrolithiasis
Kidney stones
What is a cause of nephrolithiasis?
Urinary stasis
What are the clinical findings of nephrolithiasis? (4)
- Asymptomatic
- Renal colic
- Flank pain
- Hematuria
What is the US appearance of nephrolithiasis? (4)
- Hyper echoic focus within the kidney
- Occurs in the corticomedullary junction
- Posterior acoustic shadowing
- Colour Doppler twinkle artifact
What are 2 differential diagnosis of nephrolithiasis?
- Calcified vessel
2. Angiomyolipoma