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KaBoom > Urinary System - Part 9 > Flashcards

Urinary System - Part 9 Flashcards

1
Q

RCC

A

Renal cell carcinoma

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2
Q

What are the 4 stages of RCC?

A
  1. Confined to the kidney
  2. Spread to perinephric fat
  3. Extension to the renal
    vein, IVC or lymph nodes
  4. Extension to near or
    distant structures
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3
Q

What type of carcinoma accounts for 85% of renal cell cases?

A

Adenocarcinoma

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4
Q

What are the clinical findings of RCC? (4)

A
  1. Painless gross hematuria
  2. Uncontrolled
    hypertension
  3. Palpable mass
  4. Flank pain
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5
Q

What is the US appearance of RCC? (6)

A
  1. Irregular mass with echogenicity ranging from hypo echoic (larger mass) to hyper echoic (smaller mass)
  2. Focal bulge in renal contour
  3. Indistinct borders
  4. Hypervascular mass 5. Metastasis to the lung, liver, and long bones
  5. Extension into the renal vein and IVC
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6
Q

What are are 5 differential diagnosis of RCC?

A
  1. Adrenal tumour
  2. Abscess
  3. Focal pyelonephritis
  4. Adenoma
  5. Angiomyolipoma
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7
Q

What is another term for Wilm’s tumour?

A

Nephroblastoma

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8
Q

What are the risk factors associated with Wilm’s tumour? (6)

A
  1. Beckwith-Wiedemann syndrome
  2. Hemihypertrophy
  3. Sporadic aniridia
  4. Male prevalence
  5. Omphalocele
  6. 5 years of age or less
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9
Q

Is Wilm’s tumour more common in males or females?

A

Males

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10
Q

What are the clinical findings of Wilm’s tumour? (5)

A
  1. Palpable mass
  2. Abdominal pain
  3. Nausea/vomiting
  4. Gross hematuria
  5. Hypertension
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11
Q

What is the US appearance of Wilm’s tumour? (7)

A
  1. Predominately solid, well- defined renal mass
  2. Variable echo pattern
  3. Echogenic rim
  4. Occasional calcification
    - 10%
  5. Intramural vascular flow
  6. Displacement of the IVC and aorta
  7. Metastasis to the renal vein, IVC, liver, contralateral kidney, and lymph nodes
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12
Q

What are 3 differential diagnosis of Wilm’s tumour?

A
  1. Neuroblastoma
  2. Renal carcinoma
  3. Mesoblastic nephroma
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13
Q

What causes metastases of the kidney?

A

Primary malignancy of

the bronchus, breast, gastrointestinal tract, contralateral kidney, and non-Hodgkin’s lymphoma

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14
Q

What is the clinical findings for metastases?

A

Asymptomatic

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15
Q

What is the US appearance of metastases?

A

Multiple small bilateral masses of variable echogenicity

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16
Q

What are 2 differential diagnosis for metastases?

A
  1. Angiomyolipomas

2. RCC

17
Q

What causes infarction?

A

Necrosis of tissue caused by occlusion of the arterial blood supply

18
Q

What are the clinical findings of infarction? (4)

A
  1. Asymptomatic
  2. Acute back pain
  3. Hematuria
  4. Proteinuria
19
Q

What is the US appearance for infarction?

A

Wedge-shaped hypo echoic (acute) or hyper echoic (chronic) defect

20
Q

What are 3 differential diagnosis of infarction?

A
  1. Angiomyolipomas
  2. Junctional parenchymal defect
  3. Calcified artery
21
Q

What causes renal artery stenosis? (2)

A
  1. Atherosclerosis
  2. Fibromuscular hyperplasia
    - mid to distal
22
Q

What are the clinical findings for renal artery stenosis? (5)

A
  1. Uncontrolled hypertension
  2. Renal insufficiency
  3. Abdominal bruit
  4. Decrease in urine sodium concentration
  5. Hematuria
23
Q

What is the US appearance for renal artery stenosis? (8)

A
  1. Peak systolic velocity greater than 180 cm/s
  2. Spectral broadening
  3. Absence of diastolic flow
  4. Delayed acceleration time
  5. Renal artery ratio greater than 3.5
  6. Visual narrowing of the renal artery by atherosclerosis or thickening of
    the arterial wall
  7. Kidney atrophy
  8. Kidney infarct
24
Q

What are 2 differential diagnosis for renal artery stenosis?

A
  1. Tortuous artery

2. Poor Doppler angle

25
Q

What is a risk factor for renal artery aneurysm?

26
Q

What are causes of renal artery aneurysm? (5)

A
  1. Fibromuscular dysplasia
  2. Blunt trauma
  3. Kawasaki disease
  4. Intraluminal catheter induced injury
  5. Atherosclerosis
27
Q

What are the clinical findings of renal artery aneurysm? (4)

A
  1. Asymptomatic
  2. Hypertension
  3. Flank pain
  4. Hematuria
28
Q

What is the US appearance for renal artery aneurysm? (3)

A
  1. Doubling of the normal artery
  2. Artery diameter of 1.5 cm or greater
  3. Risk of rupture when the diameter
    exceeds 2cm
29
Q

What are 3 differential diagnosis for renal artery aneurysm?

A
  1. Tortuous renal artery 2. Bifurcation of the
    renal artery
  2. Renal vein
30
Q

What causes an arteriovenous fistula? (3)

A
  1. Congenital malformation
  2. Trauma
  3. Renal biopsy complication
31
Q

What is a clinical finding of arteriovenous fistula?

A

Asymptomatic

32
Q

What is the US appearance of arteriovenous fistula? (2)

A
  1. High-peak systolic velocity associated with high diastolic velocity
  2. Extremely turbulent flow
33
Q

What is a differential diagnosis of arteriovenous fistula?

A

Renal artery stenosis

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