Urinary System Test Flashcards
1
Q
A 25-year old patient with right flank pain, nausea, and vomiting is seen for a renal ultrasound. The ultrasound reveals large echogenic foci with posterior acoustic shadowing in the kidney. The calyces appear to be dilated. What is the most likely diagnosis? calculi TCC hematoma oncocytoma
A
calculi
2
Q
A teenage boy is tackled roughly during a football game. After the game, he has abdominal pain. The pain becomes intense, and the next day he is seen at the emergency department. The laboratory values are abnormal, the hematocrit is low, and microscopic hematuria is found. A renal ultrasound is ordered. The ultrasound of the left kidney is normal. The right kidney appers normal, but a sonolucent ring is seen surrounding the kidney. This is most consistent with: perinephric hematoma AML ruptured cyst hemangioma
A
perinephric hematoma
3
Q
A patient with a history of tuberous sclerosis, recent onset of hematuria, and pain is seen for a renal ultrasound. The ultrasound reveals bilateral well-defined echogenic renal cortex masses with increased posterior acoustic enhancement. This finding is most consistent with: hematoma lipoma AML hemangioma
A
AML
4
Q
A 24 year old woman with a 12 year history of recurring urinary tract infections arrives at the ultrasound department needing a renal sonogram. She has hypertension, a high fever, nausea, vomiting and painful urination. The laboratory findings include bacteriuria, proteinuria, and increased BUN and creatinine levels. Sonographically, the right kidney appears normal, but the left renal parenchyma appears narrowed and has focal areas of increased echogenicity. In addition, the left kidney measures abnormally small and appears misshapen and its borders are difficult to visualize. What might be the cause of these sonographic findings? acute pyelonephritis renal artery stenosis emphysematous pyelonephritis chronic pyelonephritis
A
chronic pyelonephritis
5
Q
A 49 year old male construction worker with a history of an enlarged prostate is seen with right flank pain and painful urination. He claims to drink large amount of milk every day. Laboratory findings include microscopic hematuria. An abdominal sonogram shows normal anatomy except for the right kidney. It displays a hypoechoic, dilated renal collecting system to include the ureter with no echogenic foci. This would be most consistent with which of the following?
- hydronephrosis caused by the enlarged prostate obstructing flow
- pyelonephrosis caused by infection spreading from the enlarged prostate
- hydronephrosis caused by calcium deposits from excessive milk consumption
- pyonephrosis caused by prolonged obstruction from staghorn calculi
A
hydronephrosis caused by the enlarged prostate obstructing flow
6
Q
The most common congenital anomaly of the urinary tract is: horseshoe kidney duplicated collecting system renal agenesis renal hypoplasia
A
duplicated collecting system
7
Q
All of the following are clinical findings of acute renal failure except: hypertension oliguria hematuria decreased BUN and creatinine
A
decreased BUN and creatinine
8
Q
The inherited disorder associated with the development of tumors of the central nervous system and orbits, renal cysts, and adrenal tumors is: von Hippel-Lindau syndrome multicystic dyplastic kidney disease tuberous sclerosis tuberculosis
A
von Hippel-Lindau syndrome
9
Q
The systemic disorder associated with epilepsy that leads to the development of solid tumors in various organs including angiomyolipomas of the kidneys is: multicystic dysplastic kidney disease von Hippel-Lindau syndrome tuberous sclerosis tuberculosis
A
tuberous sclerosis
10
Q
Which of the following is not considered an extrinsic cause of hydronephrosis? neurogenic bladder ureteral stricture uterine leiomyoma pregnancy
A
ureteral stricture
11
Q
Which of the following renal masses would most likely cause a speed propagation artifact? renal pseudoaneurysm transitional cell carcinoma renal cell carcinoma angiomyolipoma
A
angiomyolipoma
12
Q
You have detected compensatory hypertrophy of the right kidney in a 35 year old male. This finding is associated with which of the following? all of the above nephrectomy renal agenesis renal hypoplasia
A
all of the above
13
Q
What is the normal appearance of the central sinus of the kidney?
- hypoechoic compared to the liver
- highly echogenic compared to the renal cortex
- hypoechoic compared to the renal cortex
- isoechoic to the meduallry pyramids
A
highly echogenic compared to the renal cortex
14
Q
Which malignant tumor is most common in children aged 2-5? renal lymphoma renal cell carcinoma Wilm's tumor renal hamartoma
A
Wilm’s tumor
15
Q
During routine surveillance of hte urinary bladder, you detect the presence of periodic ureteral "jets." This is a sign of: normality ureteral stone transitional cell carcinoma ureteral spasm
A
normality
16
Q
What preparation should you require of your patients scheduled for renal songrams?
- fatty meal within 30 minutes of examination
- moderate hydration with no specific preparation
- fasting for 24 hours prior to examination
- water enema
A
moderate hydration with no specific preparation
17
Q
What is the sonographic appearance of ureteropelvic junction obstruction?
- dilated ureter and collecting system to the level of the urinary bladder
- pelvicaliectasis to the level of the junction of the renal pelvis and ureter
- dilated ureter with normal intrarenal collecting sytem
- pelvocaliectasis to the level of the distal ureter
A
pelvicaliectasis to the level of the junction of the renal pelvis and ureter
18
Q
You are scanning a patient with known bladder outlet obstruction and note thickening of the urinary bladder wall. What is the most likely etiology of the wall thickening?
muscular hypertrophy
endometriosis
hematomarenal cell carcinoma
A
muscular hypertrophy
19
Q
You are scanning a 69 year old male with hematuria. You rultrasound findings include right-sided hydronephrosis and a mass within the urinary bladder. Which of the following tumors most commonly occurs within the urinary bladder? renal lymphoma renal hamartoma transitional cell carcinoma renal cell carcinoma
A
transitional cell carcinoma
20
Q
Which of the following describes the normal course of the left renal vein?
- retroaortic
- between the superior mesenteric aretery and the aorta
- anterior to the superior mesenteric artery and infreior vena cava
- between the superior mesenteric aretery and the splenic vein
A
between the superior mesenteric aretery and the aorta
21
Q
You detect a discrete echogenic focus without shadowing in the left kidney and suspect the presence of a renal calculus. Which of the following is most helpful in improving visualization of posterior acoustic shadowing? higher-frequency transducer lower-frequency transducer smaller-aperture transducer increased frame rate
A
higher-frequency transducer
22
Q
You detect the presence of free fluid in the space between the liver and right kidney. What is the name for this anatomic location? pouch of Douglas Morrison's pouch cul de sac foramen of Winslow
A
Morrison’s pouch
23
Q
What is the indication for a Doppler renal study to rule out renal artery stenosis
anemia, progressive azotemia and polyuria
hematuria
increased serum creatinine
uncontrolled hypertension
A
uncontrolled hypertension
24
Q
During performance of a renal sonogram, you identify only one kidney. What should you do?
- inform the patient of your findings and advise a thorough medical exam to detect other anatomic anomalies
- scan in the pelvis area to rule the presence of a pelvic kidney
- scan the patient in the upright position
- perform an endovaginal exam to look for bicornuate uterus
A
scan in the pelvis area to rule the presence of a pelvic kidney
25
You are scanning a patient with right flank pain and known polycystic kidney disease. You suspect the presence of hemorrhage within one of the renal cyts. What is the sonographic appearnace of this finding?
* ultrasound cannot be used to detect hemorrhage within a renal cyst
* low-level echoes within the cyst
* multiple bright focii with posterior acoustic shadowing distal to the cyst
* solid appearing nodule with increased attenuation
* all of the above
low-level echoes within the cyst
26
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A 45 year old man with a history of left flank pain is seen for a renal ultrasound. The ultrasound reveals a normal right kidney measuring 11.5 cm. The left kidney measures 12 cm and contains a round, anechoic lesion that has a thin, well defined wall located at the superior aspect. No enhancement is identified. This would be characterized as which of the following?
atypical cyst
hemorrhagic cyst
infected cyst
simple cyst
```
atypical cyst
27
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A 42 year old man with a cocaine addiction is undergoing detoxification at a local facility and is seen for a renal sonogram. He has decreased urine output and hypertension. The laboratory results reveal an acute decrease in the GFR to very low levels and a sudden increase in the serum creatinine and BUN concentrations. Sonographically, the kidneys are enlarged bilarterally and have increased echogenicty when compared with the liver. The parenchymal echotexture appears normal in echogenicty, although the renal pyramids appear enlarged and hyperechoic. Doppler analysis reveals reduced diastolic flow. Which of the following is a possible diagnosis from the aforementioned clinical and sonographic findings?
chronic renal failure
acute pyelonephritis
chronic pyelonephritis
acute tubular necrosis
```
acute tubular necrosis
28
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A 62 year old woman with a history of diabetes is referred for a renal ultrasound from the emergency department. She is severly dehydrated and not coherent. Her temperature is 103° F. She has extreme pain along her left flank. The laboratory results of the urinary sample showed the presence of hematuria and E. coli bacteria. Sonographically, the right kidney appears normal. The left kidney has multiple echogenic foci throughout it. Visualization of the left kidney is difficult because of unusual shadowing throughout the left renal area. What is the most likely diagnosis?
renal abscess
pyonephrosis
emphysematous pyelonephritis
hydronephrosis
```
emphysematous pyelonephritis
29
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A 40 year old woman is seen for a renal ultrasound. Microscopic hematuria was found during her routine annual physical examination. A solid mass is identified in the renal cortex. The mass is more echogenic than the renal sinus, and the collecting system is not dilated. What is the most likely diagnosis?
RCC
renal calculi
complex renal cyst
AML
```
AML
30
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A 32 year old patient with severe left flank pain and hematuria is seen for a renal ultrasound. The ultrasound reveals a dilated ureter, and no ureteral jet is seen on the left side. The right kidney appears normal, and the left renal collecting system is dilated. This is most consistent with:
bladder hematoma
ureteral stone
kidney stone
bladder stone
```
ureteral stone
