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ABD Board Review > Urinary Tract > Flashcards

Urinary Tract Flashcards

1
Q

fibrous sheath enclosing kidney and adrenal glands. also reffered to as the perirenal space

A

gerota’s fascia

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2
Q

crossed fused renal ectopia

A

developing kidneys fuse in the pelvis and one kidney ascends to its normal postion carrying the other one with it across the midline

ureters connect on both sides of the bladder thus one ureter crosses the midline

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3
Q

treatment choice for end-stage renal disease, diabetes being the leading cause

A

renal transplant

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4
Q

normal variation of prominent renal cortical parenchyma located between two medullary pyramids

A

column of bertin

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5
Q

course of ureters

A

posterior to renal artery and vein

descend inferiorly

anterior surface of psoas

cross anterior to common iliac vessels

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6
Q

acute glomerulonephritis

A

an inflammatory response resuting in glomerular damage caused by infectious and noninfectious causes

most common infection is streptococcus species

renal enlargement and increased RI

hematuria

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7
Q

most common location for metastases fo RCC

A

lungs

tumor extension into renal veins and IVC is comon

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8
Q

causes of intrinsic (intrarenal) renal failure

postrenal failure

A

acute tubular necrosis (most common), glomerular diseases, interstitial nephritis, autoimmune diseases

bilateral renal obstruction

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9
Q

renal disease associated with arterial aneurysms especially cerebral arterial (Berry) aneurysms of the circle of willis

A

ADPKD

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10
Q

peripelvic cysts

A

lymphatic cysts in the central sinus

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11
Q

parvus tardus

A

small slow pulse

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12
Q

most accurate lab value for determining AKI

A

serum creatinine

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13
Q

classic triad for renal cell carcinoma

A

flank pain, hematuria, and flank mass

10% of cases

often more advanced stage

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14
Q

sono findings of renal vein thrombosis

A

dilated thrombosed renal vein

absent intrarenal venous flow

enlarged hypoechoic kidney

high resistance renal artery waveform

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15
Q

acquired cystic disease

A

multiple cysts in chronincally failed kidneys during long-term hemodialysis

hemorrhage often occurs resulting in pain and hematuria

predisposes patients to RCC

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16
Q

characteristics of atypical cysts that may suggest malignant cystic lesion

A

multiple or thick septation

thick calcifications

mural nodule/ solid component

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17
Q

multicystic dysplastic kidney

A

most common cause of abd mass in newborns

multiple noncommunicating cysts with the absence of renal parenchyma

typically unilateral

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18
Q

duplex kidney

A

has a complete central cortical break within the hyperechoic sinus

complete: two ureters
incomplete: one ureter

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19
Q

xanthogranulomatous pyelonephritis

A

type of chronic infections due to a long term obstruction

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20
Q

sonographic appearence of medullary pyramids

A

anechoic, equally spaced triangles of collecting tubules between cortex and renal sinus

commonly seen in neonatal and pediatric kidneys

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21
Q

fused pelvic kidney

A

form a round mass in the pelvis known as a discoid or pancake kidney

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22
Q

main symptoms of nephrolithiasis

A

acute back pain, flank pain radiating to groin

when severe, fever, chills, dysuria, cloudy urine and hematuria

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23
Q

pylogenic cysts

A

calyceal diverticula that sonographically appear as a simple cyst

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24
Q

common cause of urinary obstruction in the male neonate patient due to mucosa flap in urethra

A

posterior uretheral valve

sono findings: large bladder, hydroureter, hydronephrosis, urinoma

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25
Q

in relation to the left kidney

A

adrenal and spleen are superior

pancreatic tail is anterior to the upper pole

left colic flexure is inferior

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26
Q

causes of medullary nephrocalcinosis

A

primary hyperparathyroidism (most common)

renal tubular acidosis

medullary sponge kidney

95%

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27
Q

pediatric cancer incidence

A

leukemia 35%

cns tumors 16.6%

lymphoma 15.0%

neuroblastomas 7.8%

soft tissue sarcomas 7.4%

wilms tumors 6.3%

bone 6.0%

hepatic tumor 1.1%

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28
Q

chart that defines imaging characteristics that relate to increased chances of malignancy

A

Bosniak renal cyst classification

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29
Q

enlarged kidneys bilaterally, hyperechoic parenchyma, loss of cortical medullary distiction multiple small cysts throughout the kidney.

A

autosomal recessive infantile polycystic kidney disease

Cysts result from cystic dilatation of the collecting tubules secondary to hyperplasia of the interstitial portions of the ducts

30
Q

renal metastases

A

lung, breast, colon

malignant cells from leukemia and lymphoma

hypoechoic masses or diffusely enlarged inhomogeneous kidney

31
Q

parapelvic cysts

A

cortical cysts that bulge into the central sinus of the kidney

32
Q

anatomy of a nephron

A

prox convoluted tubule, descending and ascending limbs of Henle’s loop, distal convoluted tubule, and collecting tubules

33
Q

azotemia

A

characterized by a decrease in glomerular filtration rate resulting in increases of BUN and creatinine

34
Q

mycetoma (fungal ball)

A

candidiasis is the most common renal fungal disease

fungal infections result from hematogenus seeding or ascend from the bladder

hyperechoic, non-shadowing mass

35
Q

RI=

A

peak systolic freq - end diastolic freq/ peak systolic freq

normal RI < .7

renal artery typically low resistance perfusion

36
Q

sono findings of acute transplant rejection

A

renal enlargement

decreased kidney echogenicity

loss of cortical medullary boundary

increasing flow resistance

37
Q

findings of transitional cell carcinoma

A

solid mass or focal thickening of bladder wall

hematuria most common clinical presentation

38
Q

renal artery stenosis diagnostic criteria

direct evaluation

indirect evaluation

A

direct: renal artery/aorta ratio >3.5
indirect: parvus tardus, absent early systolic peak

39
Q

renal cell carcinoma

A

most common solid renal mass in adult

typically unilateral encapsulated mass

hypoechoic ti renal parenchyma

40
Q

most common causes of newborn/prenatal hydro

A

vesicoureteral reflux

non-obstructive hydro

UPJ

41
Q

acute tubular necrosis

A

results from prolonged drugs and contrast agents causing damage to the tubular epithelium of the nephron

renal insufficiency can be reversible

renal enlargement increased resistive index

42
Q

resistive index commonly used to:

A

evaluate renal transplant rejection

access suspected hydro

evaluate medical renal disease

43
Q

renal arteries

A

main renal, 5 segmental, interlobar, arcuate, interlobular arteries

44
Q

untreated hydro secondary to obstruction

A

hypertension, loss of renal function, sepsis

45
Q

tuberous sclerosis

A

seizures, mental retardation

increased incidence of renal cysts and angiomyolipomas (typically bilat)

46
Q

symptoms of wilms tumor

A

large asymptomatic flank mass

hypertension, fever, hematuria

90% survival rate

wilms tumor destroys renal contour

47
Q

cortical nephrocalcinosis

A

chronic glomerulonephritis

renal cortical necrosis

transplant kidney: chronic rejection

48
Q

von Hippel-Lindau disease

A

characterized by retinal and CNS hemangioblastomas but related renal cell carcinomas and renal cysts

49
Q

major calyces

minor calyces

A

major: 3 extentions for the renal pelvis
minor: extentions of the major calyces that collects urine form the medullary pyramids

50
Q

simple renal cysts occur in what percent of people over age 50?

A

50%

simple cortical cysts that originate from obstructed uriniferous tubules

51
Q

congenital UPJ obstruction is caused by

A

ureteral hypoplasia

high insertion of ureter into renal pelvis

compression by segmental artery

52
Q

megaureter

A

>7mm in diameter

more likely in males and on left

53
Q

ultrasound findings of acute peylonephritis

A

renal enlargment

hypoechoic parenchyma

absence of sinus echoes

when focal, appears as hypoechoic wedge

54
Q

renal echogenicity

A

renal cortex- isoechoic or hypoechoic

medullary pyramids- anechoic

renal sinus- hyperechoic

55
Q

three main mechanisms of acute kidney injury (renal failure)

A

prerenal failure

hypotension

volume depletion

decreased cardiac output

56
Q

ectopic kidney increased complications

A

UPJ obstruction, ureteral reflux, and multicystic renal dysplasia

57
Q

dromedary hump

A

cortical thickening on the lateral aspect of the left kidney

58
Q

junctional parenchymal defect

A

triangular hyperechoic area on the anterior aspect of the upper pole of the right kidney

also known as fetal lobulation

59
Q

what lies posterior to the kidneys

A

psoas muscle and the quadratus lumborum muscle

60
Q

renal corpuscle (malpighian body)

A

consists of glomerulus and glomerular capsule (Bowmans capsule)

61
Q

serum creatinine

A

break down product of skeletal muscle

threshold levels 1.2 to 2.0 mg/dL

62
Q

chronic pyelonephritis

A

recurrent renal infection due to anatomic anomalies, obstructive lesions, ureteral reflux

small hyperechoic kidney with cortical thinning

63
Q

medullary sponge kidney

A

congenital dysplastic cystic dilatation of the medullary pryamids due to tubular ectasia or dysplasia

urinary stasis causes calcium deposits appear as hyoerechoic medullary pyramids

64
Q

most common childhood renal tumor, mean age 3.5 years

A

wilms tumor (nephroblastoma)

65
Q

emphysematous pyelonephritis

A

bacterial infection associated with renal ischemia

often occur in diabetics

anerobic bacteria produce intrarenal gas

66
Q

bilateral renal enlargement due ti the development of numerous cysts of varying sizes

A

autosomal dominant adult polycystic kidney disease

identified as early as 20-30 yrs old

associated with liver, pancreas, and spleen cysts

67
Q

hyperechoic benign renal tumor, 80% involve rt kidney

A

angiomyolipoma

may have propagation speed artifact

68
Q

poor function of renal transplant may be the result of what

A

acute tubular necrosis

69
Q

syndromes associated with MCDK

A

beckwith-wiedemann syndrome, trisomy 18 and VACTERL

70
Q

in relation to the right kidney

A

adrenal gland is superomedial

liver is superolateral

right colic flexure is inferior

2nd portion of the duodenum is medial

71
Q

sono findings of renal artery thrombosis

A

focal hypoechoic areas of infarct

absence of intrarenal arterial flow

renal enlargement

72
Q

blood urea nitrogen

A

urea is waste product of protein metabolism

varies with urine flow rates and production of urea

ABD Board Review (8 decks)

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