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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
in relation to the left kidney
adrenal and spleen are superior pancreatic tail is anterior to the upper pole left colic flexure is inferior
26
causes of medullary nephrocalcinosis
primary hyperparathyroidism (most common) renal tubular acidosis medullary sponge kidney 95%
27
pediatric cancer incidence
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%
28
chart that defines imaging characteristics that relate to increased chances of malignancy
Bosniak renal cyst classification
29
enlarged kidneys bilaterally, hyperechoic parenchyma, loss of cortical medullary distiction multiple small cysts throughout the kidney.
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
renal metastases
lung, breast, colon malignant cells from leukemia and lymphoma hypoechoic masses or diffusely enlarged inhomogeneous kidney
31
parapelvic cysts
cortical cysts that bulge into the central sinus of the kidney
32
anatomy of a nephron
prox convoluted tubule, descending and ascending limbs of Henle's loop, distal convoluted tubule, and collecting tubules
33
azotemia
characterized by a decrease in glomerular filtration rate resulting in increases of BUN and creatinine
34
mycetoma (fungal ball)
candidiasis is the most common renal fungal disease fungal infections result from hematogenus seeding or ascend from the bladder hyperechoic, non-shadowing mass
35
RI=
peak systolic freq - end diastolic freq/ peak systolic freq normal RI \< .7 renal artery typically low resistance perfusion
36
sono findings of acute transplant rejection
renal enlargement decreased kidney echogenicity loss of cortical medullary boundary increasing flow resistance
37
findings of transitional cell carcinoma
solid mass or focal thickening of bladder wall hematuria most common clinical presentation
38
renal artery stenosis diagnostic criteria direct evaluation indirect evaluation
direct: renal artery/aorta ratio \>3.5 indirect: parvus tardus, absent early systolic peak
39
renal cell carcinoma
most common solid renal mass in adult typically unilateral encapsulated mass hypoechoic ti renal parenchyma
40
most common causes of newborn/prenatal hydro
vesicoureteral reflux non-obstructive hydro UPJ
41
acute tubular necrosis
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
resistive index commonly used to:
evaluate renal transplant rejection access suspected hydro evaluate medical renal disease
43
renal arteries
main renal, 5 segmental, interlobar, arcuate, interlobular arteries
44
untreated hydro secondary to obstruction
hypertension, loss of renal function, sepsis
45
tuberous sclerosis
seizures, mental retardation increased incidence of renal cysts and angiomyolipomas (typically bilat)
46
symptoms of wilms tumor
large asymptomatic flank mass hypertension, fever, hematuria 90% survival rate wilms tumor destroys renal contour
47
cortical nephrocalcinosis
chronic glomerulonephritis renal cortical necrosis transplant kidney: chronic rejection
48
von Hippel-Lindau disease
characterized by retinal and CNS hemangioblastomas but related renal cell carcinomas and renal cysts
49
major calyces minor calyces
major: 3 extentions for the renal pelvis minor: extentions of the major calyces that collects urine form the medullary pyramids
50
simple renal cysts occur in what percent of people over age 50?
50% simple cortical cysts that originate from obstructed uriniferous tubules
51
congenital UPJ obstruction is caused by
ureteral hypoplasia high insertion of ureter into renal pelvis compression by segmental artery
52
megaureter
\>7mm in diameter more likely in males and on left
53
ultrasound findings of acute peylonephritis
renal enlargment hypoechoic parenchyma absence of sinus echoes when focal, appears as hypoechoic wedge
54
renal echogenicity
renal cortex- isoechoic or hypoechoic medullary pyramids- anechoic renal sinus- hyperechoic
55
three main mechanisms of acute kidney injury (renal failure)
prerenal failure hypotension volume depletion decreased cardiac output
56
ectopic kidney increased complications
UPJ obstruction, ureteral reflux, and multicystic renal dysplasia
57
dromedary hump
cortical thickening on the lateral aspect of the left kidney
58
junctional parenchymal defect
triangular hyperechoic area on the anterior aspect of the upper pole of the right kidney also known as fetal lobulation
59
what lies posterior to the kidneys
psoas muscle and the quadratus lumborum muscle
60
renal corpuscle (malpighian body)
consists of glomerulus and glomerular capsule (Bowmans capsule)
61
serum creatinine
break down product of skeletal muscle threshold levels 1.2 to 2.0 mg/dL
62
chronic pyelonephritis
recurrent renal infection due to anatomic anomalies, obstructive lesions, ureteral reflux small hyperechoic kidney with cortical thinning
63
medullary sponge kidney
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
most common childhood renal tumor, mean age 3.5 years
wilms tumor (nephroblastoma)
65
emphysematous pyelonephritis
bacterial infection associated with renal ischemia often occur in diabetics anerobic bacteria produce intrarenal gas
66
bilateral renal enlargement due ti the development of numerous cysts of varying sizes
autosomal dominant adult polycystic kidney disease identified as early as 20-30 yrs old associated with liver, pancreas, and spleen cysts
67
hyperechoic benign renal tumor, 80% involve rt kidney
angiomyolipoma may have propagation speed artifact
68
poor function of renal transplant may be the result of what
acute tubular necrosis
69
syndromes associated with MCDK
beckwith-wiedemann syndrome, trisomy 18 and VACTERL
70
in relation to the right kidney
adrenal gland is superomedial liver is superolateral right colic flexure is inferior 2nd portion of the duodenum is medial
71
sono findings of renal artery thrombosis
focal hypoechoic areas of infarct absence of intrarenal arterial flow renal enlargement
72
blood urea nitrogen
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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