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ABD Boards! > Urinary Tract > Flashcards

Urinary Tract Flashcards

1
Q

What type of organ are the kidneys and ureters?

A

Retroperitoneal organ

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2
Q

What muscles are posterior to the kidneys?

A

Psoas muscle and quadratus muscle

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3
Q

Know about the echogenicity of the kidneys…

A
  1. Renal cortex: Isoechoic or hypoechoic
  2. Medullary pyramids: Anechoic
  3. Renal sinus: Hyperechoic
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4
Q

What is the measurement of the renal cortex?

A

> 1 cm

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5
Q

What is Gerota’s fascia?

A

Fibrous sheath enclosing the kidney and adrenal glans

- AKA perirenal space

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6
Q

What is the functioning unit of the kidney?

A

Nephron

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7
Q

Know the order of the renal vascularity…

A

Main Renal Artery > Segmental Artery > Interlobar Artery > Arcuate Artery > Interlobular Artery

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8
Q

What is an Ectopic kidney?

A

Displaced or in a location away from normal location

- AKA Pelvic kidney

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9
Q

What is a horseshoe kidney?

A
  • Most common fusion anomaly in which lower poles typically connect across midline anterior to aorta.
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10
Q

What is a crossed fused renal ectopia?

A

Developing kidneys fuse in the pelvis and one kidney ascends to normal position and the other one midline

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11
Q

What is a Fused pelvic kidney?

A

Kidneys that have fused to form a round mass in pelvis

- Known as discoid or pancake kidney

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12
Q

What is a Dromedary Hump?

A

Thickening of the lateral aspect of the kidney

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13
Q

What is Junctional Parenchymal Defect?

A

Triangular Hyperechoic area on the anterior aspect of the upper pole of right kidney
- AKA fetal lobulation

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14
Q

Know about a Duplex Collecting system…

A
  • 2 collecting systems
  • Complete: two ureters
  • Incomplete: one ureter
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15
Q

What is a frequent complication of an ectopic ureter inserting into the bladder in a ectopic location?

A

Ureterocele

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16
Q

What is a Column of Bertin?

A
  • Septal Cortex

- Cortex parenchyma located between two medullary pyramids

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17
Q

What is Renal Agenesis?

A
  • Bilateral Renal Agenesis: Oligo and Pulmonary Hypoplasia, incompatible with life.
  • Unilateral Renal Agenesis: One kidney. Associated with Bicornuate or didelphic uterus, VACTERL
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18
Q

What is a Extrarenal Pelvis?

A

Pelvis lies outside the renal sinus appearing as a cystic collection medial to the renal hilum.

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19
Q

Know about posterior urethral valves…

A
  • most common cause of urinary obstruction in male neonatal patient
  • obstruction due to flap of mucosa that has slit-like opening in the area of prostatic urethra.
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20
Q

What is a common finding in people over 50 years old?

A

Simple renal cyst

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21
Q

What is a Pylogenic cyst?

A

Calyceal diverticula that appears as a simple cyst

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22
Q

What is a Parapelvic cyst?

A

Cortical cysts that bulge into the renal sinus

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23
Q

What is a Peripelvic cyst?

A

Lymphatic cysts in central sinus

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24
Q

What is a Atypical Renal cyst?

A

Cysts with a thing septation, minimal wall calcification, internal echoes caused by lobulated shapes may be associated with benign cysts

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25
Q

Know about Autosomal Dominant Polycystic Kidney Disease…

A
  • Bilateral renal enlargement due to the developmental of numerous cysts varying in sizes
  • Associated with cysts in liver, pancreas, and spleen
  • Destruction of the residual tissue in advanced stages leads to renal failure and hypertension
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26
Q

Know about Mulicystic Dysplastic Kidney…

A
  • Most common cause of abdominal mass in newborns
  • Multiple non communicating cysts with the absence of renal parenchyma
  • Syndromes: Trisomy 18, Beckwith, VACTERL
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27
Q

Know about UPJ…

A
  • high insertion of ureter into renal pelvis

- Associated with MCDK, Renal agenesis, Horseshoe kidney, Ectopic kidney

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28
Q

What is Medullary Sponge kidney?

A

Cystic dilatation of the medullary pyramids due to tubular ectasia or dysplasia

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29
Q

What is Von Hippel-Lindau Disease?

A
  • Inherited disease which usually presents in second to third decade of life with impairment
  • Retinal and central nervous system hemangioblastoma
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30
Q

What is a angiomyolipoma?

A
  • Hyperechoic benign renal tumor

- echogenicity is greater than or equal to renal sinus

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31
Q

What is Tuberour Sclerosis?

A
  • Multi-system genetic disease
  • increased incidence of renal cysts and angiomyolipomas
  • Seizures, retardation, and facial angiofibromas
32
Q

Know all about Renal Cell Carcinoma…

A
  • Most common solid renal mass in adults.
  • Travel through renal veins and IVC
  • hypoechoic adjacent to renal parenchyma
33
Q

Know about Renal Mets…

A
  • site of secondary tumors that mets to other primary organs ( lung, breast, colon)
  • Leukemia and Lymphoma can mets to kidneys
34
Q

Know about Wilm’s Tumor…

A
  • Nephroblastoma
  • most common childhood renal tumor
  • Mets seen to lungs, liver, bone, lymph nodes, and retroperitoneum
  • Also travel to renal vein and IVC
  • Wilm’s tumor will destroy the renal contour, where as normal renal contour mean adrenal neuroblastoma
35
Q

What is pyonephrosis?

A

purulent material in the collection system of the kidney associated with an infection secondary to renal obstruction.
- hyperechoic debris in dilated collecting system.

36
Q

What is a Mycetoma?

A
  • Fungal Ball
  • Candidiasis is the most common renal fungal disease
  • result from hematogenus seeding and ascend from the bladder
37
Q

What are all the hyperechoic masses of the kidneys?

A
  • Mycetoma
  • Angiomyolipomas
  • blood clots
  • pyogenic debris
  • sloughed papilla
  • renal stones
38
Q

Know about Acute Renal Injury…

A
  • AKA: Acute Renal Failure
  • abrupt decline in renal function, manifested by decreased urinary output and elevation in plasma blood urea nitrogen (BUN) and serum creatinine.
39
Q

What are the studied used to evaluate AKI?

A
  • urine output
  • urinalysis
  • BUN
  • Creatinine
40
Q

What are the three main mechanisms for AKI?

A
  • Prerenal Failure
  • Hypotension
  • Volume depletion
  • Decreased cardiac output
41
Q

Know about renal vein thrombosis…

A
  • Dilated thrombosed renal vein
  • Enlarged hypoechoic kidney
  • ** High-resistance renal artery waveform (Increased RI)
42
Q

Know about renal artery thrombosis…

A
  • sudden cause of prerenal failure that presents as acute flank pain, hematuria, rise in blood pressure
  • Findings: Absence intrarenal arterial flow, renal enlargment
43
Q

What is Acute Tubular Necrosis (ATN) ?

A
  • most common cause of acute kidney injury
  • results for ischemia causing damage to the tubular epithelium of the nephron leading to acute renal failure.
  • Increased RI
44
Q

What is Acute Glomerulonephritis (GN) ?

A
  • inflammatory response resulting in glomerular damage caused by infectious and noninfectious causes.
  • most common reason for GN is Streptococcus species
  • Increased RI
45
Q

Know about Hydronephrosis…

A
  • Dilatation of the renal pelvis

- instead of echogenic renal sinus, it is anechoic with fluid.

46
Q

What can hydronephrosis lead to?

A
  • hypertension
  • loss of renal function
  • sepsis
47
Q

What are the common areas obstruction by a stone can be?

A
  1. Ureterovesical junction (most common)
  2. UPJ
  3. Pelvic brim
48
Q

What does the RI have to be to suggest obstructive hydronephrosis?

A

Greater than 0.7

49
Q

What is the most common reason for hydronephrosis in pediatrics?

A

UPJ obstruction

50
Q

Know the measurements of the pelvic diameter…

A
  • Normal: < 7 mm
  • Mild: 7 to 8 mm
  • Moderate: 9 to 15 mm
  • Severe: > 15 mm
51
Q

What is a Megaureter?

A

Wide ureter, greater than 7 mm in diameter

- left side is more often affected than the right side.

52
Q

What is Nephrocalcinosis?

A

Formation of calcium renal stones and deposition of calcium in the renal parenchyma.

53
Q

What is the “Twinkle sign”?

A

Color Doppler artifact that appears as rapidly alternating mixture of red and blue Doppler signals distal to the renal stone

54
Q

What is renal sinus Lipomatosis?

A
  • increased renal sinus fat that replaces normal renal parenchyma.
  • compression of calyces and renal pelvis by renal sinus fat
55
Q

What is the normal measurement for the urinary bladder?

A

< 5 mm in nondistended bladder

< 3 mm in distended bladder

56
Q

What is a bladder diverticula?

A

Herniation of the bladder musoca through the bladder wall musculature.
- most acquired diverticula occur do to longstanding bladder outlet obstruction due to benign prostatic hypertrophy.

57
Q

What is a urachal cyst?

A

cystic dilatation of the fetal urachus

- seen superior and anterior to the bladder

58
Q

Where do ureters insert into the bladder?

A

Trigone

59
Q

What is a ureterocele?

A

cyst-like enlargement of the lower end of the ureter which projects into the bladder lumen at the ureterovesical junction (UVJ)

60
Q

When are ureteroceles most common?

A

complete ureteral duplication

61
Q

Know all about Transitional Cell Carcinoma…

A
  • most common bladder neoplasm
  • solid mass or focal thickening of bladder wall
  • can cause hydronephrosis
  • Hematuria is the most common clinical presentation
  • 15,000 deaths due to bladder cancer
62
Q

What kind of flow should a normal renal artery demonstrate?

A

continuous forward flow during diastole, low resistance perfusion

63
Q

What is Resistive index commonly used for?

A
  1. Evaluate renal transplant rejection
  2. Access suspected hydronephrosis
  3. Evaluate medical renal disease
64
Q

What is the equation for RI?

A

peak systolic freq. - end diastolic freq. / peak systolic freq.

65
Q

Know about renal artery stenosis…

A
  • sudden onset of hypertension

- decrease in renal size( < 9 cm in length)

66
Q

What does RAR stand for?

A

Renal Aortic Ratio

- needs to be greater than 3.5

67
Q

What is Parvus Tardus?

A

Small slow pulse

68
Q

What is the most common cause for renal disease?

A
  • diabetes
69
Q

Know all about the transplant kidney…

A
  • placed in either side of the pelvis
  • Arterial anastomosis may be with the external or internal iliac artery
  • poor function of renal transplant may result of ATN
70
Q

Know the resistances for a transplant kidney…

A
  • Normal: <0.7
  • Questionable: 0.7 - 0.8
  • Dysfunction: > 0.8
71
Q

Kidney labs….

A

Page 109 ESP

72
Q

What is the most common neonatal abdominal mass?

A

Multicystic dysplastic kidneys

73
Q

What is the most common neonatal adrenal mass?

A

Adrenal hemorrhage

74
Q

What is the most common childhood adrenal mass?

A

Neuroblastoma

75
Q

What is the most common neonatal renal mass?

A

Multicystic dysplastic kidneys

76
Q

What is the most common childhood renal mass?

A

Wilm’s tumor

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