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U/S Mattoon and Pennick > Urinary Tract > Flashcards

Urinary Tract Flashcards

1
Q

What is the normal echogenicity of the kidneys in dogs vs cats

A

dogs: cortex is similar or slightly less than liver
cats: cortex is isoechoic or hyperechoic to liver

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2
Q

What are the normal measurements of renal size in cats?

A

3.5-4.5 cm in length

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3
Q

Ddx for renal enlargement with smooth and regular contour

A

compensatory hypertrophy

acute renal failure

hydronephrosis

ethylene glycol tox

acute nephritis

early amyloidosis

PSS

infiltrative diseases

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4
Q

Ddx for renal enlargement with irregular contour

A

granuloma

abscess

cysts

polycystic disease

primary or metastatic neiplasia

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5
Q

Ddx small kidneys

A

congenital renal hypoplasia or dysplasia

chronic end stage renal disease

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6
Q

A renal pelvis or proximal ureter diameter above ____ mm is abnormal

A

3-4 mm

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7
Q

True or false: Kidneys are typically larger in intact cats

A

true

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8
Q

The renal length in dogs can be compared with:

A

aortic diameter (normal 5.5-9- less than 5.5 large) or length of L5-L6

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9
Q

What canine breed are affected with juvenile nephropathy

A

boxers

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10
Q

Causes for renal hyperechogenicity

A

renal dysplasia

juvenile nephropathy

interstitial or glomerular nephritis

acute tubular necrosis (toxins- ethylene glycol, grape, lily)

end stage renal disease

nephrocalcinosis

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11
Q

Autosomal dominant polycystic kidney disease mainly affects what feline and canine breeds?

A

cairn terriers

persian

bull terriers

chartreux cats

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12
Q

How can a renal abcess be differentiated from a cyst sonographically

A

by the presence of echoes and sedimentation within the cavitary lesion and poorly demarcated and irregular contour

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13
Q

What canine breed renal cysadenocarcinomas have been reported

A

german shepherds

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14
Q

In what canine breed has renal telangiectasia been reported

A

welsh corgis

* consists of cavernous masses filled with blood that can mimic neoplasia

p. 345 Pennick

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15
Q

Most common primary renal neoplasia in dogs

What about benign tumor?

A

renal carcinoma

*it is more common in males

Hemangioma

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16
Q

Most common primary renal neoplasia in cats

A

renal lymphoma

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17
Q

What is the typical sonographic appearance of lymphoma and histiocytic sarcoma in the kidneys?

A

they tend to appear as hypoechoic nodules

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18
Q

What can produce complex masses in the kidneys?

A

hematomas, granulomas, abscesses, acute infarcts, primary or metastatic neoplasia, infected/hemorrhagic or multilocular cysts

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19
Q

What can cause hyperechoic areas or lesions in renal cortex

A

infection, cqalcification, fibrosis, infarcts, gas, neoplasia

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20
Q

List ddx for pyelectasia and hydronephrosis in small animals

A
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21
Q

If the renal pelvis measures approx __mm or more on a transverse image, it is predictive for an outflow obstruction. (d’Anjou et al. 2011)

A

13mm

However it should be kept in mind that pelvic dilation is not a sensitive sign for obstruction

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22
Q

Sonographic appearance pyelonephritis

A

mild renal enlargement

mild to moderate pelvic and ureteral dilation

hyperechoic mucosal margin parallel to the wall of the renal pelvis and proximal ureter with echogenic fluid

echogenic medullary band at corticomedullary junction

focal hyeprechoic areas in the renal medulla and patchy focal hypoechoic or hyperechoic area in the renal cortex

hyperechoic perirenal tissue

perirenal effusion

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23
Q

hydronephrosis may progress to what

A

pyonephrosis due to urinary stasis

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24
Q

What is the most common cause of ureteral obstruction

A

bladder, urethral or prostatic tumors involving the trigone

other causes include: ureteral inflammation, blood clots, fibroepithelial polyps, calculi, extrinsic masses, ureteral fibrosis or strictures

25
Even though ureteral tumors are rare, what are some types of neoplasias that have been reported
leiomyoma, leiomyosarcoma, fibropapiloma, TCC
26
what is the most common congenital anomaly that produces hydronephrosis they are more common in males or females?
ectopic ureters females
27
What can cause bilateral vs unilateral perirenal effusion
bilatera- acute renal failure due to nephrotoxocity, lepto, interstitial nephritis unilateral- pelvic or ureteral obstruction or rupture
28
What are urinomas?
encapsulated accumulation of urine caused by a traumatic extravasation
29
Ddx for retroperitoneal masses
abscess- migrating grass awns commonly cause sublumbar abscess granulomas neoplasia- sarcomas lymphadenopathy
30
A mass _______ to the kidney may arise from adrenal gland, whereas one caudal to the kidney may arise from peritoneal structures.
craniomedial
31
Subscapsular or perirenal fluid may occur from:
blood urine exudate transudate
32
With what diseases perinephric pseudocysts have been associated with
interstitial nephritis hydronephrosis polycystic renal disease neoplasia
33
How does resistive index is calculated what is the normal RI in dogs and cats What can cause an increased RI
signals from arteries near the hilus or corticomedullary junction by substracting end diastolic velocity from peak systolic velocity and dividing the result by peak systolic velicity below 0.7 reduced renal diastolic flow indicates an increase in renal vascular resistence (high RI) increase in RI is a nonspecific finding and causes include: acute tubular necrosis, acute renal disease, renal obstruction
34
true or false: renal vein and arterial occulsion will lead to renal infarction
true renal vein thrombosis may cause edema and renal enlargement
35
What are the 4 layers of the urinary bladder
mucosa- hypoechoic submucosa- hyperechoic muscularis- hypoechoic serosa- hyperechoic
36
vesiculoureteral reflux (retrogede passage of urine from bladder to ureter due to an incompetent vesiculoureteral junction) mayh occur in younger dogs less than ______ months without underlying pathology.
6 months
37
Ureterovaginal fistulas may develop from:
penetrating trauma or inadvertent ligation of ureter during OHE
38
Limitations for ultrasonographic identification of ectopic ureters
when there is an intrapelvic bladder when there is invagination or tunneling of ureters
39
how renal parenchyma looks in acute vs chronic renal disease
acute- preserves corticomedullary definition chronic - looses corticomedullary definition
40
when to consider bx the kidneys
protein loosing enteropathy and inflammatory disease
41
what canine breed is reported to get hemorrhagic cysts
german shepherds
42
ddx complex mass
abscess granuloma hematoma neoplasia
43
If renal lymphoma in a cat is suspected what other organ systems would you do a more thorough examination
GI and spine
44
What ultrasonographic finding is pathognomonic for lymphoma in dogs and cats
hypoechoic to anechoic subcapsular rim
45
What are measurements of the renal pelvis when pyelectasia vs hydronephrosis will be considered (cole numbers)
pyelectasia 4-5 mm or less (ddx polyuria, early obstruction, pyelonephritis) hydronephrosis 1cm (ddx obstruction, ureteral stone in cats, urinary bladder stone in dogs)
46
Normal urinary bladder wall thickness
2-3mm anything above 4mm is abnormal
47
Ultrasonographic appearance cystitis
thickened irregular cranioventral aspect of urinary bladder wall
48
Causes for cystitis:
bacterial inflammatory calculi necrotic debris blood clots fungal- Histoplasma capsulatum, candida
49
Types of cystitis:
polypoid cystitis- typicallty located cranioventrally emphysematous cystitis- commonly seen w/ dabetic patients, bacteria E coli or Aerobacter pseudomembranous cystitis- associated with FLUT encrusting cystitis- associated with upper motor neuron incontinence, chronic use of antibiotic may predispose, over distention of UB bladder wall inversion- associated with long term catheter placement
50
Ddx for this
pseudomembranous cystitis encrusting cystitis characterized by severe diffuse thickening of urinary bladder wall with multiple hyperechoic luminal septations
51
Sonographic appearance of blood clots
hyperechoic non shadowing irregular in shape gravity dependent may see adherent can use doppler to ddx hematoma vs mass
52
What canine breed are reported to gt polypoid cystitis
Springle Spaniels
53
Most common neoplasia of bladder
TCC typically an irregular bladder mass with borad based attachment projecting into the lumen dorsal wall adjacent to the trigone
54
Other than TCC what are some other bladder tumors
squamous cell carcinoma rhabdomyosarcoma leiomyosarcoma hemangiosarcoma lymphoma
55
What are ureteroceles
cystic dilations of the terminal ureter within the urinary bladder. can be divided into: orthotopic or ectopic
56
what is a vesicouracha diverticulum
fluid filled structure that extends as a convex outpouching of the bladder lumen typically cranioventral wall
57
What FB have been found in the urinary bladder?
grass aws catheter parts BBs suture material
58
Non shadowing gravity dependent sediment may represent:
cellular debris, fat, proteinuria, minerals, crystalluria
59
Most common types of urethral tumors
TCC squamous cell carcinoma most commonly seen in female older dogs

U/S Mattoon and Pennick (8 decks)

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