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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
Q

Even though ureteral tumors are rare, what are some types of neoplasias that have been reported

A

leiomyoma, leiomyosarcoma, fibropapiloma, TCC

26
Q

what is the most common congenital anomaly that produces hydronephrosis

they are more common in males or females?

A

ectopic ureters

females

27
Q

What can cause bilateral vs unilateral perirenal effusion

A

bilatera- acute renal failure due to nephrotoxocity, lepto, interstitial nephritis

unilateral- pelvic or ureteral obstruction or rupture

28
Q

What are urinomas?

A

encapsulated accumulation of urine caused by a traumatic extravasation

29
Q

Ddx for retroperitoneal masses

A

abscess- migrating grass awns commonly cause sublumbar abscess

granulomas

neoplasia- sarcomas

lymphadenopathy

30
Q

A mass _______ to the kidney may arise from adrenal gland, whereas one caudal to the kidney may arise from peritoneal structures.

A

craniomedial

31
Q

Subscapsular or perirenal fluid may occur from:

A

blood

urine

exudate

transudate

32
Q

With what diseases perinephric pseudocysts have been associated with

A

interstitial nephritis

hydronephrosis

polycystic renal disease

neoplasia

33
Q

How does resistive index is calculated

what is the normal RI in dogs and cats

What can cause an increased RI

A

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
Q

true or false: renal vein and arterial occulsion will lead to renal infarction

A

true

renal vein thrombosis may cause edema and renal enlargement

35
Q

What are the 4 layers of the urinary bladder

A

mucosa- hypoechoic

submucosa- hyperechoic

muscularis- hypoechoic

serosa- hyperechoic

36
Q

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.

A

6 months

37
Q

Ureterovaginal fistulas may develop from:

A

penetrating trauma or inadvertent ligation of ureter during OHE

38
Q

Limitations for ultrasonographic identification of ectopic ureters

A

when there is an intrapelvic bladder

when there is invagination or tunneling of ureters

39
Q

how renal parenchyma looks in acute vs chronic renal disease

A

acute- preserves corticomedullary definition

chronic - looses corticomedullary definition

40
Q

when to consider bx the kidneys

A

protein loosing enteropathy and inflammatory disease

41
Q

what canine breed is reported to get hemorrhagic cysts

A

german shepherds

42
Q

ddx complex mass

A

abscess

granuloma

hematoma

neoplasia

43
Q

If renal lymphoma in a cat is suspected what other organ systems would you do a more thorough examination

A

GI and spine

44
Q

What ultrasonographic finding is pathognomonic for lymphoma in dogs and cats

A

hypoechoic to anechoic subcapsular rim

45
Q

What are measurements of the renal pelvis when pyelectasia vs hydronephrosis will be considered (cole numbers)

A

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
Q

Normal urinary bladder wall thickness

A

2-3mm anything above 4mm is abnormal

47
Q

Ultrasonographic appearance cystitis

A

thickened irregular cranioventral aspect of urinary bladder wall

48
Q

Causes for cystitis:

A

bacterial

inflammatory

calculi

necrotic debris

blood clots

fungal- Histoplasma capsulatum, candida

49
Q

Types of cystitis:

A

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
Q

Ddx for this

A

pseudomembranous cystitis

encrusting cystitis

characterized by severe diffuse thickening of urinary bladder wall with multiple hyperechoic luminal septations

51
Q

Sonographic appearance of blood clots

A

hyperechoic

non shadowing

irregular in shape

gravity dependent

may see adherent

can use doppler to ddx hematoma vs mass

52
Q

What canine breed are reported to gt polypoid cystitis

A

Springle Spaniels

53
Q

Most common neoplasia of bladder

A

TCC

typically an irregular bladder mass with borad based attachment projecting into the lumen

dorsal wall adjacent to the trigone

54
Q

Other than TCC what are some other bladder tumors

A

squamous cell carcinoma

rhabdomyosarcoma

leiomyosarcoma

hemangiosarcoma

lymphoma

55
Q

What are ureteroceles

A

cystic dilations of the terminal ureter within the urinary bladder.

can be divided into: orthotopic or ectopic

56
Q

what is a vesicouracha diverticulum

A

fluid filled structure that extends as a convex outpouching of the bladder lumen

typically cranioventral wall

57
Q

What FB have been found in the urinary bladder?

A

grass aws

catheter parts

BBs

suture material

58
Q

Non shadowing gravity dependent sediment may represent:

A

cellular debris, fat, proteinuria, minerals, crystalluria

59
Q

Most common types of urethral tumors

A

TCC

squamous cell carcinoma

most commonly seen in female older dogs

U/S Mattoon and Pennick (8 decks)

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