Wk 7

Question 1

Rental disease overview

Answer 1

50 million in US have renovascular hypertension.
Rental disease is underlying cause for 8% of hypertensive patients.
Duplex has 80-90% accuracy for identifying renal stenosis.
MRA/CTA

Question 2

Kidney anatomy

Answer 2

Regulates volume and chemical composition of body fluids.
Excrete most water soluble water products in urine.
Urine collects in bladder
Bladder empties by process of micturition

Question 3

Kidney anatomy facts

Answer 3

Located in retroperitoneum. Dorsal cavity.
Either side of spine by 12th thoracic and 3rd lumbar vertebrae.
Normal kidney is 8-13cm
Size decreases with age

Question 4

Hilum

Answer 4

Portal of entry for rental vein and artery, and exit for ureter.
Medal side of kidney

Question 5

Sinus

Answer 5

Cavity containing renal vein and artery and collecting lymp system

Question 6

Parenchyma

Answer 6

Renal tissue composed of medulla and cortex

Question 7

Kidney make up

Answer 7

One million nephrons, each contain a glomerulus and tubule.

Question 8

Glomerulus

Answer 8

Filters the blood

Located in cortex (1/3 of kidney)

Question 9

Tubule

Answer 9

Reabsorbs and secrete fluid and electrolytes to adjust urinary composition

Question 10

Medulla

Answer 10

Inner 2/3 of kidney

Contains dark striated areas=pyramids, and intervening columns.

Question 11

Dromedary hump

Answer 11

Variant
Focal bulge
Mostly seen in left kidney
Normal appearance

Question 12

Horseshoe kidney

Answer 12

Kidneys connected by lower poles

<1% of population

Question 13

Hydro plastic kidney

Answer 13

Small kidney
May be normal, incomplete development.
Usually unilateral.
Incidental finding. 
Normal kidney typically larger

Question 14

Hydronephrosis

Answer 14

Partial or complete urinary tract obstruction.
All connected, vs cysts are separate clumps on screen.
Bladder
Ureter
Urethral
Intrarenal

Question 15

Renal calculi

Answer 15

Loin pain
Hematuria
UT obstruction. 
Calcific shadow
Put color and Doppler on
No flow=cysts
Flow=mass

Question 16

Renal cysts

Answer 16

Hypoechoic
Clearly defined margins 
Acoustic enhancement 
Not all cysts effect kidney function 
Increase with age

Question 17

Autosomal-dominant polycystic kidney disease

Answer 17

Genetic
Predisposed for end stage renal disease. 
Loss of cortex
Hepatic cysts common
Loin pain, headache, hematuria

Question 18

Renal exam

Answer 18

Measure kidney
Signals from Dist RA and RV.
PSV and EDV
Any incidental findings

Question 19

Acceleration index

Answer 19

Slope of systolic upstroke divides by frequency

Question 20

Acceleration time

Answer 20

Time interval between onset and initial peak

Question 21

Parvus tardus

Answer 21

Indicated prox obstruction

Question 22

Resistive index

Answer 22

State of parenchyma.
Low index is low resistance.
High index indicates renal parenchymal disease.
RI >.8 is medical renal disease.
(PSV-EDV)/PSV.
Velocities in upper mid lower poles; and average.

Question 23

Acute renal failure

Answer 23

Normal kidney size and texture

High resistance flow

Question 24

Chronic renal failure

Answer 24

Small kidney size
Thinning of cortex
High resistance in end stages.