2nd & 3rd Tri: Genitourinary System

Question 1

When can kidneys be detected?

Answer 1

12-14 weeks

pg. E 144

Question 2

What is a normal renal pelvis measurement?

Answer 2

5 -10 mm (increasing with greater gestational age)

pg. E 144

Question 3

When can the bladder be detected sonographically?

Answer 3

10 weeks

pg. E 144

Question 4

How often does a bladder typically fill and empty?

Answer 4

every 20-30 min

pg. E 144

Question 5

What structure can mimic the kidneys?

Answer 5

adrenal gland

pg. E 145

Question 6

What is renal agenesis?

Answer 6

congenital absence of one or both kidneys

pg. E 145

Question 7

How common is unilateral renal agenesis?

Answer 7

1: 1000 births

pg. E 145

Question 8

What is unilateral renal agenesis typically associated with?

Answer 8

single umbilical artery

pg. E 145

Question 9

What is associated w/ bilateral renal agenesis?

Answer 9

Potter’s syndrome

pg. E 145

Question 10

What are the sonographic findings of renal agenesis?

Answer 10

severe oligohydramnios
absence of kidneys and arteries
bilateral: bladder not seen
pg. E 145 O 393

Question 11

What is autosomal recessive polycystic kidney disease (ARPKD)?

Answer 11

Potter’s Type 1
inherited by both parents
symmetric renal enlargement by multiple cysts
pg. E 146

Question 12

What are the sonographic findings of Potter’s type 1?

Answer 12

enlarged echogenic 
oligohydramnios
small bladder
normal (14-16 weeks)
pg. E 146

Question 13

What is multicystic dysplastic kidney (MCDK)?

Answer 13

Potter’s type 2
obstruction of kidney leading to cyst formation
pg. E 146

Question 14

What are the sonographic findings of Potter’s type 2?

Answer 14

multiple, variable sized cysts
no bladder (if bilateral)
oligohydramnios
pg. E 146

Question 15

What is the most common cause of fetal hydronephrosis?

Answer 15

ureteropelvic junction

pg. E 147

Question 16

What is a ureteropelvic junction?

Answer 16

obstruction of urine flow from renal pelvis to ureter

pg. E 147

Question 17

What are the sonographic findings of UPJ?

Answer 17

dilated renal pelvis
caliectasis (enlarged calyces)
normal AFI
pg. E 147 O 393

Question 18

What causes a UPJ obstruction?

Answer 18

abnormal bend in ureter
fibrous adhesions
pg. E 147 O 393

Question 19

What is the least common cause of hydronephrosis?

Answer 19

ureterovesical obstruction

pg. E 147

Question 20

Why does ureterovesical obstruction occur?

Answer 20

ureteral duplication w/ ureterocele
congenital
stenosis
pg. E 147-148 O 394

Question 21

Which gender are bladder outlet obstructions most common in?

Answer 21

males

pg. E 148

Question 22

What is the most common bladder outlet obstruction in males?

Answer 22

posterior urethral valves

pg. E 148

Question 23

What is the most common bladder outlet obstruction in females?

Answer 23

cloacal malformations or urethral atresia

pg. E 148

Question 24

What is posterior urethral valve obstruction?

Answer 24

presence of a membrane within posterior urethra so urine cannot pass
leads to overdistended bladder
pg. E 148 O 393

Question 25

What are the sonographic findings of posterior urethral valve obstruction?

Answer 25

``` "keyhole" sign - bladder and urethra dilated bladder wall thickening hydroureter hydronephrosis oligohydramnios pg. E 148 O 393 ```

Question 26

What is urethral atresia?

Answer 26

absent urethra that results in complete obstruction incompatible w/ life pg. E 149

Question 27

Which gender can get urethral artresia?

Answer 27

both | pg. E 149

Question 28

What are the sonographic findings of urethral atresia?

Answer 28

no amniotic fluid > 16 wks pulmonary hypoplasia pg. E 149

Question 29

What is cloacal malformation?

Answer 29

convergence of GI and GU tracts single opening in the perineum empties both GI and GU if obstructed GI and GU tracts are dilated pg. E 149

Question 30

What are the findings of cloacal malformation?

Answer 30

severe obstruction oligohydramnios poor prognosis pg. E 149

Question 31

What is a urachal cyst?

Answer 31

cystic mass between the fetal anterior abdominal wall and the anterior portion of the bladder pg. E 149

Question 32

What is another name for Prune Belly Syndrome?

Answer 32

Eagle-Barrett syndrome | pg. E 149

Question 33

What is Prune Belly Syndrome?

Answer 33

weakened abdominal wall musculature w/ dilated bladder/ureters/kidneys pg. E 149

Question 34

What is the most common cause of prune belly syndrome?

Answer 34

posterior urethral valves | pg. E 149

Question 35

What are the sonographic findings of prune belly syndrome?

Answer 35

``` abnormal compression of abdominal wall oligohydramnios bilateral hydronephrosis distended bladder pg. E 149 ```

Question 36

When do testes typically descend into scrotum?

Answer 36

26-34 weeks | pg. E 150

Question 37

Are hydroceles common?

Answer 37

small are common large need to be evaluated postnatal pg. E 150

Question 38

What is a fetus w/ male genitalia and ovaries described as?

Answer 38

46XX intersex or hermaphroditism

Question 39

When do the kidneys begin to produce urine?

Answer 39

12 weeks

Question 40

When do the kidneys take over on fluid production?

Answer 40

16 weeks