Chapter 27 Pedi Kidneys

Question 1

Occurs when the fetus is stressed during a difficult delivery or a hypoxic insult.

Answer 1

Adrenal hemorrhage

Question 2

Lie at the base of the medullary pyramids and appear as echogenic structures.

Answer 2

Arcuate arteries

Question 3

Congenital polycystic kidney disease that usually presents during middle age; the severity of the disease varies widelyautosomal dominant polycystic kidney disease (ADPKD)

Answer 3

autosomal dominant polycystic kidney disease (ADPKD)

Question 4

Rare, conginital polycystic renal disease; typically occurs with diffuse enlargement, sacculations and cystic diverticula of the medullary portions of the kidneys.

Answer 4

autosomal recessive polycystic kidney disease (ARPKD)

Question 5

Most common benign renal tumor of the neonate and infant

Answer 5

congenital mesoblastic nephroma

Question 6

Outer rim of the kdiney; in the neionate it has an echogenicity similar to that of the normal liver parenchyma

Answer 6

cortex

Question 7

Dilation of any tubular vessel

Answer 7

ectasia

Question 8

Ectopic insertion and cystic dilation of distal ureter of duplicated renal collecting system

Answer 8

ectopic ureterocele

Question 9

dilation of the renal collecting system

Answer 9

hydronephrosis

Question 10

large and hypoechoic in the neonate

Answer 10

medullary pyramids

Question 11

Most common cause of renal cystic disease in the neonate; multiple cystic masses within the kidney; may have contralateral ureteral pelvic junction obstruction

Answer 11

multicystic dysplasit kidney (MCDK)

Question 12

Abnormal persistence of fetal renal blastoma

Answer 12

nephroblastomatosis

Question 13

Malignant adrenal mass seen in pediatric patients; hemorrhaging tumor consisting promarily of cells resembling neuroblasts

Answer 13

neuroblastoma

Question 14

Poorly function ing enlarged kidneys

Answer 14

polycystic renal disease

Question 15

Most common cause of bladder outlet obstruction in the male neonate

Answer 15

posterior urethral valves

Question 16

classification of cystic renal disease

Answer 16

Potter facies

Question 17

Dilation of the fetal abdomen to severe bilateral hydronephrosis and fetal ascites; fetus also has oligohydramnios and pulmonary hypoplasia

Answer 17

prune-belly syndrome

Question 18

underdevelopment of the lung tissue that occurs in utero secondary to oligohydramnios

Answer 18

pulmonary hypoplasia

Question 19

Kidny becomes enlarged and edematous as a result of obstruction of the renal vein

Answer 19

renal vein thrombosis

Question 20

Most common neonatal obstruction of the urinary tract; results from intrinsic narrowing or extrinsic vasular compression

Answer 20

ureteropelvic junction obstruction

Question 21

Adds cardiac and limb anomalies to the VATER syndrome

Answer 21

VACTERL

Question 22

Vetebral, anal, tracheoesophageal fistula and renal anomalies

Answer 22

VATER

Question 23

Most common malignant tumor in the neonate and infant

Answer 23

Wilms’ tumor (nephroblastoma)

Question 24

In the second trimester, the kidney develops from small _______ composed of a central large pyramid with a thin peripheral rim of cortex.

Answer 24

renunculi

Question 25

As the renunculi fuse progressively, their adjoining cortices form a(n) ___________.

Answer 25

column of Bertin

Question 26

The former renunculi are at the point called ________.

Answer 26

lobes

Question 27

The _________ continues to grow throughout childhood, whereas the ______ become smaller in size.

Answer 27

cortex, pyramids

Question 28

The larger amount of cortical ______ is not present in the neonate and pediatric patient, which allows clear distinction of the corticomedullary junction.

Answer 28

fat

Question 29

The _______ are large and hypoechoic and should not be mistaken for dilated calyces or cysts.

Answer 29

medullary pyramids

Question 30

The surrounding cortex is quite thin, with echogenicity essentially similar to or slightly greater than that of normal _______ parenchyma.

Answer 30

liver

Question 31

The ______ vessels are seen as intense specular echoes at the corticomedullary junction.

Answer 31

arcurate

Question 32

At the siste of the fetal obulation, a parenchymal tringular defect may be identified in the anterosuperior or inferoposterior aspect of the kidney, known as a(n) _________ defect.

Answer 32

junctional parenchymal

Question 33

Each adrenal glad lies immediately ________ to the upper pole of the kidney.

Answer 33

superior

Question 34

The normal urinary bladder is thin-walled in the distended state and should measure less than ______ mm.

Answer 34

3

Question 35

The dilatation of the urinary collecting system is known as _______.

Answer 35

hydronephrosis

Question 36

The most common type of obstruction of the upper urinary tract is ______; it most often results from intrinsic narrowing or extrinsic vascular compression at the level of the ureteropelvic junction.

Answer 36

ureteropelvic junction obstruction

Question 37

The obstruction produces _____(proximal or distal) dilatation of the collecting system; the ureter is normal in caliber.

Answer 37

proximal

Question 38

The most common cause of bladder outlet obstruction in the male neonate is ________ valves.

Answer 38

posterior urethral

Question 39

Urinary _______ or a perirenal ______ can result from high-pressure vesicoureteral reflux rupturing a calyceal fornix or tearing the renal parenchyma.

Answer 39

ascites, urinoma

Question 40

The ectopic _______ is seen as a fluid mass within the rinary bladder and is located inferomedially to the ureteral insertion of the lower pole ureter.

Answer 40

ureterocele

Question 41

The triad of hypoplasia, or deficiency, of the abdominal musculature, cryptorchidism, and urinary tract anomalies is known as the ________ syndrome.

Answer 41

prune belly

Question 42

The most common cause of renal cystic disease presenting in the neonate is ______, and when hydronephrosis is excluded, it is the most comon cause of an abdominal mass in the newborn.

Answer 42

multicystic dysplastic kidney

Question 43

Sonographically, the classic appearance of MCDK is of a unilateral mass resembling a bunch of grapes, which represents a cluster of discrete _____ cysts, the larges of which are peripheral.

Answer 43

noncommunicating

Question 44

The kidneys are hyperechoic and greatly enlarged with a hypoechogenic outer rim, which represents the cortex compressed by the expanded pyramids in __________.

Answer 44

autosomal recessive polycystic kidney disease

Question 45

The most common intra-abdominal malignant renal tumor is _________ in young children.

Answer 45

Wilms’ tumor

Question 46

A (n) _________ is a malignant tumor that arises in sympathetic chain ganglia and adrenal medulla; it may be dectected on antenatal sonography or at birth.

Answer 46

neuroblastoma

Question 47

About half of neuroblastoma tumors arise in the medulla of the ________, although tumors have also been found in the neck, mediastinum, retroperitoneum, and pelvis.

Answer 47

adrenal gland

Question 48

Sonographically, adrenal ________ results in ovoid enlargement of the gland or a portion of the gland.

Answer 48

hemorrhage