Chapter 7 The Urinary Tract Flashcards
(203 cards)
1
Q
What is the most common location for a urolithiasis to become lodged?
A
Ureterovesicular junction
2
Q
a stone that completely fills the renal pelvis is referred to as:
A
Staghorn calculus
3
Q
Clinical findings of Glomerulonephritis
A
- recent throat infection
- smoky urine
- hematuria
- proteinuria
- fever
- Hypertension
- Azotemia
4
Q
The most common cause of fungal UTI is:
A
Candida Albicans
5
Q
The presence of purulent material within the renal collecting system is termed:
A
Pyonephrosis
6
Q
_____would be a common finding in a patient undergoing peritoneal dialysis?
A
Ascites
7
Q
Suspicion of cortical thinning should occur when the renal cortex measures:
A
Less than 1cm
8
Q
Clinical findings of a simple renal cyst
A
- Asymptomatic
9
Q
The systemic disorder associated with epilepsy that leads to the development of solid tumors in various organs, including angiomyolipomas of the kidney, is:
A
Tuberous sclerosis
10
Q
Describe the sonographic appearance of a kidney affected by ARPKD:
A
Bilateral enlarged, echogenic kidneys
11
Q
Infantile polycystic kidney disease may also be referred to as:
A
ARPKD
12
Q
_____would most likely present with a clinical finding of hematuria?
A
Hemorragic renal cyst
13
Q
______ is considered the most common solid renal mass?
A
Angiomyolipoma
14
Q
What is the most likely location of TCC in the kidney?
A
Renal pelvis
15
Q
The inherited disorder associated with the development of tumors of the central nervous system and orbits, renal cysts, and adrenal tumors is:
A
Von Hippel-Lindau syndrome
16
Q
Renal cysts that project out away from the kidney are termed:
A
Exophytic
17
Q
Sonographically, compared to normal kidneys, those affected by CRF will appear:
A
Smaller in size and more echogenic
18
Q
What renal cystic disease would be most likely caused by and thus associated with hemodialysis?
A
Acquired renal cystic disease
19
Q
______is the most common cause of CRF
A
Diabetes mellitus
20
Q
What is the most common location of an ectopic kidney:
A
Pelvis
21
Q
A renal scar most likely appears as:
A
Echogenic area that extends from the renal sinus through the renal parenchyma
22
Q
The most common congenital anomaly of the urinary tract is:
A
Duplicated collecting system
23
Q
A bulge on the lateral border of the kidney is referred to as:
A
Dromedary hump
24
Q
Enlargement of the unaffected contralateral kidney with unilateral renal agenesis or compromised renal function is AKA:
A
Compensatory hypertrophy
25
The vessel located **anterior** to the **abdominal aorta** and **posterior** to the **superior mesenteric artery** is the:
Left renal vein
26
The protective capsule of the kidney is referred to as:
Renal capsule
27
_____are retroperitoneal organs
Kidneys
28
What is the functional unit of the kidneys?
Nephron
29
_______is a _childhood_, **autoimmune disease** that results in the development of **purple spots** on the **skin** and possible **renal failure**?
Henoch-schonlein purpura
30
Sonographic findings of a renal hematoma
1. Variable appearance depending on the stage of the blood
2. Blood may accumulate under the capsule(subcapsular), in the perinephric area or intramuscular
3. Chronic hematomas may calcify and produce acoustic shadowing
31
Clinical findings of a renal hematoma (5):
1. trauma to the kidneys
2. flank pain
3. abdominal pain
4. hematuria
5. decreased hematocrit
32
_____is a primary form of renal cancer, meaning this form of cancer begins in the kidneys, specifically originates from renal tubular epithelium
Renal cell carcinoma
33
Clinical findings of renal cell carcinoma (7):
1. Anorexia
2. flank pain
3. gross hematuria
4. hypertension
5. palpable mass
6. smoker
7. weight loss
34
Sonographic findings of renal cell carcinoma
1. Hypoechoic, isoechoic or hyperechoic solid mass on the kidney
2. Can have a complex cystic appearance as well
3. check the renal vein and IVC for tumor invasion
35
______of the kidney is a **malignant tumor** that is most often **found in** the area of the **renal pelvis**
Transitional cell carcinoma
36
Clinical findings of renal transitional cell carcinoma
1. gross hematuria
2. pain secondary to renal obstruction
3. history of smoking
37
Sonographic findings of renal transitional cell carcinoma (2):
1. hypoechoic or isoechoic mass in renal sinus
2. Hydronephrosis may be present
38
Renal adenoma typically measure:
Less than 1cm
39
_____is a **benign mass** that appears sonographically **similar** to its malignant counterpart, the **RCC**
Renal adenoma
40
Sonographic findings of renal adenoma
1. Hyperechoic, vascular mass with internal calcifications
2. May produce acoustic shadowing
41
Clinical findings of renal adenoma
1. Asymptomatic
2. May complain of hematuria
42
Sonographic findings of other renal malignancies
1. Bilateral, hypoechoic masses with lymphoma
2. Lymphoma or leukemia can manifest as an enlarged kidney
3. Metastases have varying sono findings but most often solid tumors are hypoechoic or hyperechoic
43
Clinical findings of other renal malignancies
1. History of primary cancer (often lung or breast)
2. Hematuria
3. fever
4. weight loss
44
Compression or entrapment of the left renal vein as it passes between the SMA and abdominal aorta is termed:
Nutcracker syndrome
45
Clinical findings in nutcracker syndrome (4):
1. Hematuria
2. Proteinuria
3. Possible left-sided abdominal or flank pain
4. Left-sided testicular pain
46
Sonographic findings of nutcracker syndrome (2):
1. Compression of the left renal vein
2. Elevated pressure within the left renal vein
47
Sonographic findings of renal vein thrombosis
1. heterogeneous renal echotexture
2. enlarged renal vein
3. absent renal vein doppler signals
4. thrombus may not be seen
48
Clinical findings of renal artery stenosis
1. Smoker
2. high BP
3. high cholesterol
4. diabetes
5. Hypertension that does not respond to treatment
49
____is a blood clot within the renal vein
Renal vein thrombosis
50
Clinical findings of renal vein thrombosis
1. pain
2. hematuria
51
Sonographically renal lipomas are:
1. Well-circumscribed, hyperechoic mass
2. Measures less than 5mm in diameter
52
Clinical findings of a renal lipoma
1. Asymptomatic
53
Clinical findings of a renal hemangioma
1. Asymptomatic
2. Hemorrhage of the mass can lead to pain and hematuria
54
Sonographic findings of a renal hemangioma
1. Small, hyperechoic mass
55
_____ is a **benign renal tumor** that is often **found in men in their 60s** and is the second most common renal mass after the angiomyolipoma
Oncocytoma
56
Sonographic findings of an oncocytoma
1. Isoechoic, hyperechoic, or hypoechoic mass
2. May also contain a hypoechoic central scar
57
Clinical findings of an oncocytoma
1. Asymptomatic
2. May produce pain or hematuria
58
______is the most common benign renal tumor
Angiomyolipoma
59
Clinical findings of angiomyolipoma (3):
1. Asymptomatic in most individuals
2. Patient may have a history of tuberous sclerosis
3. Pain, hematuria and hypertension can occur with hemorrhage of the mass
60
Sonographic findings of angiomyolipoma (3):
1. Solid, hyperechoic mass
2. acoustic shadowing
3. multiple and bilateral with tuberous sclerosis
61
Sonographically, cortical nephrocalcinosis appears as:
Small calculi within the cortex
62
Medullary sponge kidney appears sonographically as:
Highly echogenic renal pyramids that may shadow
63
**Nephrocalcinosis** that occurs within the **cortex** is termed:
Cortical nephrocalcinosis
64
Two forms of nephrocalcinosis
* Medullary nephrocalcinosis
* Cortical Nephrocalcinosis
65
______is the accumulation of calcium within abnormally dilated collecting ducts located within the medulla
Medullary sponge kidney
66
_____is an accumulation of calcium within the renal parenchyma
Nephrocalcinosis
67
Sonographic findings of nephrocalcinosis
1. Medullary nephrocalcinosis (echogenic renal pyramids, medullary sponge kidney)
2. Cortical nephrocalcinosis (echogenic foci within the cortex)
68
Clinical findings of nephrocalcinosis
1. hypercalcemia
2. hyperparathyroidism
3. UTI
4. history of urinary calculi
69
Sonographic findings of urolithiasis
1. echogenic focus that produces acoustic shadowing
2. "twinkle sign" seen posterior to the stone with the use of color doppler
3. Hydronephrosis and dilation or ureter may be present
70
A stone that completely fills and takes on the shape of the renal pelvis is called
Staghorn calculus
71
_____are kidney stones located anywhere within the urinary tract
urolithiasis
72
Clinical findings of urolithiasis (4):
1. hematuria
2. renal colic
3. oliguria
4. UTI
73
Abnormalities that are located **outside** the urinary tract that leads to **renal obstruction** are referred to as:
Extrinsic causes of hydronephrosis
74
Irregularities that lead to **renal obstruction** that are located **inside** the urinary tract are called:
intrinsic causes of hydronephrosis
75
____is dilation of the calices, infundibula and renal pelvis
Hydronephrosis
76
sonographic findings of renal artery stenosis
1. thickening and calcification of the renal artery may not be noted
2. renal to aorta ratio that is greater than 3.5
3. possibly a tardus-parvus spectral waveform downstream from the stenosis
77
Sonographic findings of hydronephrosis
1. anechoic fluid filling all or part of the renal collecting system
2. can also alter the renal artery resistive index within the arcuate or interlobar vessels
78
Dilation of the urinary tract occurs:
proximal to the level of obstruction
79
Sonographic findings of chronic glomerulonephritis
1. Small, echogenic kidneys
80
Clinical findings of renal fungal disease
1. immunocompromised person
2. diabetes mellitus intravenous drug abuse or long-standing indwelling catheter
3. infant with an indwelling catheter
4. flank pain
5. fever
6. chills
81
Clinical findings of glomerulonephritis (7):
1. recent throat infection (acute)
2. smoky urine
3. hematuria
4. proteinuria
5. fever
6. hypertension
7. Azotemia
82
A stellate (star-shaped) central scar may be noted within an:
oncocytoma
83
______is a hereditary disorder that may also be referred to as infantile polycystic kidney disease
Autosomal recessive polycystic kidney disease
84
Clinical findings of ARPKD (2):
1. Clinical findings of renal failure
2. Abnormal LFTs
85
Sonographic findings of ADPRD
1. Bilateral enlarged kidneys that contain numerous cortical renal cysts
2. Possible cyst identified in the pancreas, liver and/or spleen
86
Clinical findings of ADPKD
1. Asymptomatic until 3rd or 4th decade of life
2. Decreased renal function
3. UTI
4. Renal calculi
5. Flank pain
6. Hematuria
7. Palpable abdominal mass
87
_______are located within the cortex and maybe difficult to differentiate from prominent renal pyramids, especially if solitary
Small cortical cysts
88
_____ is one that originates in the renal parenchyma and protrudes into the renal sinus
Parapelvic cyst
89
Renal cysts that appear to be projecting out away from the kidney may be termed:
Exophytic
90
Sonographic findings of a simple renal cyst
1. Anechoic mass
2. Smooth walls
3. Posterior acoustic enhancement
91
Clinical findings of a simple renal cyst
1. Asymptomatic
92
_____is the most common renal mass
Simple cyst
93
____uses a solution that is instilled into the abdominal via a catheter
Peritoneal dialysis
94
Both ______utilize a machine that essentially acts as a kidney whereby it extracts the patient's blood, filters it and returns the filtered blood
Hemodialysis and hemofiltration
95
Dialysis may be either in the form of:
* Hemodialysis
* Hemofiltration
* Peritoneal dialysis
96
_____is used to remove the accumulated urea, other wasted materials and excess water from patient whose kidney function is inadequate
Dialysis
97
The most common cause of chronic renal failure is
Diabetes mellitus
98
Kidneys that fail to function normally will lead to:
End-stage renal disease
99
The gradual decrease in renal function over time, typically months or years is referred to as:
Chronic renal failure
100
Clinical findings of chronic renal failure
1. Diabetes mellitus
2. Malaise
3. Elevated BUN and creatinine
4. fatigue
5. Hypertension
6. Hyperkalemia
101
Sonographic findings of chronic renal failure (4):
1. Small, echogenic kidneys
2. Cortical thinning
3. Loss of normal corticomedullary differentiation
4. Renal cysts
102
_____ is the cystic dilation of the ureter as it enters the bladder
ureterocele
103
Urinary jets typically occur at least:
once every minute
104
Enlarged and distended with urine, the ureters will appear as:
*anechoic
*tubular structures
105
The point at which the ureter meets the urinary bladder is referred to as:
Ureterovesicular junction
106
Patent urachus will appear as an:
Anechoic tube that extends from the umbilicus to the apex of the urinary bladder
107
Urachal cyst and urachal diverticulum will appear as a:
Cystic structure between the bladder and the umbilicus
108
Urachal sinus will appear as a:
Linear fluid-filled structure that is continuous with the umbilicus
109
______ is a remnant of embryonic development
Urachus
110
_____is the most common solid malignant pediatric abdominal mass
Wilms tumor
111
_______, is the retrograde flow of urine from the bladder to the ureter, is a widespread malady in the pediatric population
VUR
112
_____are folds of excessive urethral tissue found exclusively in males
Posterior urethral valves
113
The most common cause of congenital hydronephrosis in infants and children is a:
Ureteropelvic junction obstruction
114
_____cause dilation of the bladder, both ureters and both renal collecting systems
Posterior urethral valves
115
_____is typically by megacystis, a massively dilated urinary bladder
Prune belly syndrome
116
_____describes the result of the abdominal wall musculature being stretched by the extremely enlarged urinary bladder
Prune belly syndrome
117
The most common congenital anomaly of the urinary tract is the:
Duplex or duplicated collecting systems
118
A sudden decrease in renal function, typically over the course of days or weeks, is termed
Acute renal failure (ARF)
119
_____is an autoimmune, inflammatory vascular disease that mostly affects children and can permanently damage the kidneys
Henoch-schonlein purpura
120
The most common cause of ARF is:
Acute tubular necrosis
121
Clinical findings of a ureterocele
1. Asymptomatic
2. Signs of a UTI
122
Sonographic findings of a ureterocele
1. Anechoic, balloon-like structure within the urinary bladder near the ureterovesicular junction
123
Clinical findings of megaureter and hydroureter
1. Asymptomatic
2. UTI
124
Sonographic findings of megaureter and hydroureter
1. Large, anechoic tubular structure that extends from the kidney to the urinary bladder, only a section may be enlarged
125
The _____ marks the single urethral opening and bilateral ureteral openings
Trigone
126
The _____ controls the appropriate emptying of the urinary bladder
Detrusor muscle
127
The four layers of the bladder wall
*Mucosa
*Submucosa
*Muscularis
*Serosa
128
When the bladder wall is thickened, its diameter will exceed _______in a distended state
4mm
129
______elevates as a result of cell death
LDH
130
The _____can be used to evaluate the overall function of the kidney
GFR
131
An elevation in either BUN or creatinine indicates
Some form of renal disease
132
______Measures the amount of creatinine phosphate found in the skeletal muscles
Creatinine
133
______measures the amount of urea nitrogen, a byproduct of protein metabolism that occurs within the liver and is excreted by kidneys
BUN
134
The left renal vein has to travel across the abdomen, between the:
SMA and Abdominal aorta
135
The renal veins exit the kidneys at their respective renal hilums and connect to the:
Lateral aspects of the IVC
136
The right renal artery travels _____ and is therefore longer than the left renal artery
Posterior to the IVC
137
The renal medullary, the inner part of the parenchyma id responsible for:
Absorption
138
Neurogenic bladder may be caused by:
*Brain or spinal trauma
*Congenital spinal abnormalities
*Diabetes
139
_______is poorly functioning secondary to any type of neurologic disorder
neurogenic bladder
140
Sonographic findings of a neurogenic bladder
1. Urinary bladder wall thickening
2. Trabeculae of the bladder wall
3. Postvoid images will show excessive urinary retention
4. The patient may have a distended bladder but does not feel the need to urinate
5. Bladder stones may be present
141
Clinical findings of a neurogenic bladder
1. Past history of brain or spinal trauma, congenital spinal abnormalities or diabetes
2. Unnecessary urgency to void
3. Rarely feel the need to urinate
142
______is an outpouching in the bladder wall
Bladder diverticulum
143
Clinical findings of a bladder diverticulum
1. Can be asymptomatic
2. UTI
144
Sonographic findings of a bladder diverticulum
1. Anechoic outpouching of the bladder wall
2. A visible neck connecting the diverticulum to the bladder
145
Inflammation of the urinary bladder is referred to as _______
Cystitis
146
Clinical findings of cystitis
1. Dysuria
2. Urinary frequency
3. Lower abdominal pain
4. Nocturia
5. Hematuria
147
Sonographic findings of cystitis
1. Hypoechoic bladder wall that may appear focally or diffusely thickened, measuring greater than 4mm in thickness
2. Bladder may contain echogenic layering material echogenic layering material within its lumen
148
Sonographic appearance of bilateral stones
1. Echogenic, mobile, shadowing foci within the lumen of the urinary bladder
149
Sonographic appearance of blood clots in the bladder
1. Echogenic, nonshadowing mass that may be mobile or adhered to the wall of the bladder
150
The most common malignant tumor of the bladder is:
Transitional cell carcinoma
151
Clinical findings of transitional cell carcinoma of the bladder
1. Gross hematuria
2. May urinate blood clots
152
Sonographic findings of transitional cell carcinoma of the bladder
1. Smooth or papillary hypoechoic or hyperechoic mass that projects into the lumen of the bladder
2. A solid tumor will not be mobile and will often demonstrate vascularity
153
The _____begins at the trigone of the urinary bladder and ends at the urethral orifice
Uretha
154
The kidneys also work to regulate blood pressure by producing the enzyme ______
Renin
155
The nephron begins to function by the _____of gestation and urine production begins between 11 and 13 weeks
9th
156
The functioning unit of the kidney is the:
Nephron
157
Sonographic findings of acute glomerulonephritis
1. Enlarged kidney(s) with increased echogenicity
2. Prominent renal pyramids
158
Sonographic findings of renal fungal disease
1. Fungal balls appear as hyperechoic nonshadowing, mobile structures within the renal collecting system
159
"Xantho" means
Yellow
160
Clinical findings of xanthogranulomatous pyelonephitis
1. Dull or persistent flank pain
2. Pyuria
3. Hematuria
4. fever
5. Leukocytosis
161
Sonographic findings of Xanthogranulomatous pyelonephritis
1. Hydronephrosis
2. Staghorn calculus
3. Perinephric fluid collection
162
A rare and yet life threatening, complication of pyelonephritis is
Emphysematous pyelonephritis
163
Sonographic findings of emphysematous pyelonephritis
1. Gas or air within the renal parenchyma
2. Dirty shadowing or reverberation artifact coming from the renal parenchyma
164
Clinical findings of emphysematous pyelonephritis
1. Diabetes mellitus
2. Immunocompromised patient
3. Fever
4. Flank pain
5. Leukocytosis
165
Sonographic findings of a renal or perinephric abscess (3):
1. Anechoic, hypoechoic or complex
2. Gas shadows/dirty shadowing
3. Reverberation artifact
166
_____is a collection of purulent material that has leaked through the capsule into the tissue surrounding the kidney
Perinephric abscess
167
Clinical findings of a renal or perinephric abscess
1. Symptoms of pyelonephritis
2. fever
3. Flank pain
4. Leukocytosis
168
_____can lead to xanthogranulomatous pyelonephritis and end-stage renal disease
Chronic pyelonephritis
169
Clinical findings of chronic pyelonephritis
1. flank pain
2. bacteriuria
3. pyuria
4. leukocytosis
5. dysuria
6. urinary frequency
7. history of VUR
170
_____describes the condition of having **pus within** the **collecting system** of the **kidneys**
Pyonephrosis (purulent material)
171
Sonographic findings of pyonephrosis
1. hydronephrosis
2. pus and debris appear as internal, layering and low-level echoes within the dilated collecting systems
172
Clinical findings of pyonephrosis
1. pyuria
2. bacteriuria
3. fever
4. flank pain
5. leukocytosis
173
_____is an inflammation of the kidney or kidneys
Acute pyelonephritis
174
Sonographic findings of acute pyelonephritis
1. May appear normal
2. Renal enlargement
3. Focal areas of altered echotexture
4. Compression of the renal sinus
175
Clinical findings of acute pyelonephritis
1. Flank pain
2. bacteriuria
3. pyuria
4. leukocytosis
5. dysuria
6. urinary frequency
176
_____is a systemic disorder that leads to the development of tumors within various organs
tuberous sclerosis
177
Sonographic findings of tuberous sclerosis
1. Bilateral renal cysts
2. Bilateral angiomyolipomas
178
Clinical findings of tuberous sclerosis
1. Epilepsy
2. Skin lesions of the face
179
Sonographic findings of chronic pyelonephritis
1. Small, echogenic kidneys that have lobulated boarders
2. Renal scar appears as an echogenic area within the kidney that extends from the renal sinus through the renal parenchyma
180
Sonographic findings of Von hippel-lindau syndrome
1. Multiple renal cysts
2. Cysts may be complex and have mural nodules
3. Cysts within the pancreas
4. Pheochromocytoma present
181
Clinical findings of Von hipple- Lindau syndrome
1. Symptoms of a brain and/or an eye tumor
182
_____is an inherited disorder characterized by tumors of the central nervous system and orbits
von hippel-lindau syndrome
183
Acquired renal cystic disease is often the result of
Chronic hemodialysis
184
Sonographic findings of acquired renal cystic disease
1. The kidney will appear small initially during end-stage renal disease with some small cysts
2. With time, the kidneys may enlarge and have numerous small cysts noted throughout the renal parenchyma
185
Clinical findings of acquired renal cystic disease
1. clinical findings of CRF
2. History of hemodialysis
186
MCDK is thought to be caused by
An early, first trimester obstruction of the ureter
187
Sonographic findings of MCDK
1. Unilateral, smooth-walled noncommunicating cysts of varying sizes located within the renal fossa
2. Compensatory hypertrophy of the contralateral kidney
188
Clinical findings of multicystic dysplastic kidney disease
1. Asymptomatic
2. Normal renal function
189
Sonographic findings of the ARPKD
1. Bilateral, enlarged echogenic kidneys
2. Loss of corticomedullary differentiation
190
Sonographic findings of parasitic UTI
1. Schistosomiasis (bladder wall thickening
2. Hydatid cyst (depends on the stage of its maturation as it may appear completely anechoic, contain a daughter cyst with internal debris or complex mass
191
Clinical findings of parasitic UTI
1. Hematuria
2. Flank pain
3. Pyuria
4. Dysuria
5. Possible recent travel out of the country (hydatid cyst)
192
Clinical findings of acute renal failure
1. Elevated BUN & creatinine
2. Oliguria
3. Hypertension
4. Leukocytosis
5. Hematuria
6. Edema
7. Hypovolemia
193
Sonographic findings of acute renal failure
1. Normal kidneys
2. May appear more echogenic
3. Hydronephrosis may be present
194
Sonographic findings of vesicoureteral reflux
1. Patients with minimal reflux may have normal appearing kidneys
2. hydronephrosis and/or hydroureter may be present in the bladder
3. Bladder debris may be seen
195
VUR is the most commonly caused by an abnormal
Angle of insertion of the distal ureter into the bladder at the ureterovesicular junction, resulting in a faulty valve
196
Urine-containing bacterium that travels from the bladder, up the ureter and into the kidney, can result in
Kidney infection with subsequent scarring and permanent damage to the renal parenchyma
197
Clinical findings of vesicoureteral reflux
1. May be asymptomatic
2. unexplained fever
3. irritability
4. flank pain
5. leukocytosis
6. Bacteriuria
7. Hematuria
8. Dysuria
9. Urgency to void
198
Clinical findings of Wilms tumor
1. Palpable abdominal mass
2. Abdominal pain
3. Hematuria
4. Fever
5. Hypertension
199
Sonographic findings of Wilms tumor
1. Large, solid, mostly echogenic masses that may contain anechoic or hypoechoic areas
200
Clinical findings of urachal anomalies (2):
1. signs of UTI
2. Palpable abdominal mass between the umbilicus and urinary bladder
201
The most common place for a urinary stone to become lodged is
Ureterovesicular junction
202
Clinical findings of a ureteral stone
1. Renal colic
2. Pain in the groin, labia, or testicle on the side of the stone
3. possible hematuria
203
Sonographic findings of a ureteral stone (2):
1. Echogenic foci within the ureter that shadows
2. Dilation of the ureter proximal to the stone
