Congenital Anomalies of the Kidney and Urinary Tract Flashcards Preview

Renal and Urinary 3 > Congenital Anomalies of the Kidney and Urinary Tract > Flashcards

Flashcards in Congenital Anomalies of the Kidney and Urinary Tract Deck (22)
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1
Q

Proneprhos
Mesoneprhos
Metanephros

A

Non functioning - 4th week

Meso - at end of 4th week…develops to the degenerating pronephros

Meta - final human kidney @ 5th week and fully functiona at 9 weeks

2
Q

Kidney origin

A

From intermediate mesoderm of urogenital ridge

Wolffian duct is divided into 3 segs

3
Q

More embryology

A

Ureteric bud branches from Wolffian duct…forms collecting system

Induces formation of neprhons in metaneprhic blastema

Neprhoblastic cells of blastema diff into glomeruli, PCT, Loos, and DCT

4
Q

Hydroneprhosis

A

80% of newborns with urinary tract anomilies will have this

Physiologic is common and is a “slow draining” kidney

5
Q

Primary vesicoureteral reflux

A

Related to how ureter is inserting into bladder - shorter or abnormal angle

Needs to be diff from secondary - urinary tract obstruction or neurogenic bladder

6
Q

Test of primary vesicoureteral reflux and tx

A

Voiding cystourethrogram, cannot be dx on renal ultrasound

Frequently outgrown over first years of life

Prophylactic ABs to avoid UTIs

7
Q

Obstructive uropathy

A

Interference of flow at any site

Leads to urine accumulation behind the obstruction…potentially damaging

Can be congenital or acquired

8
Q

Obstructive uropathy how to ID

A

Hydroneprhosis or hydroureter

Acute complete unilat can significantly dec GFR and increase seurm creatinine somewheat…bilateral = renal failure

Renal nuclear scan

9
Q

Post urethral valves

A

Obstructing membraneous folds within lumen of prostatic urethra

Only in males

10
Q

UPJ obstruction

UVJ onbstruction

A

ONe hydroneprhotic kdiney, normal ureters nad bladde
r

One hydroneprhoitc kdiney…one dilated ureter on same side…normal bladder and other kdiney normal

11
Q
POst urethral valves
Vesicourteral reflux (uni)
A

Bilateral hydroneprhosis and hydroureter, abnormal nladder with trabeculations and wall thickening

One hydroneprhotic kidney, one dilated ureter on the same side, normal bladder, other kidney normal…similar to UVJ but ureter not as severely dilated

12
Q

Unilateral renal agensis

A

Disruption of metaneprhic developemt

Compensatory hypertrophy of contralateral kidney

Look for unusual location of the absent kidney by renal scan

13
Q

Prognosis of unilateral renal agensis

A

No evidence it will elad to restircted kidney function in absence of other comorbitieis

14
Q

Primary renal dysplasia

A

INteraction bt ureteric bud and metaneprhic mesenchym generates neprhons of each kidney

Low neprhon number

Pure - decreased number but otherwise normal kidney

Renal dysplasia - evidence of aberrant development fates of metaneprhic mesenchyme

15
Q

Bilateral renal agenesis

A

Bilateral failure with POtter syndrome

Oligohydramnios in 2nd trimester of pregnancy in severe

Complete absence of renal parenchya and amnitoic fluid predicts grave prognosis

16
Q

MCDK

A

Unilaterla multiloculated ab mass with thin walled non communicating cyts and no detectable normal renal tissue

No reniform shape

Reflux into non-MCDK kidney

Involution over time but not guaranteed

Can cause HTN secondary to renin secretion

17
Q

Horshoe kidney

A

Fusion of kidneys at level of lower poles with renal parenchymal or fibrous isthmus

Hrshoe kdineys are MOST COMMON type of fusion

Obstruction, sotnes, infection, VCR

18
Q

Excretory urography

A

Used to ID horshoe kidney

19
Q

Pelvic kidney

A

Most common form of renal ectopia…opposite of sacrum and below aortic bifurcation

Due to abnormalities of ureteric bud or metaneprhic blastema

Dx prenatally

20
Q

Pelvic kdiney dx and risks

A

Renal US, exc urography, diuretic renogram

Blockage, VCR, kidney stones, UTI

21
Q

Crossed fused ectopic kidney

A

Fusion of both kidneys with at least one kidney on opposite side

Asx

22
Q

Duplex kidney

A

Duplicated collecting system…2 ureters empty separaretly into the bladder or fuse to form single ureteral orifice

Single ureteral bud bifurcates prematurely or there are 2 sep ureteric buds

Common