Kidney & Suprarenal Gland Practice Questions Flashcards
(15 cards)
The tip of the arrow is pointing to which one of the following anatomical structures of the kidney?
A. Renal column
B. Renal pelvis
C. Renal cortex
D. Papilla of renal pyramid
E. Minor calyx
F. Ureter
G. Fibrous capsule
H. Renal medulla
E
See: Slide 17 and Slide 18
A 67-year-old man was involved in an automobile accident and after all efforts by the physician, it is determined the patient has no brain activity and cannot breathe without mechanical devices (artificial support). Prior to progressing with the patients wish for organ transplantation, a CT angiogram reveals an anomaly with the patient’s left kidney, which is similar to the accompanying 3-D rendered image. Which of the following is true regarding the left kidney in the associated image?
A. Horseshoe kidney
B. Perinephric abscess
C. Bifid ureters
D. Ectopic kidney
E. Renal artery stenosis
F. Not present
D
See: Slide 54 and be able distinguish expected differences with Slide 55.
The anterior anatomical surface of the kidney is closely associated with other abdominal organs and structures. The surface area which is represented with the letter “X” (dark green colored area) on the kidney in the accompanying image has what name?
A. Pancreatic
B. Right colic flexure
C. Diaphragmatic
D. Area for the 11th rib
E. Hepatic
F. Duodenal
G. Splenic
B
See: Slide 12 and Slides 11 and 16
Recognize this is the anterior surface of the right kidney (as the ureter passes most posteriorly from the renal hilum)
A 71-year-old woman is admitted to the hospital with severe pain radiating from her lower back toward her pubic symphysis. Ultrasound examination reveals that a renal calculus (kidney stone) is partially obstructing her left ureter. At which of the following locations is the calculus most likely to lodge?
A. Major calyx
B. Minor calyx
C. Pelvic brim
D. As the ureter passes posterior to the ovarian artery E. Between the pelvic inlet and the uterine cervix
C
See: Slide 27 and Slides 57 and 58.
The lymphatic vessels of the left suprarenal (adrenal) gland are likely to drain to which lymph nodes first?
A. Lumbar (para-aortic)
B. External iliac
C. Deep inguinal
D. Celiac
E. Internal iliac
F. Superficial inguinal
A
See: Slide 28.
A 63-year-old woman has a history of urinary tract infections and presents to her physician with right costovertebral angle tenderness. Medical imaging reveals two large renal calculi (kidney stones) that are indicated at the tips of the arrows in the accompanying image and are obstructing her right ureter. In this patient, the renal calculi are most likely located at which common site of constriction?
A. Renal papilla
B. Minor calyx
C. Ureteropelvic junction
D. Ureterovesical junction
E. Pelvic inlet
C
See: Slides 27, 57 and 58.
There are 3 common sites of constriction associated with the ureter…the arrows are high above the pelvis/iliac crest so the first constriction (junction of the renal pelvis exiting the kidney and becoming the ureter) will likely be the location in this patient. You can see the dark outline of the kidney and therefore the minor calyx would not be this medial and would therefore not be the best answer.
Which one of the following arteries branches directly from the abdominal aorta?
A. Superior suprarenal
B. Middle suprarenal
C. Inferior suprarenal
D. Interlobar
E. Segmental
F. Arcuate
B
See: Slides 21, 24 and the image in Slide 25.
Nutcracker syndrome will typically occur on one side (unilaterally) due to the vascular compression of (i) which vein that ultimately leads to varicocele of (ii) what venous plexus?
A. Right inferior phrenic – Renal plexus
B. Left inferior phrenic – Renal plexus
C. Inferior vena cava – Testicular plexus
D. Internal iliac – Testicular plexus
E. Left renal – Pampiniform plexus
F. Right renal – Pampiniform plexus
E
See: Slide 62.
This question links directly with the “Inguinal Region, Testes and Scrotum” lecture. Note: the renal plexus is not venous – it is a nervous plexus!
Fusion of the caudal portions of the kidneys during embryonic development is most likely to result in what congenital condition?
A. Bicornuate uterus
B. Cryptorchidism
C. Horseshoe kidney
D. Hypospadias
E. Renal agenesis
C
See: Slide 56.
Failure to urinate during embryonic or fetal life usually causes respiratory difficulties postnatally. Which of the following relationships best describes the situation in this case?
A. Oligohydramnios linked with hypoplastic lungs
B. Polycystic kidneys linked to tracheoesophageal fistula
C. Polyhydramnios
D. Renal agenesis linked to insufficient surfactant
E. Urethral obstruction linked to ectopic viscera
A
See: Slide 51 and 52.
A 57-year-old man is admitted to the emergency department with pain in his left lumbar (flank) region and testicles. Laboratory tests indicate hematuria and anemia. A CT scan examination provides evidence that blood flow in the left renal vein is being occluded where it crosses anterior to the aorta. Which of the following is the most likely cause of the testicular pain in this patient?
A. Occlusion of flow of blood in the artery to vas deferens
B. Occlusion of flow of blood in the testicular vein
C. Compression of the afferent fibers in the lumbar splanchnic nerves
D. Compression of the posterior vagal trunk
B
See: Slide 62.
Blood flow would be greatly reduced in the left testicular vein because of the occlusion of the left renal vein by the superior mesenteric artery — would result in pain as the testicular venous vessels become swollen. Pain mediated from the renal organs would pass to the T11 and T12 spinal cord levels via the thoracic splanchnic nerves. There would be no compression of lumbar splanchnic nerves in this case. The vagus nerve does not carry visceral pain fibers in the abdomen; pain is mediated by branches of the sympathetic chains.
A 23-year-old pregnant woman visits her gynecologist for her routine ultrasound checkup. Ultrasonographic examination reveals unilateral renal agenesis and oligohydramnios. Which of the following conditions most likely occurred?
A. Polycystic kidney disease
B. Degeneration of the mesonephros
C. Ureteric duplication
D. Failure of a ureteric bud to form
E. Extrophy of the cloaca
D
See: Slide 52.
A 32-year-old woman is being assessed for atherosclerosis and the accompanying CT image shows the branching pattern of arteries from the abdominal aorta. Which TWO (2) organs receive blood from the vessel indicated by the tip of the arrow?
A. Left ovary and kidney
B. Right ovary and kidney
C. Left suprarenal gland and ovary
D. Right suprarenal gland and ovary
E. Left kidney and suprarenal gland
F. Right kidney and suprarenal gland
E
See: Slides 21 and 24.
A 7-year-old girl presents with a large abdominal mass just superior to the pubic symphysis. The mass is tender when palpated and fixed in location. During surgery, a fluid-filled mass is noted, which is connected to the umbilicus superiorly and to the urinary bladder inferiorly. In this case, what is the diagnosis?
A. Ectopic kidney
B. Horseshoe kidney
C. Polycystic disease of the kidney
D. Urachal cyst
E. Extrophy of the urinary bladder
F. Canal of Nuck
D
See: Slide 47.
Where are the proximal convoluted tubules of the definitive (permanent) kidney derived?
A. Ureteric bud
B. Metanephric blastema
C. Mesonephric duct
D. Pronephric tubules
E. Cloaca
B
See: Slides 35 and 37.
