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MIDS 127 > Kidneys > Flashcards

Kidneys Flashcards

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1
Q

Location of kidneys?

A

Along posterior abdominal wall between lower ribs + iliac crest

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2
Q

3 poles of kidneys?

A

-Upper
-Mid
-Lower

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3
Q

Which kidney sits lower?

A

Right sits 2-8cm lower

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4
Q

What are the 4 different layers of supportive tissue?

A

-Renal capsule (innermost)
-Perirenal fat/Adipose capsule (middle)
-Renal/Gerota fascia (outer, is around kidney + adrenals)
-Pararenal fat (outermost)

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5
Q

What are the 2 renal fascia’s?

A

-Anterior gerota fascia
-Posterior zuckerkandl fascia

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6
Q

Which RA is longer?

A

Right

(b/c AO is further away, it has to pass behind IVC to reach right kidney)

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7
Q

Measurement of RA’s?

A

5-6mm

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8
Q

Measurement of RV’s?

A

10-12mm

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9
Q

What is the course of the RRV + LRV?

A

RRV - shorter, goes directly into IVC + does NOT receive blood from other veins

LRV - longer, receives blood from L adrenal, L gonadal + inferior phrenic veins before entering IVC

(think opposite of the renal arteries)

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10
Q

Function of the kidneys?

A

-Filters blood, puts back into body + removes waste through urine
-Regulates body
-Produces hormones

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11
Q

What does the nephron do?

A

-Filters blood by removing waste + returned for circulation (99%)
-Produces urine (1%)
-Regulates pH

(over 1 million nephrons in each kidney)

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12
Q

What are the 3 components of a nephron?

A

-Renal corpuscle
-Renal tubule
-Vascular component

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13
Q

Describe the BUN test?

A

-Increased with renal failure (older + diabetics)
-Measures amount of urea nitrogen in blood

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14
Q

Describe the creatinine test, does it increase or decrease?

A

-Increased if kidney isn’t functioning right
-Only increases

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15
Q

Describe the eGFR test, does it increase or decrease?

A

-Only decreases
-Glomeruli isn’t filtering blood correctly

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16
Q

Describe the hematuria test?

A

-RBC in urine
-Gross (visible in urine)
-Microscopic (visible on urinalysis)
-Kidney stones is a cause

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17
Q

Describe the albuminuria test?

A

-Increased albumin protein in urine

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18
Q

Describe the proteinuria test?

A

-Protein passing through glomerulus into urine
-Diabetes is cause

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19
Q

Measurements of kidney?

A

9-12cm long
5-7cm wide
3-5cm thick

(should be 2cm of each other in length)

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20
Q

When should we do a volume measurement?

A

-Pediatrics
-If kidneys are small in adults
-To assess renal function

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21
Q

What is a sonographic sign of renal disease?

A

A thin cortex
(Sinus to capsule measurement is 15-20mm)

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22
Q

What does the renal cortex look like?

A

-Hypoechoic/isoechoic to liver
-Hypoechoic to spleen
(will be brighter in peds)
-Smooth in adults
-Bumpy in children (think lobulations)
-Homogeneous

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23
Q

What is the renal medulla?

A

-Inner part kidney
-Contains pyramids
-Hypoechoic circles in cortex
-Larger in children
-See if pt is well hydrated

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24
Q

What is the renal sinus?

A

-Contains calyces, renal pelvis, vessels, fat, nerves + lymphatics
-Echogenic
-Middle part kidney

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25
What is the renal hilum?
-Middle indent -Site where vessels, ureters + lymphatics come in/out (vein is ant to artery, ureter is post to artery)
26
What is the renal pelvis?
-Urine from calyces empty into pelvis -Cavity beside hilum that is continuous with ureter -Can't see on u/s (unless dilated, pt is hydrated or has extra pelvis)
27
What is the diameter of the ureters?
3-4mm (only see if dilated)
28
What is pelviectasis?
Dilation of renal pelvis
29
What is pelvicaliectasis?
Dilation of renal pelvis + calyces
30
What is m/c cause of hydronephrosis in young adults?
Nephrolithiasis
31
What is m/c cause of hydronephrosis in adult men?
Enlarged prostate
32
What is m/c cause of hydronephrosis in adult women?
Pelvic mass
33
What is a staghorn stone?
Very large stone that fills the entire renal pelvis (must be surgically removed)
34
What does chronic renal disease look like sonographically?
Small echogenic kidneys
35
What is UPJ?
-Uteropelvic junction (renal pelvis + calyces dilated if stone) -Junction where ureter exits kidney
36
What is UVJ?
-Uterovesical junction (renal pelvis, calyces + ureter dilated if stone) -Junction where ureter meets bladder
37
Lightbulb for adenoma?
-Malignant potential -Less than 2-3cm
38
Lightbulb for onocytoma?
-Central stellate scar -Up to 20cm -Men
39
Lightbulb for AML?
-Hyperechoic in cortex -Women
40
Lightbulb for juxtaglomerular?
-Increased renin -Women
41
Lightbulb for RCC?
-Basket sign! -Men -Smoking -Hematuria -Cortex
42
Lightbulb for TCC?
-Men -Hypoechoic -Mass in renal pelvis! -Smoking
43
Lightbulb for SCC?
-Staghorn -Horseshoe (think "S" in SCC for staghorn)
44
Lightbulb for lymphoma?
Never hyperechoic
45
What does acute pyelonephritis look like?
-Inflamed renal pelvis -Enlarged kidneys (may also look normal)
46
What does chronic pyelonephritis look like?
-Caliceal clubbing (thick + dilated renal pelvis) -Small + asymmetrical kidneys
47
Lightbulb for xanthroganulomatous?
-Staghorn -Diabetes + women
48
Lightbulb for emphesymatous?
-Gas -Echogenic lines -Diabetes + women
49
What is dromedary hump?
Spleen presses on LK causing hump mid pole
50
What is hypertrophied column of bertin?
Hypoechoic cortex goes half way through echogenic sinus (m/c left)
51
What is junctional parenchymal defect?
Hyperechoic area on anterior aspect kidney (incomplete fusion of UP + LP)
52
What is extrarenal pelvis?
Pelvis outside renal hilum (instead of in the sinus)
53
What is renal sinus lipomatosis?
Increased fat in sinus causes very thin cortex
54
What is renal hypoplasia?
Small kidney/no kidney on 1 side, other side has enlarged kidney to compensate
55
What is renal agenesis?
No kidney on 1 side
56
M/c spot for ectopic kidney?
Pelvis
57
What is crossed ectopic kidney?
-When UP ectopic kidney fuses with LP of normal kidney -Is when both kidneys are on the same side of the body (m/c R side) (hard to tell if 1 large kidney or fused kidneys)
58
What is nephroptosis?
Wandering kidney
59
What is horseshoe kidney?
Fusion of UP's or LP's (m/c) + goes across chest (ureters pass anterior to fused part)
60
What is duplicated collecting system?
Hypoechoic cortex goes completely through echogenic sinus (is the m/c anomaly)
61
What is supernumerary kidneys?
More than 2 kidneys
62
What are congenital megacalyces + megaureters?
-Megacalyces: enlarged calycles -Megaureters: enlarged ureters (both m/c in pediatrics)
63
What is hydronephrosis?
Urine dilation in calyces + pelvis (pregnancy associated + RK)
64
What are the different grades of hydropnephrosis?
1/mild - sinus 2/mild - sinus + some calyces 3/moderate - sinus + all calyces 4/severe - very dilated all around
65
What is pyonephrosis?
-Pus in collecting system -Very urgent -M/c cause nephrolithiasis
66
What is nephrolithiasis along with the m/c symptoms + risk factors?
-Kidney stones (less than 4mm can pass) -M/c in men -Dehydration is main r/f -Renal colic is main symptom (painful spasms) (stones in medulla is m/c than in cortex)
67
What are parapelvic cysts + what does it look like?
-From kidney tissue into sinus -Solitary, large + well defined
68
What are peripelvic cysts?
-From sinus -Multiple, small + irregular walls
69
What does septated/multilocular cyst look like?
Echogenic line through cyst
70
What is a milk of calcium cyst?
Anechoic cyst with echogenic calcium under it (m/c UP)
71
What is ACKD?
-3+ cysts -Seen with dialysis + men
72
What is ADPKD?
Enlarged kidneys with multiple cysts
73
What is von hippel lindau?
-Cysts -RCC complication
74
What is medullary sponge kidney?
-Cysts in medulla too small to see -Caroli's + nephrocalcinosis (too much calcium in kidneys) associated -Women -Pyramids look echogenic w/o shadowing (b/c can't see cysts) + normally sized
75
What is an increased risk when someone has tuberous sclerosis?
RCC
76
Name the 4 bosniak cyst definitions
1 - simple benign 2 - mildy complex (thin calcifications) 2F - moderately complex (greater than 3cm, needs follow up) 3 - intermediately complex (thick calcifications) 4 - very complex
77
Why do renal abscesses develop?
M/c cause due to UTI's
78
Who are fungal infections most common in?
Children (has renal fungus ball in kidney, is hyperechoic)
79
What is the S/F sign for TB?
Putty kidney (echogenic, small, calcified kidneys)
80
What does papillary necrosis look like?
Anechoic spaces with multiple echogenic foci + shadowing
81
What does lupus look like?
VERY echogenic kidneys!!! (m/c women - think selena gomez)
82
What are the m/c causes of acute tubular injury?
Ischemia or toxic injury (looks like hyperechoic pyramids)
83
What is the cause of acute interstitial nephritis?
Allergic reaction to drugs
84
What are the m/c causes + appearance of chronic kidney disease?
-Diabetes -Hypertension -Small, echogenic kidneys + can't see pyramids or sinus (m/c elderly people)
85
What are patients prone to getting when on dialysis?
Cysts
86
What is measurement for cortical thickness?
15-20mm (quiz answer was just greater than 15mm)
87
What is the m/c cause of nephrotic syndrome?
Primary - FSGS Secondary - diabetes (M/C)
88
SF of AIDS nephropathy?
Very echogenic kidneys that are a normal size
89
What LABS indicate AIDS?
Increased creatinine + BUN
90
What are the 2 types of dialysis?
Hemodialysis - blood filtered through machine + back into body Peritoneal dialysis - tube in body brings fluid to abdomen which drains waste out of blood via a catheter
91
What is a struvite stone?
Staghorn

MIDS 127 (14 decks)

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