Kidneys Flashcards

Question

What is prominent or hypertrophic column of Bertin?

Answer 1

Considered a variant Double thickness of cortical tissue between 2 pyramids can create or mimic a pseudocyst

Answer 2

Renal sinus is clearly defined Largest dimension is less than 3 cm It is continuous or contiguous with the renal cortex Echogenicity is close to that of the cortex

Answer 3

A variant Bulging of the mid section of left kidney Same echogenicity as cortex

Answer 4

Anomaly Lower pole of kidneys are fused at the midline of body 1 in 400 IVP and CT are good for identification of horseshoe kidney in adjunct to ultrasound

Answer 5

Anomaly Non-visualization of a kidney in renal fossa Ectopic kidney. Failed to ascend to upper quadrant. Note: transplanted kidneys are in the pelvis

Answer 6

Anomaly No kidney formation. Will have unilateral large kidney due to contra-lateral compensation

Answer 7

Fetal Lobation Typically occurs on the anterior surface of the upper pole of kidney

Answer 8

Anomaly Very rare Complete duplication of kidney Extra kidney with its own blood supply. Usually ectopically placed and shares ureter

Answer 9

When a kidney ascends to the contralateral side. You will see 2 kidneys on one side of abdomen and none on the other One ureter crosses midline to enter other side of bladder

Answer 10

Unilateral fused kidney The developing kidneys fuse while in the pelvis and one kidney ascends to its normal position, carrying the other one with it across the midline

Answer 11

An extra renal pelvis that lies outside the renal sinus. | Sonographically appears as a cystic collection medial to the renal hilum

Answer 12

``` Common cause of urinary obstruction in a male infant due to a flap of mucosa that has a slit-like opening in the opening of the area of the prostatic urethra. You will see a large bladder Hydroureter Hydronephrosis Possible urinoma ```

Answer 13

Excessive fatty infiltration of the renal pelvis associated with obesity, or Parenchymal atrophy

Answer 14

``` Hematuria Oligouria (scanty urine) Flank pain Increased serum creatinine Palpable mass in lumbar region Chronic UTI Obstruction of the GU tract such as nephrolithiasis ```

Answer 15

Secondary to respiratory infection, its prevalence can cause mortality. Usually originates from bladder and spreads to kidneys. E-colimis the most common bacteria responsible for 85% UTI Women are more susceptible due to shorter urethra. Urinary stasis from voiding interference enhances bacterial growth (pregnancy, urolithiasis, benign prostatic hypertrophy- BPH)

Answer 16

Urethra, lymphatics, vascular. | Skin, bone and heart infections can disseminate to the nephron's via blood

Answer 17

Women due to shorter urethra Women with increased sexual activity Pregnancy due to increased pressure on bladder and ureters

Answer 18

Sudden Renal Plevis inflammation Abrupt onset. Usually caused by gram-negative bacilli from intestinal tract Causes suppuration (puss) Unilateral or bilat Focal or diffused infection Can lead to micro abcess formations in kidney Associated with UTI

Answer 19

``` Flank pain Fever and chills Urinary frequency Elevated WBC Dysuria (painful/difficult urination) Pyuria (puss in urine) ```

Answer 20

Kidneys may have normal appearance in early stages. | As infection progresses, the kidneys may show abnormal echopatterns (focal or diffused)

Answer 21

Enlarged, hypoechoic kidney with absence of sinus echoes

Answer 22

Enlarged echogenic kidney due to multiple abscess Cortex also becomes echogenic if there is abscess formation The sinus will blend with the parenchyma

Answer 23

Focal wedge-shaped area or a hypoechoic renal lobe without renal enlargement

Answer 24

Emphysema- presence of air on tissue Intrarenal gas accumulates causing a dirty ringdown reverberation artifact Common in diabetes, immune-suppressed patients and those with UTI

Answer 25

A silent, insidious, progressive disorder From recurrent infections like UTI, obstructive lesions or vesico-ureteral reflux Inflammation leads to scarring which can contribute to tubular dysfunction and parenchymal atrophy.

Answer 26

``` Flank pain Oliguria HTN Foul smelling urine Slight increase in WBC Mild fever and chills Proteinuria (urine will be smoky) ```

Answer 27

Poor renal function (decreased GFR) Proteinuria Increased blood creatinine Increased BUN

Answer 28

Kidneys will atrophy as the disease progresses (<8 cm) Increased parenchymal echoes due to fibrosis Echogenic Zone extends beyond normal areas of the sinus

Answer 29

Carbuncle | Perinephric Abscess

Answer 30

Bacterial infections such as staph. Aureus or Gram Negative Bacilli spread to kidneys via blood or the ascending route from bladder. Abscess results in flank pain, Fever and chills

Answer 31

``` Echogenic Renal mass Thick wall Irregular margins Reverberation or shadow artifact from gas-producing organisms Septations Possible acoustic enhancement ```

Answer 32

Due to chronic infection and obstruction of the uretero-pelvic junction from a staghorn calculus (blocking renal pelvis)

Answer 33

``` Renal enlargement Parenchymal abcess Staghorn calculus Papillary necrosis Possible hydronephrosis ```

Answer 34

Purple to material in the collecting system Associated with renal obstruction Percutaneous or surgical drainage is required Echogenic debris in a dilated renal collecting system is seen on ultrasound

Answer 35

An antigen-antibody inflammatory response (autoimmune reaction) in the glomerulus, secondary to streptococcal infection Leads to increased peritubular capillary permeability and cell proliferation resulting in leakage of proteins and RBC into the filtrate (ends up in tubules which congest area and slow down filtration process Decreases GFR Fluid and waste retention occurs, leading to ARF if prolonged Chronic conditions can lead to CRF

Answer 36

Flank pain Hematuria Edema (beginning at face) HTN leading to headache, nausea, fatigue and stroke

Answer 37

Increased creatinine Increased BUN Azotemia (abnormally high levels of nitrogen-containing compounds in the blood such as urea, creatinine) RBC in urine

Answer 38

Enlarged Echogenic kidney Cortex will have equal echogenicity to sinus followed by increased cortical echogenicity Post treatment of primary streptococcal infection will return the kidney's size and echogenicity back to normal

Answer 39

``` Prinmary cause is Acute Tubular Necrosis (ATN) Decreased GFR Acute Glomerulonephritis Prolonged circulatory shock or trauma Septicemia Burns Interstitial nephritis Urinary tract obstruction Bilat renal artery occlusion or DVT Heart failure and Hypotension Tumors ```

Answer 40

Oliguria: Decreased urine output Tissue breakdown Diuretic phase: Few days to 6 weeks after onset Increased urine output Indicates nephron recovery

Answer 41

``` Oliguria Hypertension Muscle fatigue GI bleed Infections ```

Answer 42

May be normal in early stages Kidneys may also enlarge bilat Homogenous echogenic pattern Increased RI with hypoperfusion

Answer 43

``` Decrease in GFR Hypotension Diseases such as: AGN (acute glomerulonephritis) CPN (chronic pyelonephritis) Renal vascular disease Diabetes Toxins Polycystic disease ```

Answer 44

``` Early stage: Polyuria Nausea HTN Increased BUN & Creatinine Later stage: Oliguria Dry skin Impotence Encephalopathy CHF ```

Answer 45

Small, shrunken, echogenic kidney which is definitive of end stage renal failure Kidney measures < 8 cm in length Cortical thinning < 1 cm

Answer 46

Fungal ball Candidiasis is another name Most common renal fungal disease as a result from hematogenous seeding or ascend from bladder Usually seen in immune suppressed patients such as AIDS fungal balls appear as hyperechoic, non shadowing masses

Answer 47

Lateral aspect of lower pole | 10 degree cephalad angulation

Answer 48

Used to evaluate renal transplants, access suspected hydronephrosis, medical renal disease and suspected renal neoplasm RI= PSV-EDV/PSV

Answer 49

``` Commonly encountered in patients over 40 years old Found in 50% of patients over 50 Origin is usually unknown Serous fluid filled Usually solitary ```

Answer 50

Normal characteristics of a simple cyst Range in size 98% accuracy with ultrasound Mural growth may indicate malignancy

Answer 51

``` Cortical/single Cortical/multiple Pyelogenic cyst Parapelvic Peripelvic ```

Answer 52

Renal pelvis, infundibulum or calyces (calyceal diverticulum) Show appearance of a simple cyst in ultrasound

Answer 53

Cysts that bulge into the central sinus of the kidney which may cause symptoms and can be mistaken for hydronephrosis

Answer 54

Lymphatic cysts in the central sinus. Identical ultrasound appearance of parapelvic cysts

Answer 55

Cortical cysts: originate from uriniferous tubules Pyelogenic cysts: calyceal diverticula Parapelvic cysts: parenchymal cysts Peripelvic cysts: lymphatic cysts

Answer 56

Yes 31% | They can also be associated with trauma

Answer 57

Abdominal pain Back and flank pain Hematuria

Answer 58

Low grade inflammation and partial or complete blockage of a calyceal diverticulum Quite common and represents calcium carbonate crystals

Answer 59

Anechoic area near calyx Echogenic mobile foci or gravity dependent wall Acoustic shadowing

Answer 60

``` Congenital autosomal recessive defect Common/innocuous Localized to medullary collecting ducts Dysplastic cystic dilation of pyramids Bilateral, multiple cystic dilation Occurs in adults ```

Answer 61

Calcifications in dilated cysts Infection Urinary calculi

Answer 62

Hyperechoic medullary pyramids bilaterally Ectastatic collecting tubules No shadowing

Answer 63

Patients on chronic hemodialysis develop bilat renal cysts Hemorrhage often occurs into acquired cysts, resulting in pain, Hematuria and echogenic collections of cysts Higher incidence of renal cell carcinoma

Answer 64

Multi-systemic disorder associated with renal cyst formation and multiple angiomyolipomas (sebaceous cysts) Patients present clinically with mental retardation, seizure and cutaneous lesions

Answer 65

``` Cause is unknown Inherited Autosomal Dominant defect Potter III disease Latent until 3-4th decade Bilat disease Cystic origin: convulated tubules, bowman's capsule Incidence: 1-1000-2000 Leads to renal failure and requires transplant ```

Answer 66

Flank pain Back pain HTN Hematuria

Answer 67

Increased BUN Increased creatinine Hematuria Proteinuria

Answer 68

Destruction of residual tissue Advanced stages lead to renal failure and HTN Associated with Berry's Aneurysm: cerebral arterial/circle of Willis

Answer 69

Transplant

Answer 70

Unknown cause Theory states dilation of collecting tubules due to hyperplasia of interstitial portions Inherited Autosomal Recessive defect Potter I Common in infants Bilateral kidney involvement Associated with renal dysfunction and hepatic fibrosis

Answer 71

Oligohydramnios in utero | Cannot produce urine due to a,punt of cysts

Answer 72

BEEK: Bilateral, Echogenic, Enlarged Kidneys Absence of renal parenchyma Abscess of renal sinus

Answer 73

Cause by atresia of uretero-pelvic junction during fetal development Most common cause of abdominal mass in newborn It can be unilateral or bilat Bilateral case can be fatal within 24 hrs of delivery Potter II

Answer 74

Oliguria | Anuria if bilat

Answer 75

Cysts of varying shapes and size Absence of communication between cysts Absence of renal sinus and parenchyma Renal architecture is gone

Answer 76

``` Most prevalent benign renal tumor From tubular epithelium Can only be distinguished from malignancy by histology Treated as malignant 3:1 ratio male over female Occurs usually in 6-7th decade ```

Answer 77

Painless Hematuria

Answer 78

``` Similar to RCC Variable echogenicity Highly vascular May have internal echoes 1 cm in size mostly Rarely >3 cm ```

Answer 79

Fat, blood vessels and smooth muscle Cortical lesions More common in women 40-60 years old

Answer 80

May be asymptomatic May have flank pain Hematuria HTN

Answer 81

Echogenicity is greater than or equal to renal sinus fat Solitary Posterior displacement of structures behind these masses may be seen as a result of the slower acoustic velocity in these fatty Tumors (propagation speed artifact) Multiple associated with tubular sclerosis

Answer 82

Hypernephroma

Answer 83

``` Most common solid renal mass in adult 80-85% of adult renal tumor Unilateral Most common in men and African American 5-7th decade ```

Answer 84

Pain Hematuria Palpable mass

Answer 85

Unilateral, encapsulated solid mass Hyperechoic in cortex relative to adjacent normal tissue Multilocular cyst and hemorrhagic components may be present due to necrosis and hemorrhage Calcifications are common METS to liver, lymph nodes, adrenals and contralateral kidney

Answer 86

1: inside kidney 2: outside of kidney 3: goes to IVC 4: goes to lymph nodes and other organs

Answer 87

Nephrectomy

Answer 88

``` Von Hipple-Lindau syndrome Acquired cystic kidney disease ADPKD Tuberous Sclerosis Other syndromes associated with multiple cysts in kidneys ```

Answer 89

``` Ipsilateral renal vein IVC Contralateral kidney and renal vein Retroperitoneum Liver for METS ```

Answer 90

Over 90% of TCC malignancies involve the renal pelvis and ureter Majority of TCC arises in the bladder Avg age diagnosis 61 yrs old

Answer 91

Painless Hematuria Hydronephrosis Central filling defect on excretory urogram

Answer 92

Irregular hypoechoic mass in the renal sinus Usually too small for US detection Clot or fungal ball pattern Hypoechoic to isoechoic collecting system mass Secondary calyectasis Multiple and bilat

Answer 93

Non-Hodgkin lymphoma is the most common type | Bilat enlarged hypoechoic renal masses

Answer 94

``` Nephroblastoma Most common tumor in babies Malignant Arising from immature renal cells Less than 3 years old Large asymptomatic mass Mets is common to lungs, liver, bones, lymph nodes, adrenals and retroperitoneum IVC and renal veins should be evaluated for tumor extension Must be differentiated from adrenal neuroblastomas ```

Answer 95

Nephrolithiasis Urolithiasis Calculi

Answer 96

Hot climates that promote dehydration, leading to concentrated urine and increases isolated precipitates of dissolved salts such as calcium oxylate, calcium phosphate

Answer 97

``` Hereditary Renal dysfunction Bacteria Calyceal scarring Calyceal obstruction of collecting system Urine stasis ```

Answer 98

``` Hematuria Oliguria Renal colic Nausea Vomiting Fever Pyuria Anuria Abdominal distention ```

Answer 99

Echogenic foci Posterior acoustic shadowing Possible hydronephrosis Hydroureter

Answer 100

Calcifications of the kidney

Answer 101

Cortical nephrocalcinosis and | Medullary nephrocalcinosis

Answer 102

``` Hyperparathyroidism Vitamin D intoxication Chronic glomerulonephritis AIDS Malignancies Acute cortical necrosis ```

Answer 103

Non-obstructive dilation of the collecting system

Answer 104

``` Grade 1 Mild hydro Dilated renal pelvis Grade 2 Moderate hydro Dilated calyces Grade 3 Severe hydro Dilated pelvis, calyces and cortical thinning or loss of renal parenchyma ```

Answer 105

``` Pregnancy Fibroids Bening prostatic hypertrophy BPH Tumors Mass effect ```

Answer 106

Common congenital anomaly. | Associated with a contralateral multicystic Dysplastic kidney

Answer 107

Ureterovesicle junction (ureter/bladder junction)

Answer 108

Renal calculi Pelvic tumors Trauma Infection

Kidneys Flashcards

(134 cards)