Lesson 4B (Part 2) Flashcards
Xanthogranulomatous Pyelonephritis
Chronic suppurative renal infection with a destroyed parenchyma is replaced with lipid-laden macrophages
Is xanthogranulomatous pyelonephritis uni or bilatera?
Unilateral
- diffuse, focal or segmental
Who does xanthogranulomatous pyelonephritis commonly affect?
Middle aged diabetic women
What does xanthogranulomatous pyelonephritis look like on US? (3)
- Renal enlargement
- Lack of corticomedullary differentiation
- Focal masses
What does ischemia lead to?
Papillary necrosis
- lose of blood flow that leads to cell death
What are causative factors of papillary necrosis? (9)
- Analgesic abuse
- Diabetes
- UTI
- Renal vein
- Thrombosis
- Prolonged urinary tract obstruction
- Dehydration
- Sickle cell anemia
- Hemophilia
What does papillary necrosis look like on US? (5)
- Swollen pyramids
- Cystic papilla
- Clubbed calyx
- Hydronephrosis
- Debris in collecting system
TB
Tuberculosis
Who do tuberculosis affect?
The kidneys of 5-10 year olds after initial infection
What are the S/S of TB?
Frequency, dysuria, nocturia, urgency, gross or microscopic hematuria
What does TB look like on US? (3)
- Focal renal lesions
- Variable echotexture and size
- May involve bladder
- focal or diffuse wall thickening
What is the best way to asses TB? (2)
- CT
2. Urography
What is the most common fungal agent?
Candida Albicans
What are the patients who are at risk for fungal infections? (7)
- Diabetes mellitus
- Chronic indwelling catheters
- Malignancy
- Hematopoietic disorders
- Chronic antibiotic or steroid therapy
- Transplantation
- IV drug abuse
What do fungal infections look like on US? (2)
- Small cortical hypoechoic lesions
- small abscesses - Fungus balls in collecting system
- echogenic
What is the most common agent seen with parasitic infections?
Schistosomiasis
Schistosomiasis
Worms penetrate skin to liver via the portals
Hematuria
Eggs deposited in venules of bladder wall/ureter
Bladder stasis
Increased incidence of ureteral and bladder calculi and repeated infections
What is found in 2-5% of patients with hydatid disease?
Echinoccal hydatid Renal disease
What does echinoccal hydatid Renal disease affect? (3)
- Kidneys
- Ureters
- Bladder
Who do filiariasis affect?
Children between 10-12 years of age
How is filiariasis transmitted?
Mosquitos
Where do worms enter with filiariasis?
The lymphatic system through the kidneys
