Lesson 4B (Part 2) Flashcards Preview

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Flashcards in Lesson 4B (Part 2) Deck (30)
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1

Xanthogranulomatous Pyelonephritis

Chronic suppurative renal infection with a destroyed parenchyma is replaced with lipid-laden macrophages

2

Is xanthogranulomatous pyelonephritis uni or bilatera?

Unilateral
- diffuse, focal or segmental

3

Who does xanthogranulomatous pyelonephritis commonly affect?

Middle aged diabetic women

4

What does xanthogranulomatous pyelonephritis look like on US? (3)

1. Renal enlargement
2. Lack of corticomedullary differentiation
3. Focal masses

5

What does ischemia lead to?

Papillary necrosis
- lose of blood flow that leads to cell death

6

What are causative factors of papillary necrosis? (9)

1. Analgesic abuse
2. Diabetes
3. UTI
4. Renal vein
5. Thrombosis
6. Prolonged urinary tract obstruction
7. Dehydration
8. Sickle cell anemia
9. Hemophilia

7

What does papillary necrosis look like on US? (5)

1. Swollen pyramids
2. Cystic papilla
3. Clubbed calyx
4. Hydronephrosis
5. Debris in collecting system

8

TB

Tuberculosis

9

Who do tuberculosis affect?

The kidneys of 5-10 year olds after initial infection

10

What are the S/S of TB?

Frequency, dysuria, nocturia, urgency, gross or microscopic hematuria

11

What does TB look like on US? (3)

1. Focal renal lesions
2. Variable echotexture and size
3. May involve bladder
- focal or diffuse wall thickening

12

What is the best way to asses TB? (2)

1. CT
2. Urography

13

What is the most common fungal agent?

Candida Albicans

14

What are the patients who are at risk for fungal infections? (7)

1. Diabetes mellitus
2. Chronic indwelling catheters
3. Malignancy
4. Hematopoietic disorders
5. Chronic antibiotic or steroid therapy
6. Transplantation
7. IV drug abuse

15

What do fungal infections look like on US? (2)

1. Small cortical hypoechoic lesions
- small abscesses
2. Fungus balls in collecting system
- echogenic

16

What is the most common agent seen with parasitic infections?

Schistosomiasis

17

Schistosomiasis

Worms penetrate skin to liver via the portals

18

Hematuria

Eggs deposited in venules of bladder wall/ureter

19

Bladder stasis

Increased incidence of ureteral and bladder calculi and repeated infections

20

What is found in 2-5% of patients with hydatid disease?

Echinoccal hydatid Renal disease

21

What does echinoccal hydatid Renal disease affect? (3)

1. Kidneys
2. Ureters
3. Bladder

22

Who do filiariasis affect?

Children between 10-12 years of age

23

How is filiariasis transmitted?

Mosquitos

24

Where do worms enter with filiariasis?

The lymphatic system through the kidneys

25

When do symptoms develop for filiariasis?

5- 20 years after infection

26

Is US the best modality for filiariasis diagnosis?

No - not helpful in diagnosis

27

HIV

An acquired immunodeficiency syndrome

28

What has decreased the incidence of opportunistic infections for HIV?

Antiviral therapy

29

What kind of disease is HIV associated nephropathy?

Chronic renal disease

30

What is US used for with HIV? (3)

1. Exclude obstruction
2. Determine renal size
3. Cortical echogenicity