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OBGYN 2 > M9: Fetal GU > Flashcards

M9: Fetal GU Flashcards

(50 cards)

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1
Q

which structure forms the renal collecting sys

A

ureteric buds from the wolffian ducts

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2
Q

which structure forms the nephrons (glomeruli and loop of henle)

A

metanephros

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3
Q

when does urine production start

what produced amniotic fluid before this

A

11 wks

membranes and lungs

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4
Q

where in the body are the primitive kidneys located

what happens if they fail to migrate

A

pelvis

ectopic kidney

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5
Q

name for the primitive kidneys

A

metanephros

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6
Q

in which plane do we image kidneys

A

TRX, only SAG if there’s pathology

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7
Q

norm kidney length

A

equal to gestational age in mm

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8
Q

upper limit of norm for renal pelvis dilation

20 wks and 20 + wks

A

5mm up to 20 wks

8mm from 20 wks- term

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9
Q

2 segments of the cloaca

A

cloaca is the terminal end of the hindgut….

segments:
urinary and rectal

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10
Q

what does the caudal end of the cloaca form

what does the allantois form

A

urethra and bladder neck

the rest of the bladder

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11
Q

another name for ureters

A

mesonephric ducts

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12
Q

when do the genitals form

A

8-10 wks. (prior to 8 wks they are ambiguous)

male genitals develop w/ testosterone present, w/o, female genitals develop due to maternal estrogen

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13
Q

bilateral renal genesis is associated w/ which other anomalies

risk factors for bilateral renal agenesis

A

GU, GI and cardiac abnormalities
sirenomelia syndrome

teratogens - warfarin, cocaine, maternal diabetes type 1

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14
Q

US appearance of unilateral renal agenesis

A

kidney thats present may be enlarged since its doing all the work… fetus may be asymp

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15
Q

US appearance of bilateral renal agenesis

A

absent bladder
oligohydramnios or anhydramnios
small AC and IUGR

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16
Q

describe potters syndrome

A

a sequence that refers to the consequence of severe oligohydramnios due to bilateral renal agenesis

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17
Q

describe the phenotype of potters syndrome

A

pulmonary hypoplasia
abnormal hand and foot positions
facial anomalies
IUGR

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18
Q

describe hydronephrosis

A

distention of the renal pelvis and calyces w/ urine due to obstruction
usually unilateral

accounts for most renal abnormalities and sometimes associated w/ other syndromes

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19
Q

causes of hydro

A

obstruction
reflux
ureterocele

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20
Q

which part of the urinary sys will be dilated w/ obstruction at the UPJ

A

kidneys/renal pelvis

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21
Q

which part of the urinary sys will be dilated w/ obstruction at the UVJ

Study These Flashcards
A

kidneys/renal pelvis and ureters

22
Q

which gender does posterior uretheral valve obstruction effect

23
Q

grading hydro in fetuses

Study These Flashcards
A

grade 1: only renal pelvis dilated
grade 2: renal pelvis and calyces visible
grade 3: renal pelvis and calyces dilated
grade 4: parenchymal thinning

24
Q

whats the most common urinary obstruction in neonates

what should you look for

Study These Flashcards
A

UPJ obstruction

dilated renal pelvis and calyces

25
US appearance of unilateral UPJ obstruction bilateral?
normal bladder and amniotic fluid olihydromnios w/ hydro of varying degrees
26
US appearance of severe UPJ obstruction
renal parenchyma may be destroyed
27
false + for UPJ obstruction
extra-renal pelvis prominent renal veins reflux (dilation will come and go/be transient)
28
most common cause of ureterovescial obstruction/UVJ
duplicated collecting sys w/ an ectopic ureter location from the upper pole of the kidney
29
US appearance of UVJ obstruction w/ duplicated collecting sys the ureter can mimic which structure
dilated upper pole of kidney w/ dilated ureter, lower pole is normal bowel (but bowel is medial in the body, ureter is lateral)
30
define ureterocele
cystic dilation of the intravesicular portion of the ureter, associated w/ dilation of upper pole of kidney in a duplicated collecting sys
31
what are posterior urethral valves
membranes that occur in the prostatic urethra of a male fetus that obstruct retrograde flow of urine
32
US appearance of posterior urethral valves
large distended bladder (keyhole) oligohydramnious hydro
33
PUV may be a precursor to which syndrome
prune belly syndrome/eagle-barrett syndrome
34
describe a bladder exstrophy what causes it
failure of closure of the bladder, lower urinary tract, symphysis pubis, rectus muscles and skin defect in development of cloacal membrane
35
bladder exstrophy is associated w/ which condition
cloacal extrophy
36
what is the OEIS complex
omphalocele extrophy of the bladder imperforate anus spinal abnormalities
37
describe infantile polycystic kidney disease (ARPKD) US appearance/diagnostic criteria
autosomal recessive disorder primarily effecting the collecting ducts/cortex - bilaterally enlarged echogenic kidneys (many small cysts under 1-2 mm) - severe oligohydramnios - absent bladder
38
ARPKD/IPKD is associated w/ which conditions
meckel Gruber syndrome Roberts syndrome - IPKD, phocomelia, cleft palate T13
39
ddx for IPKD
benign glomerulosclerosis - large echogenic kidneys but hypo pyramids and norm fluid (diagnosed in a lab)
40
what is phocomelia
hands and feet attached to trunk w/ single bone
41
describe ADPKD US appearance
-rarely seen antenatally but fetus is assessed if parents have the condition enlarged kidneys w/ cysts, may be hyperechoic norm amniotic fluid and bladder
42
describe multi cystic dysplastic kidney (MCDK) US appearance
multiple cystic lesions that arise from tubules of the cortex, cysts dont communicate - kidneys not reniform shape - unilateral usually - bilaterally - low fluid, associated w/ potters sequence, IS FATAL due to lack of fluid
43
is MCDK a genetic condition
no
44
2 types of renal tumors
nephroblastoma (wilm's tumor) - solid mass, not commonly identified in utero mesoblastic nephroma
45
most common congenital renal tumor
mesoblastic nephroma
46
2 adrenal pathologies
neuroblastoma | hemorrhage
47
possible genital pathologies
Male: hydrocele cryptorchidism Female: hydrometrocolpos ovarian cysts Both: ambiguous genitals X linked syndromes - Turners, Noonan's, hemophilia
48
which structures can be mistaken for the kidneys if theres renal agenesis
adrenals since they will occupy the space of the kidney (laying down adrenals?)
49
US appearance of bladder rupture w/ which pathology can this occur
ascites thick bladder wall moderate hydro PUV
50
When gendering a male, which structure must be included
Penis

OBGYN 2 (15 decks)

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