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ARDMS ABD REVIEW > Pathology #6 > Flashcards

Pathology #6 Flashcards

1
Q

An asymptomatic patient presents for a renal US for size evaluation due to chronic systemic HTN. The right kidney demonstrates a 1 cm rounded hyperechoic mass within the renal cortex. There is no posterior enhancement of shadowing noted with the mass. Which of the following can be used to describe the US findings?

angiomyolipoma or lipoma
adenoma or fibroma
oncocytoma
hepatoma

A

angiomyolipoma or lipoma

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2
Q

RCC is also called:

hypernephroma
TCC
nephroblastoma
Wilm-s tumor

A

hypernephroma

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3
Q

The term allograft refers to:

the bypass graft used in arterial revascularization of a organ

the native organ that will be replaced by a transplanted organ

the transplanted organ

an external portal shunt

A

the transplanted organ

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4
Q

The findings on the image are most suggestive of:

duplicated collecting system
junctional parenchymal defect
column of Bertin
cross fused renal ectopia

A

duplicated collecting system

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5
Q

A 30 year old male presents with pelvic discomfort. He has a 2 year history of HIV infection and is an insulin dependent diabetic. When evaluation the urinary bladder, you identify a mobile, round, hyperechoic solid mass with no posterior shadowing. What is the most likely diagnosis for these findings?

fungal ball
TCC
bladder stone
squamous cell carcinoma

A

fungal ball

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6
Q

The most common place for an ectopic kidney to be located is:

connected to the lower pole of the opposite kidney
mid-epigastric region posterior to bowel
adjacent to the opposite kidney in the same quadrant
right or left lower quadrant, slightly off midline

A

right or left lower quadrant, slightly off midline

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7
Q

Which of the following correctly describes Xanthogranulomatous Pyelonephritis?

most cases demonstrate a staghorn calculus and thinned renal cortex

caused by recurrent severe dehydration

prevalent in males and HIV patients

most commonly bilateral and fatal

A

most cases demonstrate a staghorn calculus and thinned renal cortex

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8
Q

The image demonstrates ___, which is commonly associated with ___.

UPJ obstruction, staghorn calculus
parapelvic cyst, bladder diverticulum
staghorn calculus, hydronephrosis
duplicated collecting system, ureterocele

A

duplicated collecting system, ureterocele

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9
Q

Which of the following would result in a 7cm right kidney and a 9.8cm left kidney in an average sized patient?

renal lymphoma
RRA stenosis
ADPKD
acute thrombosis of the RRV

A

RRA stenosis

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10
Q

Which of the following is the most common cause of acute renal failure in an allograft?

MCKD
acute tubular necrosis
RA stenosis
polycystic disease

A

acute tubular necrosis

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11
Q

A patient is referred for a renal ultrasound due to suspected cross fused renal ectopia. What is the expected ultrasound finding for this condition?

both kidneys are located on the same side of the body and fused together at varied locations

there is a single kidney located in the midline pelvic region

the kidneys are in their normal position but the upper poles of the kidneys are joined across the midline, usually anterior to the mid AO

the kidneys are in their normal position but the lower poles of the kidneys are joined across the midline, usually anterior to the mid AO

A

both kidneys are located on the same side of the body and fused together at varied locations

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12
Q

Which of the following correctly describes TCC?

most commonly presents as diffuse bladder wall thickening with multiple masses within the wall

most common mass encountered on the adrenal gland

always causes bilateral hydronephrosis

urinary incontinence is the most common symptom

A

most commonly presents as diffuse bladder wall thickening with multiple masses within the wall

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13
Q

Which of the following sonographic characteristics is an expected finding in a patient with acute renal vein thrombosis?

increased diastolic flow in the RAs
enlarged kidney with mottled echogenicity
high velocity, continuous venous flow within the kidney
prominent corticomedullary definition

A

enlarged kidney with mottled echogenicity

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14
Q

Children with Beckwith Wiedemann Syndrome have a significant risk of developing:

nephroblastoma
hyperparathyroidism
cholelithiasis
PHTN

A

nephroblastoma

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15
Q

Oncocytoma, RCC, and FNH share what sonographic characteristic?

thick septations within the mass
posterior enhancement
invasion of vasculature
central scar

A

central scar

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16
Q

Which of the following correctly describes how a Sonographer can differentiate a neuroblastoma from a nephroblastoma on an abdominal US?

it is not possible to differentiate these two tumors sonographically

the neuroblastoma is highly vascular while the nephroblastoma is mainly necrotic due to limited vascular supply

the nephroblastoma will not distort the renal contour or disrupt the capsule, the neuroblastoma will distort the renal contour and disrupt the capsule

the neuroblastoma will not distort the renal contour or disrupt the capsule, the nephroblastoma will distort the renal contour and disrupt the capsule

A

the neuroblastoma will not distort the renal contour or disrupt the capsule, the nephroblastoma will distort the renal contour and disrupt the capsule

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17
Q

If a pregnant patient has unilateral hydronephrosis, what is the preferred method to rule out an obstructive ureteral calculus as the cause?

apply color Doppler to identify the ureteral jets

obstructive ureteral calculi cannot be evaluated in a pregnant patient, a CT abdomen and pelvis exam with contrast is required

obstructive ureteral calculi cannot be evaluated in a pregnant patient, an intravenous pyelogram is required

ask the patient to empty bladder and apply color Doppler to locate a stone with twinkling artifact

A

apply color Doppler to identify the ureteral jets

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18
Q

A patient presents for a renal ultrasound due to a recent diagnosis of staphylococcus aureus infection, right flank pain and microscopic hematuria. The chart states the referring physician suspects a renal carbuncle has formed. How will this abnormality be identified sonographically?

a hyperechoic mass of fibrous tissue replaces the tissues of the renal sinus causing significant outflow obstruction

1.5cm complex mass located within the renal pelvis that is causing RV thrombosis

1.5cm complex mass with ringdown and dirty shadowing located within the renal parenchyma

a single large calculus obstructing the renal pelvis with severe hydronephrosis

A

1.5cm complex mass with ringdown and dirty shadowing located within the renal parenchyma

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19
Q

Unilateral renal agenesis is associated with what anomaly in women? and in men?

ovarian agenesis, testicular agenesis
uterine agenesis, testicular agenesis
bicornuate uterus, agenesis of seminal vesicles
ovarian agenesis, agenesis of seminal vesicles

A

bicornuate uterus, agenesis of seminal vesicles

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20
Q

The image demonstrates the Doppler evaluation of a transplant kidney. The findings on the image are most suggestive of:

RA stenosis
acute rejection
RV thrombosis
normal flow

A

RV thrombosis

**venous outflow is obstructed, resistance to arterial inflow is significantly increased

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21
Q

___ is the most common renal tumor in neonates, while ___ is the most common renal tumor in pediatric patients.

mesoblastic nephroma, angiomyolipoma
mesoblastic nephroma, nephroblastoma
nephroblastoma, neuroblastoma
nephroblastoma, mesoblastic nephroma

A

mesoblastic nephroma, nephroblastoma

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22
Q

A patient presents with a history of neurogenic bladder and recent onset of mild hematuria. Which of the following statements is true regarding the findings on the image?

it is necessary to change the patient position while scanning to determine mass mobility

the mass appears to be a remnant of the catheter balloon that was thought to be removed one week ago

the hypoechoic mass is most likely malignant due to the significant infiltration of the bladder wall

if the hypoechoic mass is mobile, it is most likely a calciulus

A

it is necessary to change the patient position while scanning to determine mass mobility

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23
Q

A patient presents with flank pain, fever, and nausea for 2 days. Urinalysis shows RBC and WBC present in the sample. Which of the following would be the most likely diagnosis made from the renal ultrasound images provided from this patient’s exam?

RCC
focal pyelonephritis
renal adenoma
diffuse pyelonephritis

A

focal pyelonephritis

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24
Q

Which of the following renal pathologies will appear the same sonographically as focal acute pyelonephritis?

angiomyolipoma
renal adenoma
renal infarct
pyonephritis

A

renal infarct

** both will demonstrate normal renal size with a focal, indistinct, hypoechoic wedge shaped segment of parenchyma

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25
Q

Which of the following has the lowest risk of developing RCC?

patients with ARPKD
patients with acquired cystic disease
patients on long term dialysis
patients with tuberous sclerosis

A

patients with ARPKD

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26
Q

A male patient presents with a palpable flank mass, pain, hematuria and a history of Von Hippel-Lindau syndrome. The findings on the image are most suggestive of:

RCC
spontaneous hematoma
renal adenoma
focal pyelonephritis

A

RCC

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27
Q

If Doppler evaluation of the parenchymal artery of a kidney demonstrates a RI of 0.45, the findings are considered:

suspicious for ARF
suspicious for CRF
normal
suspicious for proximal RA stenosis

A

suspicious for proximal RA stenosis

** low RI ( <0.5 ) indicates reduced inflow

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28
Q

A renal transplant is usually positioned in the RLQ with an arterial connection with what native artery?

inferior mesenteric artery
external iliac
AO
internal iliac

A

external iliac

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29
Q

Which of the following correctly describes the sonographic appearance of renal lymphoma?

unilateral renal atrophy
bilateral renal enlargement
bilateral renal atrophy with renal failure
unilateral renal enlargement

A

bilateral renal enlargement

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30
Q

Which of the following renal tumors is a hypoechoic mass most commonly found in the renal pelvis?

oncocytoma
adenoma
RCC
TCC

A

TCC

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31
Q

The purple arrow on the image indicates which of the following?

two kidneys fused at the mid poles, the arrow is pointing to the point of connection and the shared parenchymal tissue

a malignant mass of tissue separating the sinus into 2 portions

a normal variant in a renal parenchymal formation called a dromedary hump

a normal variant in renal formation usually related to a duplicated collecting system

A

a normal variant in renal formation usually related to a duplicated collecting system

** column of Bertin = strip of renal cortex that extends into the renal sinus

if the column of tissue reaches the cortex of the opposing side of the kidney, a duplicated collecting system is usually present

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32
Q

A large calculus located in the renal pelvis area is called:

parapelvic stone
staghorn calculi
Gerota calculi
parapelvic stone or staghorn calculus

A

staghorn calculi

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33
Q

If the left kidney has the same appearance, the findings are most consistent with:

acquired cystic disease
ADPKD
MCKD
ARPKD

A

ADPKD

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34
Q

Increased RI in the renal parenchymal arteries is an expected finding with:

acute renal artery occlusion and ARF
acute tubular necrosis and RV thrombosis
infrarenal aortic aneurysms
renal allografts placed less than 1 week ago

A

acute tubular necrosis and RV thrombosis

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35
Q

A 60 year old female patient presents with a recent history of a renal biopsy of the lower pole of the left kidney. Currently, she is suffering from flank pain, fever, nausea and vomiting. The clinical and ultrasound findings are most suggestive of:

renal hematoma with thrombus formation

large urinoma caused by possible puncture of the ureter during the biopsy

renal abscess with pus accumulation

A or B, not enough information to differentiate

A

renal abscess with pus accumulation

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36
Q

Which of the following is an expected sonographic finding with complete duplication of the collecting system of the kidney?

circumferential cortex at the upper, mid and lower poles

circumferential cortex at the lower pole

circumferential cortex at the upper pole

circumferential cortex at the mid pole

A

circumferential cortex at the mid pole

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37
Q

The most common location for a urinary obstruction caused by a renal calculus is in the ___.

distal urethra
trigone of the bladder
distal ureter
proximal ureter

A

distal ureter

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38
Q

Which of the following are complications associated with chronic hydronephrosis?

portal thrombosis and pulmonary embolism
urinoma and hematoma
systemic HTN and renal failure
neurogenic bladder and medullary sponge kidney

A

systemic HTN and renal failure

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39
Q

A patient presents for a renal ultrasound due to a history of tuberous sclerosis. What is the doctor looking for?

renal failure
hydronephrosis
angiomyolipomas
RA stenosis

A

angiomyolipomas

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40
Q

All of the following would indicate chronic renal disease, EXCEPT:

bilateral hydronephrosis
bilateral renal cysts
enlarged kidneys
unilateral hydronephrosis

A

enlarged kidneys

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41
Q

On ultrasound, a mycetoma appears as:

a hypoechoic mass that causes propagation artifact

a hyperechoic mass with posterior enhancement

a hypoechoic mass that forms in the renal pelvis with a bacterial infection

a hyperechoic mass without posterior shadowing

A

a hyperechoic mass without posterior shadowing

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42
Q

What bacteria is responsible for most infectious processes that affect the kidneys?

Methicillin-resistant staphylococcus aureus (MRSA)
staphylococcus aureus
staphylococcus epidermidis
escherichia coli (E. coli)

A

E. coli

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43
Q

Which of the following statements is true regarding the image displayed?

the patient will present with a fever and increased WBC count

the renal cortex is thinned and increased in echogenicity

a staghorn calculus is seen in the central pelvis of the kidney causing the hydronephrosis

the BUN and creatinine serum levels will be decreased due to decreased renal function

A

the patient will present with a fever and increased WBC count

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44
Q

What is the most common primary renal malignancy?

TCC
Wilm’s tumor
cystadenocarcinoma
RCC

A

RCC

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45
Q

Which of the following is associated with echogenic debris/calcification in the renal pyramids?

pyelonephritis
papillary necrosis
hyperthyroidism
angiomyolipoma

A

papillary necrosis

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46
Q

A small, hyperechoic, round mass with no associated shadowing is seen in the cortex of the kidney. These findings are most consistent with:

staghorn calculus
renal calculus
angiomyolipoma
nephrocalcinosis

A

angiomyolipoma

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47
Q

If the patient voids normally and the image remains the same, the findings are most suggestive of:

urethral obstruction
RV thombosis
ureteral obstruction
BPH

A

ureteral obstruction

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48
Q

A 65 year old male presents with a recent diagnosis of secondary carcinoma of the seminal vesicles. A urinary system ultrasound is ordered. The findings displayed in the image most likely represent which of the following?

cystitis, which is a common side effect of the chemotherapy meds

thrombus accumulation with gross hematuria, which is a common side effect of the chemotherapy meds

bladder calculi and sludge due to malfunction of the seminal vesicles

primary and secondary bladder carcinoma

A

primary and secondary bladder carcinoma

49
Q

Which of the following statements best describes the findings on the image?

a hyperechoic, rounded mass is attached to the anterior, lateral aspect of the mid pole of the kidney

a hyperechoic, rounded mass is attached to the anterior, medial aspect of the mid pole of the kidney

a hyperechoic, rounded mass is attached to the posterior, lateral aspect of the mid pole of the kidney

a hyperechoic, rounded mass is attached to the posterior, medial aspect of the mid pole of the kidney

A

a hyperechoic, rounded mass is attached to the anterior, medial aspect of the mid pole of the kidney

50
Q

The findings on the image of the left flank are caused by:

PHTN
pancreatitis
PKD
ureteral obstruction

A

PHTN

51
Q

Sonographic signs of chronic renal failure include a/an ___ in size and a/an ___ in echogenicity.

decrease, increase
decrease, decrease
increase, increase
increase, decrease

A

decrease, increase

52
Q

While scanning the urinary bladder using color Doppler, the left urinary jet is detected but is partially obstructed by a thin membrane that balloons into the bladder lumen. What is the finding displayed?

posterior urethral vales
UPJ obstruction
urethrocele
ureterocele

A

ureterocele

53
Q

A 55 year old female presents with mild flank pain. The right kidney measures 13cm and demonstrates 3 cysts. The left kidney measures 13.8cm and demonstrates 2 cysts. Which of the following is the most likely explanation of the findings?

ADPKD
acquired cystic kidney disease
MCKD
ARPKD

A

ADPKD

54
Q

Analgesic abuse is the most common cause of what real abnormality?

glomerulonephritis
papillary necrosis
nephroncalcinosis
acute renal failure

A

papillary necrosis

55
Q

Which of the following are common causes for bilateral hydronephrosis?

pancreatic pseudocyst and nephrolithiasis
bladder outlet obstruction and pregnancy
Nutcracker syndrome and bladder obstruction
vascular calcification and nephrolithiasis

A

bladder outlet obstruction and pregnancy

56
Q

Which of the following renal disorders is usually detected in utero due to oligohydramnios?

duplicated collecting system
horseshoe kidney
ARPKD
MCKD

A

ARPKD

57
Q

___ transplant rejection appears as swollen kidney, loss of corticomedullary definition, enlarged renal pyramids, compression of the renal sinus, and decreased blood flow with increased RI value.

chronic

acute

chronic or acute, stages of rejection are not able to be differentiated with sonography

rejection of a renal allograft is not usually evaluated by sonography

A

acute

58
Q

Schistosomiasis and chronic cystitis are commonly associated with what sonographic findings in the urinary bladder?

ureterocele formation

the bladder lumen is filled with numerous non-shadowing stones

diffuse bladder wall calcification

bladder wall atrophy due to reduced arterial spply

A

diffuse bladder wall calcification

59
Q

Clubbing of the renal calyces is a sign of:

candidiasis infection and mycetoma formation
TCC and papillary necrosis
chronic pyelonephritis and papillary necrosis
hypernephroma and candidiasis infection

A

chronic pyelonephritis and papillary necrosis

60
Q

The attached image demonstrates which abnormality, commonly associated with medullary sponge kidneys?

nephrocalcinosis
nephrolithiasis
pyelonephritis
granuloma formation

A

nephrocalcinosis

61
Q

A 12 year old male patient presents for a renal ultrasound. Mild to moderate hydronephrosis is noted in the left kidney. The image displayed is of the patient’s left side of the bladder. Which of the following is the most likely diagnosis?

urethrocele
posterior urethral valves
diverticulum
ureterocele

A

ureterocele

62
Q

In cases of moderate to severe medical renal disease the renal parenchyma will be ___.

isoechoic to the liver
hypoechoic to the sinus
hypertrophied to >10mm thickness
atrophied to <10mm thickness

A

atrophied to <10mm thickness

63
Q

A 3 year old patient presents with flank pain and increased serum levels of creatinine. The images of the right kidney are displayed here. The right ureter was not dilated. The left kidney and bladder were normal. These findings are most suggestive of:

right UPJ obstruction
right parapelvic cyst
right ureterocele
right UVJ obstruction

A

right UPJ obstruction

64
Q

What is the most common cause for an abdominal mass in a newborn?

MCKD
RCC
hemangioma
hepatoblastoma

A

MCKD

65
Q

Tumor invasion into the urinary bladder is most commonly caused by ___ in females and by ___ in males.

ovarian cancer, testicular cancer
uterine cancer, prostate cancer
colon cancer, prostate cancer
uterine cancer, colon cancer

A

uterine cancer, prostate cancer

66
Q

The renal anomaly where the kidneys do not separate completely during embryonic development is called:

duplicated collecting system
horseshoe kidney
ectopic kidney
renal agenesis

A

horseshoe kidney

67
Q

Which of the following is a sonographic characteristic of acute tubular necrosis?

prominent renal pyramids
increased diastolic flow in the arcuate arteries
cortical thickness <1cm
atrophied kidney

A

prominent renal pyramids

68
Q

Which of the following best describes the ultrasound appearance of nephrocalcinosis?

multiple linear calcifications within the renal parenchyma

three or more renal calculi identified in each pole of the kidney

hyperechoic renal pyramids that may shadow

a large calculus within the renal pelvis causing hydronephrosis

A

hyperechoic renal pyramids that may shadow

69
Q

A 4 year old presents for a renal ultrasound with a suspected mass on the lateral aspect of the left kidney seen on a KUB x-ray. The ultrasound reveals a focal outward thickening of the normal renal cortex near the mid pole of the kidney. Which of the following best describes the finding?

Wilm’s tumor
column of Bertin
dromedary hump
duplicated collecting system

A

dromedary hump

70
Q

How does a junctional parenchyma defect appear on ultrasound examination?

narrowing or obstruction of the junction of the renal pelvis and ureter

thicker cortex on the lateral aspect of the left kidney

triangular hyperechoic area on the anterior aspect of the upper pole of the right kidney

prominent renal cortical parenchyma located between 2 medullary pyramids

A

triangular hyperechoic area on the anterior aspect of the upper pole of the right kidney

71
Q

Which of the following lists the most common ultrasound findings with acute glomerulonephritis?

small, smooth echogenic kidneys

bilateral renal enlargement with increased cortical echogenicity

bilateral microcyst formation that causes increased cortical echogenicity

unilateral renal enlargement with decreased cortical echogenicity

A

bilateral renal enlargement with increased cortical echogenicity

72
Q

Increased renal fat in the renal sinus with a thinned cortex indicates:

CRF
acute tubular necrosis
sinus lipomatosis
angiomyolipomatosis

A

sinus lipomatosis

73
Q

Which of the following will demonstrate the lowest RI value?

acute RA occlusion
acute tubular necrosis
RV thrombosis
ARF

A

acute RA occlusion

74
Q

What is the most common congenital anomaly of the urinary system?

dromedary hump
duplicated collecting system
ectopic kidney
pancake kidney

A

duplicated collecting system

75
Q

The findings on the image are most consistent with a patient history of:

ureteral calculi or recent history of urinary bladder catheterization

RV thrombosis or acute tubular necrosis

ADPKD or Von-Hippel Landau syndrome

ureterocele or obstruction of the ureteropelvic junction

A

ureteral calculi or recent history of urinary bladder catheterization

76
Q

Which of the following statements is true regarding the displayed images from a renal ultrasound exam?

the left kidney is fused to the right kidney on the right side of the body

renal function will be increased due to the fusion of the kidney tissues

the images represent the surgical connection of the kidneys in an effort to increase renal function

a duplicated collecting system is present

A

the left kidney is fused to the right kidney on the right side of the body

77
Q

Which congenital renal anomaly is commonly associated with ureterocele formation?

horseshoe kidney
duplicated collecting system
dromedary hump
renal agenesis

A

duplicated collecting system

78
Q

Which of the following is true regarding a renal oncocytoma?

may have a central scar similar to RCC

usually occur in pediatric patients

easily differentiated from RCC by the presence of a central scan within the tumor

usually malignant and very aggressive

A

may have a central scar similar to RCC

79
Q

Which of the following is a Doppler indication of acute RV thrombosis?

RI >0.7 in the cortex
decreased cortical resistance
enlarged kidney
increased diastolic flow

A

RI >0.7 in the cortex

80
Q

Extrinsic compression, pregnancy, stone, and mass formation are all causes of what urinary abnormality?

medullary sponge kidney
RA stenosis
hydronephrosis
renal carbuncle

A

hydronephrosis

81
Q

A patient presents with a history of high fever, HTN, nausea and vomiting. Lab results indicate the presence of WBCs, pus, and bacteria in the urine. A small, shrunken, misshapen left kidney and a normal right kidney are documented on the ultrasound exam. What are these findings most suggestive of?

acute glomerulonephritis
ARF
chronic pyelonephritis
emphysematous pyelonephritis

A

chronic pyelonephritis

82
Q

A patient presents for a renal ultrasound after an aortic surgery led to sepsis. The findings on the image are most consistent with.

papillary necrosis
emphysematous pyelonephritis
mycetoma
acute tubular necrosis

A

acute tubular necrosis

83
Q

In an otherwise normal kidney, an angiomyolipoma is ___ to the renal cortex and ___ to the renal sinus.

isoechoic, hyperechoic
hyperechoic, hypoechoic
hyperechoic, isoechoic
hypoechoic, iseoechoic

A

hyperechoic, isoechoic

84
Q

How does significant hydronephrosis affect the blood flow in the renal cortex?

increases diastolic flow
decreases the RI in the parenchymal arteries
increases systolic flow
increases the RI in the parenchymal arteries

A

increases the RI in the parenchymal arteries

85
Q

Which renal condition is always fatal?

ADPKD
horseshoe kidney
ARPKD
unilateral renal agenesis

A

ARPKD

86
Q

A 6 year old female presents with hematuria and a palpable mass in the RUQ. The most likely diagnosis is:

pheochromocytoma or neuroblastoma
Wilm’s tumor or oncocytoma
nephroblastoma or staghorn calculus
nephroblastoma or Wilm’s tumor

A

nephroblastoma or Wilm’s tumor

87
Q

A patient presents for a renal ultrasound to rule out RA stenosis. A wedge shaped hypoechoic area is noted within the parenchyma of the lower pole of the left kidney and no arcuate flow is detected in the area with color Doppler. The findings are most consistent with:

nephrocalcinosis
medullary sponge kidney
acute pyelonephrosis
renal infarct

A

renal infarct

88
Q

Acute occlusion of the main RA can cause ___ acute renal failure.

postrenal
prerenal
intrinsic
extrinsic

A

prerenal

89
Q

Which of the following sonographic characteristics is the most suggestive of acute RV thrombosis?

diastolic flow reversal in the RAs
atrophied kidney with mottled echogenicity
hyperarterial flow within the kidney
increased corticomedullary definition

A

diastolic flow reversal in the RAs

90
Q

The findings on the image of the right flank are commonly associated with:

RA stenosis
acute RA occlusion
nephrocalcinosis
ARPKD

A

RA stenosis

91
Q

What renal abnormality is suspected when sloughed papilla are identified in the urine?

nephrocalcinosis
acute pyelonephritis
hydronephrosis
papillary necrosis

A

papillary necrosis

92
Q

The renal anomaly where the kidneys demonstrate congenital duplication of the renal pelvis/calyces is called:

ectopic kidney
duplicated collecting system
renal agenesis
horseshoe kidney

A

duplicated collecting system

93
Q

Which of the following statements is true regarding the Doppler tracing from the RA?

normal flow pattern and velocity are demonstrated but an incorrect Doppler angle is used to assess the flow causing aliasing to occur

according to RAS diagnostic criteria, stenosis >60% is demonstrated

the renal to aortic ratio is most likely below 3.5

normal flow pattern and velocity are demonstrated

A

according to RAS diagnostic criteria, stenosis >60% is demonstrated

94
Q

What two bladder abnormalities are most commonly associated with a duplicated collecting system?

vesicoureteral reflux and bladder diverticulum
neurogenic bladder and posterior urethral valves
ureterocele and bladder diverticulum
ureterocele and vesicoureteral reflux

A

ureterocele and vesicoureteral reflux

95
Q

An ultrasound exam demonstrates a 1.8cm renal cyst in the upper pole of the left kidney with debris that layers in the dependent portion of the cyst when the patient changes position. These findings are most suggestive of:

infected cyst
milk of calcium cyst
renal abscess
porcelain cyst

A

milk of calcium cyst

96
Q

Which of the following describes a tardus parvus waveform?

low velocity with late systolic peak
high velocity with sharp peak
low velocity with diastolic flow reversal
high velocity with diastolic flow reversal

A

low velocity with late systolic peak

97
Q

Which of the following is correct regarding acute pyelonephritis?

diffuse involvement will demonstrate prominent distinction of the renal sinus echoes in affected kidney/segment

focal involvement will demonstrate a hyperechoic ovoid segment of parenchyma

usually treated with antibiotics

critical finding that requires immediate nephrectomy to prevent sepsis

A

usually treated with antibiotics

98
Q

Which of the following would normally present as a hypoechoic renal mass?

angiomyolipoma
milk of calcium cyst
mycetoma
oncocytoma

A

oncocytoma

99
Q

Which congenital anomaly is associated with hydronephrosis of the upper OR lower pole of the kidney?

duplicated collecting system
UPJ obstruction
column of Bertin
posterior urethral valves

A

duplicated collecting system

100
Q

Accessory renal arteries:

must be documented prior to renal resection of transplantation

usually originate from the contralateral RA

always enter the hilum adjacent to the main RA

demonstrate the same flow pattern as lumbar arteries

A

must be documented prior to renal resection of transplantation

101
Q

Which of the following Doppler criteria is used to evaluate the parenchymal flow in a renal allograft?

renal aortic ratio
PSV
RI
SD ratio

A

RI

102
Q

A UTI is most commonly caused by ___ and starts in the ___.

bacteria from the intestinal tract, bladder
bacteria from the vagina, bladder
bacteria from the intestinal tract, kidney
bacteria from the vagina, kidney

A

bacteria from the intestinal tract, bladder

103
Q

The renal collecting system is dilated and contains mildly echogenic material with dirty shadowing posteriorly. This most likely represents:

staghorn calculus
pyelonephritis
pyonephrosis
hydronephrosis

A

pyonephrosis

104
Q

A tardus parvus waveform is described as:

absence of early systolic peak and prolonged acceleration time

reduced systolic velocity with diastolic flow reversal

pronounced of early systolic peak and prolonged acceleration time

RI of 1.0 or greater

A

absence of early systolic peak and prolonged acceleration time

105
Q

Which of the following statements is true regarding the form of PKD demonstrated on the image displayed from a 32 year old male patient?

one parent has the disorder and it spans generations

the most commonly associated organ with additional cyst formation is the spleen

this form of PKD is usually fatal early in life

it requires two defective genes in pair to cause this type of PKD

A

one parent has the disorder and it spans generations

106
Q

Which of the following statements best describes the findings on the image?

a hypoechoic, rounded mass is present in the lower pole of the kidney

a hyperechoic, rounded mass is present in the lower pole of the kidney

a large renal calculus is present in the lower pole of the kidney

the lower pole of the kidney demonstrates the classic appearance of an infarct

A

a hyperechoic, rounded mass is present in the lower pole of the kidney

107
Q

Which of the following is most likely to produce posterior shadowing?

mycetoma
angiomyolipoma
renal lipoma
sloughed papilla

A

sloughed papilla

108
Q

The most common site for RA stenosis is:

at the origin of the RA
in the segmental artery of the upper pole
at the renal hilum
in the segmental artery of the lower pole

A

at the origin of the RA

109
Q

A 72 year old patient presents for an abdominal ultrasound for epigastric pain. You note a 3cm cyst on the periphery of the right kidney and 3 smaller cortical cysts on the left kidney. The cysts are anechoic with smooth borders. Both kidneys are normal in size and echotexture. These findings are most consistent with:

simple cortical cysts
ADPKD
acquired cystic disease
MCKD

A

simple cortical cysts

110
Q

What type of aneurysm is most commonly associated with ADPKD?

pseudoaneurysm
saccular
berry
fusiform

A

berry

111
Q

The attached image demonstrates:

sludge ball on the urinary bladder
echinococcal cyst in the urinary bladder
foley catheter in the bladder
ureterocele in the urinary bladder

A

foley catheter in the bladder

112
Q

Fluid dilatation of the renal pelvis and calyces is called:

pyonephrosis
hydronephrosis
hydronephritis
pyelonephrosis

A

hydronephrosis

113
Q

Multicystic dysplastic kidneys are usually the result of:

autosomal recessive genetic disorder
an obstruction of the UPJ in utero
autosomal dominant genetic disorder
chronic UTIs as a child

A

an obstruction of the UPJ in utero

114
Q

Which of the following can be treated using lithotripsy techniques?

RA stenosis
staghorn calculus
Budd Chiari
lymphoma

A

staghorn calculus

115
Q

The most common cause of ARF is ___ and the most common cause of CRF is ___.

acute tubular necrosis, diabetes
trauma, RV thrombosis
acute tubular necrosis, RA stenosis
RA stenosis, RV thrombosis

A

acute tubular necrosis, diabetes

116
Q

Hepatic fibrosis and PHTN are seen with which of the following?

MCKD
juvenile ARPKD
perinatal ARPKD
ADPKD

A

juvenile ARPKD

117
Q

Which of the following are commonly associated findings with horseshoe kidneys?

RCC and oncocytoma
bilateral renal atrophy and echogenic cortex
calculi and hydronephrosis
emphysematous pyelonephritis and ureterocele

A

calculi and hydronephrosis

118
Q

Which of the following will better evaluate the anomaly on the image?

core needle biopsy
intravenous pyelogram
KUB x-ray
serum BUN and creatinine levels

A

intravenous pyelogram

119
Q

If a patient complains of a recent onset of uncontrollable systemic HTN with average BP readings exceeding 170/90mmHG, what vascular cause should be suspected?

PHTN
hepatic congestion
subclavian stenosis
RA stenosis

A

RA stenosis

ARDMS ABD REVIEW (27 decks)

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