Flashcards in RENAL PATHOLOGY Deck (43)
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ACUTE RENAL FAILURE
SUDDEN DECREASE IN RENAL FUNCTION
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CAUSES OF ACUTE RENAL FAILURE
-ACUTE TUBULAR NECROSIS (MOST COMMON)
-RENAL ARTERY STENOSIS
-RENAL INFECTION
-URINARY TRACT OBSTRUCTION
-POLYCYSTIC KID DISEASE
-METABOLIC DISORDERS
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ACUTE TUBULAR NECROSIS
ISCHEMIC DAMAGE AND CELL DESTRUCTION. RESULTS IN RENAL FAILURE
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CLINICAL FINDINGS OF ACUTE RENAL FAILURE
1. ELEVATED BUN & CREATININE
2. OLIGURIA (ABNORMALLY SMALL AMOUTS OF URINE)
3. HTN
4. LEUKOCYTOSIS
5. HEMATURIA
6. EDEMA
7. HYPOVOLEMIA
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SONOGRAPHIC FINDINGS OF ACUTE RENAL FAILURE
1. NORMAL KID
2. MAY APPEAR more echogenic
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CHRONIC RENAL FAILURE
GRADUAL DECREASE IN RENAL FUNCTION OVER TIME
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CAUSES OF CHRONIC RENAL FAILURE
-DM (MOST COMMON)
-GLOMERULONEPHRITIS
-CHRONIC PYLONEPHRITIS
-METABOLIC DISORDERS
-CHRONIC URINARY TRACT OBSTRUCTION
-TUBERCULOSIS
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CLINICAL FINDINGS OF CHRONIC RENAL FAILURE
1.DM
2.MALAISE
3.ELEVATED BUN & CREATININE
4.FATIGUE
5.HTN
6.HYPERKALEMIA
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SONOGRAPHIC FINDINGS OF CHRONIC RENAL FAILURE
1. SMALL, ECHOGENIC KID
2. LOSS OF NORMAL CORTICOMEDULLARY DIFFERENTIATION
3. RENAL CYSTS MAY BE SEEN
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SIMPLE RENAL CYSTS LOCATION
PERIPELVIC, PARAPELVIC, CORTICAL, OR EXOPHYTIC
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PERIPELVIC CYSTS
ORIGINATE AT RENAL SINUS
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PARAPELVIC CYSTS
ORIGINATES IN THE RENAL PARENCHYMA AND PROTRUDES INTO RENAL SINUS. MAY BE DIFFICULT TO DIFFERENTIATE DROM A DILATED RENAL PELVIS
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CORTICAL CYSTS
LOCATED WITHIN THE CORTEX. DIFFUCULT TO IMAGE ESPECIALLY IF SOLITARY
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EXOPHYTIC CYSTS
APPEAR TO BE PROJECTING OUT AWAY FROM THE KID
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CLINICAL FINDING OF SIMPLE RENAL CYST
ASYMPTOMATIC
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SONOGRAPHIC FINDINGS OF SIMPLE RENAL CYST
1. SPHERICAL
2. ANECHOIC MASS
3. SMOOTH WALLS (INCLUDING WELL DEFINED POSTERIOR WALL)
4. POSTERIOR ACUSTIC ENHANCEMENT
5. NO INTERNAL ECHOES
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CHARACTERISTICS OF COMPLEX RENAL CYST (MALIGNANCY)
SEPTATION, IRREGULAR DEBRIS, MURAL NODULES, PAPILLARY PROJECTION, OR IRREGULAR BORDERS
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RENAL CYST W INTERNAL CALCIFICATION
-PREVIOUS HX OF A HEMORRHAGIC OR INFECTED CYST
-ASYMPTOMATIC
-POSTERIOR SHADOWING FROM CALCIFICATION WITHIN THE CYST
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HEMORRHAGIC RENAL CYST
-SIMPLE CYSTS MAY BLEED INTO THEMSELVES
-POSSIBLE HX OF TRAUMA
-FLANK PAIN
-HEMATURIA
-ANECHOIC, HYPOECHOIC, HYPERECHOIC OR COMPLEX MASS, DEPENDING ON STAGE OF HEMOLYSIS
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INFECTED RENAL CYST
-UTI
-FEVER
-FLANK PAIN
-HEMATURIA
-LEUKOCYTOSIS
-INTERNAL DEBRIS
-THICK WALLS
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MILK OF CALCIUM CYST
-ASYMPTOMATIC
-FLUID-FLUID LEVEL WITHIN THE CYST
-MILK OF CALCIUM WILL SHADOW AND LEYER WITHIN THE CYST
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MULTILOCULAR RENAL CYST
-PREVIOUS HX OF A HEMORRHAGIC OR INFECTED CYST
-ASYMPTOMATIC
-THIN SEPTATIONS SEPARATING THE LOCULES OF FLUID
-NO BLOOD FLOW WITHIN SEPTATIONS
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AUTOSOMAL DOMINANT POLYCYSTIC KID DISEASE
AKA ADULT POLYCYSTIC KID DISEASE.
ADPKD HAS 40% ASSOCIATION WITH POLYCYSTIC LIVER DISEASE.
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CLINICAL FINDINGS OF AUTOSOMAL DOMINANT POLYCYSTIC KID DISEASE
1. ASYMPTOMATIC UNTIL 3RD OR 4TH DECADE OF LIFE
2. DECREASED RENAL FUNCTION
3. UTI
4. RENAL CALCULI
5. FLANK PAIN
6. HEMATURIA
7. PALPABLE ABDOMINAL MASS
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SONOGRAPHIC FINDINGS OF AUTOSOMAL DOMINANT POLYCYSTIC KID DISEASE
1. B/L ENLARGED KID TAHT CONTAINS NUMEROUS CORTICAL RENAL CYSTS
2. POSSIBLE CYSTS IDENTIFIED IN THE PANCREAS, LIVER AND/OR SPLEEN
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AUTOSOMAL RECESSIVE POLYCYSTIC KID DISEASE
AKA INFANTILE POLYCYSTIC KID DISEASE
-CHARACTERIZED BY DILATION OF THE RENAL COLLECTING TUBULES.
-CAN BE OFTEN RECOGNIZED IN THE FETUS
-IF PRENATAL DEATH DOES NOT OCCUR, PATIENTS OFTEN DIE SECONDARY TO DILATION OF THE RENAL COLLECTING TUBULES.
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CLINICAL FINDINGS OF AUTOSOMAL RECESSIVE POLYCYSTIC KID DISEASE
1. CLINICAL FINDINGS OF RENAL FAILURE
2. HEPATIC DISEASE
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SONOGRAPHIC FINDINGS OF AUTOSOMAL RECESSIVE POLYCYSTIC KID DISEASE
1. B/L, ENLARGED ECHOGENIC KID
2. LOSS OF CORTICOMEDULLARY DIFFERENTIATION
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MULTICYSTIC DYSPLASTIC RENAL DISEASE
AKA MULTICYSTIC RENAL DYSPLASIA
-CAUSE BY EARLY, 1ST TRIMESTER OBSTRUCTION OF THE URETER
-IF B/L, IT IS FATAL
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CLINICAL FINDINGS OF MULTICYSTIC DYSPLASTIC RENAL DISEASE
1. ASYMPTOMATIC
2. NORMAL RENAL FUNCTION
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SONOGRAPHIC FINDINGS OF MULTICYSTIC DYSPLASTIC RENAL DISEASE
1. UNILATERAL, SMOOTH-WALLED, NONCOMMUNICATING CYSTS OF VARYING SIZES LOCATED WITHIN RENAL FOSSA
2. COMPENSATORY HYPERTROPHY OF CONTRALATERAL KID
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ACQUIRED RENAL CYSTIC DISEASE
-OFTEN THE RESULT OF CHRONIC HEMODIALYSIS.
- PTS WITH HX OF DIALYSIS AND WHO HAVE ACQUIRED RENAL CYSTIC DISEASE ARE AT INCREASED RISK FOR DEVELOPING RCC
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CLINICAL FINDINGS OF ACQUIRED RENAL CYSTIC DISEASE
1. CLINICAL FINDINGS OF CHRONIC RENAL FAILURE
2. HX OF HEMODIALYSIS
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SONOGRAPHIC FINDINGS OF ACQUIRED RENAL CYSTIC DISEASE
1. KID WILL APPEAR SMALL INITIALLY DURING END-STAGE RENAL DISEASE WITH SOME SMALL CYSTS
2. WITH TIME, KID MAY ENLARGE AND HAVE NUMEROUS SMALL CYSTS NOTED THROUGHOUT RENAL PARENCHYMA
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VON HIPPEL-LINDAU SYNDROME
INHERITED DISORDER CHARACTERIZED BY TUMOES OF THE CENTRAL NERVOUS SYSTEM AND ORBITS.
PTS WITH THIS SYNDROME HAVE THE PROPENSITY TO DEVELOP CYSTS WITHIN KID, RCC, AND PHEOCHROMOCYTOMAS.
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CLINICAL FINDINGS OF VON HIPPEL-LINDAU SYNDROME
1. SYMPTOMS OF A BRAIN AND/OR EYE TUMORS
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SONOGRAPHIC FINDINGS OF VON HIPPEL-LINDAU SYNDROME
1. MULTIPLE RENAL CYSTS
2. CYSTS MAY BE COMPLEX AND HAVE MURAL NODULES (SIGN OF RCC)
3.CYSTS WITHIN PANCREAS
4. PHEOCHROMOCYTOMA MAY BE PRESENT
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TUBEROUS SCLEROSIS
SYSTEMIC DISORDER THAT LEADS TO THE DEVELOPMENT OF TUMORS WITHIN VARIOUS ORGANS.
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CLINICAL FINDINGS OF TUBEROUS SCLEROSIS
1. EPILEPSY
2. SKIN LESIONS OF THE FACE
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SONOGRAPHIC FINDINGS OF TUBEROUS SCLEROSIS
1. B/L RENAL CYSTS
2. B/L ANGIOMYOLIPOMAS
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ACUTE PYELONEPHRITIS
INFLAMMATION OF KIDNEY OR KIDNEYS.
BACTERIA SPREAD THROUGH BLOODSTREAM OR, MORE COMMONLY, THE LOWER URINARY TRACT. REFERRED TO AS ACENDING INFECTION. BEGINS IN BLADDER AND REFLUXES UP THROUGH THE URETERS INTO KID. MOST COMMONLY IN WOMEN
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CLINICAL FINDINGS OF ACUTE PYELONEPHRITIS
1. FLANK PAIN
2. BACTERURIA
3. PYURIA
4.LEUKOCYTOSIS
5.DYSURIA
6. URINARY FREQ,
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