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Flashcards in RENAL PATHOLOGY Deck (43)
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1

ACUTE RENAL FAILURE

SUDDEN DECREASE IN RENAL FUNCTION

2

CAUSES OF ACUTE RENAL FAILURE

-ACUTE TUBULAR NECROSIS (MOST COMMON)
-RENAL ARTERY STENOSIS
-RENAL INFECTION
-URINARY TRACT OBSTRUCTION
-POLYCYSTIC KID DISEASE
-METABOLIC DISORDERS

3

ACUTE TUBULAR NECROSIS

ISCHEMIC DAMAGE AND CELL DESTRUCTION. RESULTS IN RENAL FAILURE

4

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

5

SONOGRAPHIC FINDINGS OF ACUTE RENAL FAILURE

1. NORMAL KID
2. MAY APPEAR more echogenic

6

CHRONIC RENAL FAILURE

GRADUAL DECREASE IN RENAL FUNCTION OVER TIME

7

CAUSES OF CHRONIC RENAL FAILURE

-DM (MOST COMMON)
-GLOMERULONEPHRITIS
-CHRONIC PYLONEPHRITIS
-METABOLIC DISORDERS
-CHRONIC URINARY TRACT OBSTRUCTION
-TUBERCULOSIS

8

CLINICAL FINDINGS OF CHRONIC RENAL FAILURE

1.DM
2.MALAISE
3.ELEVATED BUN & CREATININE
4.FATIGUE
5.HTN
6.HYPERKALEMIA

9

SONOGRAPHIC FINDINGS OF CHRONIC RENAL FAILURE

1. SMALL, ECHOGENIC KID
2. LOSS OF NORMAL CORTICOMEDULLARY DIFFERENTIATION
3. RENAL CYSTS MAY BE SEEN

10

SIMPLE RENAL CYSTS LOCATION

PERIPELVIC, PARAPELVIC, CORTICAL, OR EXOPHYTIC

11

PERIPELVIC CYSTS

ORIGINATE AT RENAL SINUS

12

PARAPELVIC CYSTS

ORIGINATES IN THE RENAL PARENCHYMA AND PROTRUDES INTO RENAL SINUS. MAY BE DIFFICULT TO DIFFERENTIATE DROM A DILATED RENAL PELVIS

13

CORTICAL CYSTS

LOCATED WITHIN THE CORTEX. DIFFUCULT TO IMAGE ESPECIALLY IF SOLITARY

14

EXOPHYTIC CYSTS

APPEAR TO BE PROJECTING OUT AWAY FROM THE KID

15

CLINICAL FINDING OF SIMPLE RENAL CYST

ASYMPTOMATIC

16

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

17

CHARACTERISTICS OF COMPLEX RENAL CYST (MALIGNANCY)

SEPTATION, IRREGULAR DEBRIS, MURAL NODULES, PAPILLARY PROJECTION, OR IRREGULAR BORDERS

18

RENAL CYST W INTERNAL CALCIFICATION

-PREVIOUS HX OF A HEMORRHAGIC OR INFECTED CYST
-ASYMPTOMATIC
-POSTERIOR SHADOWING FROM CALCIFICATION WITHIN THE CYST

19

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

20

INFECTED RENAL CYST

-UTI
-FEVER
-FLANK PAIN
-HEMATURIA
-LEUKOCYTOSIS
-INTERNAL DEBRIS
-THICK WALLS

21

MILK OF CALCIUM CYST

-ASYMPTOMATIC
-FLUID-FLUID LEVEL WITHIN THE CYST
-MILK OF CALCIUM WILL SHADOW AND LEYER WITHIN THE CYST

22

MULTILOCULAR RENAL CYST

-PREVIOUS HX OF A HEMORRHAGIC OR INFECTED CYST
-ASYMPTOMATIC
-THIN SEPTATIONS SEPARATING THE LOCULES OF FLUID
-NO BLOOD FLOW WITHIN SEPTATIONS

23

AUTOSOMAL DOMINANT POLYCYSTIC KID DISEASE

AKA ADULT POLYCYSTIC KID DISEASE.
ADPKD HAS 40% ASSOCIATION WITH POLYCYSTIC LIVER DISEASE.

24

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

25

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

26

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.

27

CLINICAL FINDINGS OF AUTOSOMAL RECESSIVE POLYCYSTIC KID DISEASE

1. CLINICAL FINDINGS OF RENAL FAILURE
2. HEPATIC DISEASE

28

SONOGRAPHIC FINDINGS OF AUTOSOMAL RECESSIVE POLYCYSTIC KID DISEASE

1. B/L, ENLARGED ECHOGENIC KID
2. LOSS OF CORTICOMEDULLARY DIFFERENTIATION

29

MULTICYSTIC DYSPLASTIC RENAL DISEASE

AKA MULTICYSTIC RENAL DYSPLASIA
-CAUSE BY EARLY, 1ST TRIMESTER OBSTRUCTION OF THE URETER
-IF B/L, IT IS FATAL

30

CLINICAL FINDINGS OF MULTICYSTIC DYSPLASTIC RENAL DISEASE

1. ASYMPTOMATIC
2. NORMAL RENAL FUNCTION

31

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

32

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

33

CLINICAL FINDINGS OF ACQUIRED RENAL CYSTIC DISEASE

1. CLINICAL FINDINGS OF CHRONIC RENAL FAILURE
2. HX OF HEMODIALYSIS

34

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

35

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.

36

CLINICAL FINDINGS OF VON HIPPEL-LINDAU SYNDROME

1. SYMPTOMS OF A BRAIN AND/OR EYE TUMORS

37

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

38

TUBEROUS SCLEROSIS

SYSTEMIC DISORDER THAT LEADS TO THE DEVELOPMENT OF TUMORS WITHIN VARIOUS ORGANS.

39

CLINICAL FINDINGS OF TUBEROUS SCLEROSIS

1. EPILEPSY
2. SKIN LESIONS OF THE FACE

40

SONOGRAPHIC FINDINGS OF TUBEROUS SCLEROSIS

1. B/L RENAL CYSTS
2. B/L ANGIOMYOLIPOMAS

41

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

42

CLINICAL FINDINGS OF ACUTE PYELONEPHRITIS

1. FLANK PAIN
2. BACTERURIA
3. PYURIA
4.LEUKOCYTOSIS
5.DYSURIA
6. URINARY FREQ,

43

SONOGRAPHIC FINDINGS OF ACUTE PYELONEPHRITIS

1. MAY APPEAR NORMAL
2. RENAL ENLARGEMENT
3. FOCAL AREAS OF ALTERED ECHOTEXTURE
4. COMPRESSION OF RENAL SINUS