RENAL PATHOLOGY

Question 1

ACUTE RENAL FAILURE

Answer 1

SUDDEN DECREASE IN RENAL FUNCTION

Question 2

CAUSES OF ACUTE RENAL FAILURE

Answer 2

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

Question 3

ACUTE TUBULAR NECROSIS

Answer 3

ISCHEMIC DAMAGE AND CELL DESTRUCTION. RESULTS IN RENAL FAILURE

Question 4

CLINICAL FINDINGS OF ACUTE RENAL FAILURE

Answer 4

1. ELEVATED BUN & CREATININE
2. OLIGURIA (ABNORMALLY SMALL AMOUTS OF URINE)
3. HTN
4. LEUKOCYTOSIS
5. HEMATURIA
6. EDEMA
7. HYPOVOLEMIA

Question 5

SONOGRAPHIC FINDINGS OF ACUTE RENAL FAILURE

Answer 5

1. NORMAL KID

2. MAY APPEAR more echogenic

Question 6

CHRONIC RENAL FAILURE

Answer 6

GRADUAL DECREASE IN RENAL FUNCTION OVER TIME

Question 7

CAUSES OF CHRONIC RENAL FAILURE

Answer 7

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

Question 8

CLINICAL FINDINGS OF CHRONIC RENAL FAILURE

Answer 8

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

Question 9

SONOGRAPHIC FINDINGS OF CHRONIC RENAL FAILURE

Answer 9

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

Question 10

SIMPLE RENAL CYSTS LOCATION

Answer 10

PERIPELVIC, PARAPELVIC, CORTICAL, OR EXOPHYTIC

Question 11

PERIPELVIC CYSTS

Answer 11

ORIGINATE AT RENAL SINUS

Question 12

PARAPELVIC CYSTS

Answer 12

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

Question 13

CORTICAL CYSTS

Answer 13

LOCATED WITHIN THE CORTEX. DIFFUCULT TO IMAGE ESPECIALLY IF SOLITARY

Question 14

EXOPHYTIC CYSTS

Answer 14

APPEAR TO BE PROJECTING OUT AWAY FROM THE KID

Question 15

CLINICAL FINDING OF SIMPLE RENAL CYST

Answer 15

ASYMPTOMATIC

Question 16

SONOGRAPHIC FINDINGS OF SIMPLE RENAL CYST

Answer 16

1. SPHERICAL
2. ANECHOIC MASS
3. SMOOTH WALLS (INCLUDING WELL DEFINED POSTERIOR WALL)
4. POSTERIOR ACUSTIC ENHANCEMENT
5. NO INTERNAL ECHOES

Question 17

CHARACTERISTICS OF COMPLEX RENAL CYST (MALIGNANCY)

Answer 17

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

Question 18

RENAL CYST W INTERNAL CALCIFICATION

Answer 18

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

Question 19

HEMORRHAGIC RENAL CYST

Answer 19

• SIMPLE CYSTS MAY BLEED INTO THEMSELVES
• POSSIBLE HX OF TRAUMA
• FLANK PAIN
• HEMATURIA
• ANECHOIC, HYPOECHOIC, HYPERECHOIC OR COMPLEX MASS, DEPENDING ON STAGE OF HEMOLYSIS

Question 20

INFECTED RENAL CYST

Answer 20

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

Question 21

MILK OF CALCIUM CYST

Answer 21

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

Question 22

MULTILOCULAR RENAL CYST

Answer 22

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

Question 23

AUTOSOMAL DOMINANT POLYCYSTIC KID DISEASE

Answer 23

AKA ADULT POLYCYSTIC KID DISEASE.

ADPKD HAS 40% ASSOCIATION WITH POLYCYSTIC LIVER DISEASE.

Question 24

CLINICAL FINDINGS OF AUTOSOMAL DOMINANT POLYCYSTIC KID DISEASE

Answer 24

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

Question 25

SONOGRAPHIC FINDINGS OF AUTOSOMAL DOMINANT POLYCYSTIC KID DISEASE

Answer 25

1. B/L ENLARGED KID TAHT CONTAINS NUMEROUS CORTICAL RENAL CYSTS 2. POSSIBLE CYSTS IDENTIFIED IN THE PANCREAS, LIVER AND/OR SPLEEN

Question 26

AUTOSOMAL RECESSIVE POLYCYSTIC KID DISEASE

Answer 26

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.

Question 27

CLINICAL FINDINGS OF AUTOSOMAL RECESSIVE POLYCYSTIC KID DISEASE

Answer 27

1. CLINICAL FINDINGS OF RENAL FAILURE | 2. HEPATIC DISEASE

Question 28

SONOGRAPHIC FINDINGS OF AUTOSOMAL RECESSIVE POLYCYSTIC KID DISEASE

Answer 28

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

Question 29

MULTICYSTIC DYSPLASTIC RENAL DISEASE

Answer 29

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

Question 30

CLINICAL FINDINGS OF MULTICYSTIC DYSPLASTIC RENAL DISEASE

Answer 30

1. ASYMPTOMATIC | 2. NORMAL RENAL FUNCTION

Question 31

SONOGRAPHIC FINDINGS OF MULTICYSTIC DYSPLASTIC RENAL DISEASE

Answer 31

1. UNILATERAL, SMOOTH-WALLED, NONCOMMUNICATING CYSTS OF VARYING SIZES LOCATED WITHIN RENAL FOSSA 2. COMPENSATORY HYPERTROPHY OF CONTRALATERAL KID

Question 32

ACQUIRED RENAL CYSTIC DISEASE

Answer 32

- 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

Question 33

CLINICAL FINDINGS OF ACQUIRED RENAL CYSTIC DISEASE

Answer 33

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

Question 34

SONOGRAPHIC FINDINGS OF ACQUIRED RENAL CYSTIC DISEASE

Answer 34

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

Question 35

VON HIPPEL-LINDAU SYNDROME

Answer 35

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.

Question 36

CLINICAL FINDINGS OF VON HIPPEL-LINDAU SYNDROME

Answer 36

1. SYMPTOMS OF A BRAIN AND/OR EYE TUMORS

Question 37

SONOGRAPHIC FINDINGS OF VON HIPPEL-LINDAU SYNDROME

Answer 37

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

Question 38

TUBEROUS SCLEROSIS

Answer 38

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

Question 39

CLINICAL FINDINGS OF TUBEROUS SCLEROSIS

Answer 39

1. EPILEPSY | 2. SKIN LESIONS OF THE FACE

Question 40

SONOGRAPHIC FINDINGS OF TUBEROUS SCLEROSIS

Answer 40

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

Question 41

ACUTE PYELONEPHRITIS

Answer 41

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

Question 42

CLINICAL FINDINGS OF ACUTE PYELONEPHRITIS

Answer 42

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

Question 43

SONOGRAPHIC FINDINGS OF ACUTE PYELONEPHRITIS

Answer 43

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