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Renal & Urinary Flashcards

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1
Q

What is azotemia?

A

Elevated blood urea nitrogen and creatinine

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2
Q

What is uremia?

A

Elevated blood urea nitrogen

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3
Q

What is nocturia?

A

Frequent urination at night

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4
Q

What is pyuria?

A

Pus in urine

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5
Q

What is polyuria?

A

Excessive volume of urine

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6
Q

What is oliguria?

A

Abnormally small volume of urine

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7
Q

What is cystitis?

A

Inflammation of the bladder

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8
Q

What are S&S of cystitis?

A
  • pain
  • frequency, urgency
  • hematuria
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9
Q

What is the sono app of cystitis?

A
  • normal
  • focal/diffuse wall thickening
  • lumen echoes- layering
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10
Q

The bladder wall is considered thickened when it is over

A

3 mm

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11
Q

What are causes of bladder wall thickening?

A
  • muscular hypertrophy
  • tumor
  • infection
  • under distended bladder
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12
Q

What is the sono app of bladder wall thickening?

A

Focal/diffuse increased thickness

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13
Q

What is bladder diverticulum?

A
  • bladder wall defect
  • pouch, pocket or sac that protrudes out of the bladder
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14
Q

What is the typical cause of bladder diverticulum?

A

Outlet obstructions

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15
Q

What are S&S of bladder diverticulum?

A
  • retention
  • UTI
  • hematuria
  • abdominal distention
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16
Q

What is the sono app of bladder diverticulum?

A
  • solitary or multiple areas of discontinuity of wall
  • anechoic fluid filled pocket outside of bladder wall
  • cystoscopy
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17
Q

What is a lower tract calculi?

A

Focal calcification in the collecting system

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18
Q

What are the S&S of lower tract calculi?

A
  • asymp
  • obstructing: pain, hematuria
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19
Q

What is the sono app of lower tract calculi?

A
  • focal, echogenic mass
  • shadowing
  • obstructive hydro, distended ureter
  • mobile if in bladder
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20
Q

What is a urinary hematoma?

A

Localized collection of blood within lower urinary tract

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21
Q

What is the sono app of urinary hematoma?

A
  • low-level echoes
  • focal, mass like
  • layering dependent on gravity
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22
Q

What is urinary adenoma?

A

Benign growth of glandular tissue, AKA bladder polyp

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23
Q

What are S&S of adenoma?

A
  • asymp
  • painless hematuria
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24
Q

What is the sono app of adenoma?

A
  • focal lumen mass
  • irregular wall thickening
  • variable size/echogenicity
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25
What is transitional cell carcinoma?
Primary malignant epithelial tumor
26
Where does transitional cell carcinoma originate?
Collecting system
27
What are S&S of transitional cell carcinoma?
- asymp - painless hematuria
28
What is the sono app of transitional cell carcinoma?
- focal lumen mass - irregular wall thickening - echogenic ureteral mass - variable echogenicity - obstructive hydro
29
How does metastatic disease to the bladder typically occur?
By direct extension to the bladder
30
What are S&S of metastatic disease to the bladder?
- asymp - with obstruction: pain, oliguria
31
What is the sono app of metastatic disease?
- focal lumen mass - irregular wall thickening - echogenic ureteral mass - variable echogenicity - obstructive hydro
32
What is Column of Bertin?
- continuity of renal cortex - inward extension of cortex between renal pyramids
33
What is the sono app of Column of Bertin?
- no change in sinus fat composition - prominent cortical tissue in medulla - easily mistaken for cortical mass
34
What is dromedary hump?
- lateral cortical thickening - typically midpole
35
What is the sono app of dromedary hump?
- normal vascularity - normal echogenicity/comp - bulging from outer border of cortex - easily mistaken for cortical mass
36
What is junctional parenchymal defect?
Results from partial fusion of the embryonic parenchymatous structues
37
What is the sono app of junctional parenchymal defect?
- triangular or linear hyperechoic structure - anterosuperior or posteroinferior surface of kidney
38
What is persistent fetal lobulation?
Contour lobulations past 5 years old
39
What is the sono app of persistent fetal lobulation?
- multiple smooth cortical lobulations - anterior surface
40
What is horseshoe kidney?
Lower poles of bilateral kidneys are fused
41
What is horseshoe kidney associated with?
Improper ascent and malrotation, stones
42
What is the most common fusion anomaly?
Horseshoe kidney
43
What is the midline connection of horseshoe kidneys called?
Isthmus
44
What is the sono app of horseshoe kidney?
- lies lower than normal kidneys - mistaken for lymphadenopathy - renal pelvis anteriorly rotated
45
What is renal agenesis?
Total failure of kidney and ureter to develop in utero
46
Renal agenesis is more common in
Males
47
Bilateral vs unilateral renal agenesis
Bilateral: incompatible with life Unilateral: more common, normal prognosis
48
What is supernumerary kidney?
- Abnormal division during embryology - Complete duplication of kidney - Separate vascular supply, collecting system & parenchyma
49
What is the sono app of supernumerary kidney?
- lower than typical kidneys - normal echogenicity and vascularity
50
What is duplex collecting system?
Two separate collecting systems with 2 separate ureters
51
What is extrarenal pelvis?
- Chamber where urine forming ducts meet before ureter - Dilation of extra renal pelvis - Calyces are unaffected
52
What is the most common congenital renal anomaly?
Extrarenal pelvis
53
What is the sono app of extrarenal pelvis?
- Cystic like region within pelvis - Does not extend into ureter or calyces
54
What can extrarenal pelvis be mistaken for?
Hydronephrosis or cyst
55
What is ectopic kidney?
- Kidney fails to ascend - Congenital shortening of ureter
56
When does kidney ascent occur?
Between 12-15 weeks gestation
57
What can ectopic kidney result in?
Infections, blockage, failure
58
What is the sono app of ectopic kidney?
Normal appearance but located in pelvis
59
What is crossed fused renal ectopia?
Bilateral kidneys are fused and located on one side, kidneys fuse in pelvis before ascent
60
Who is crossed fused renal ectopia more common in?
Males
61
What is renal malrotation?
- Renal hilum faces wrong direction - Uni or bilateral
62
What is the normal direction of the renal hilum?
Anteriomedial
63
What is the sono app of renal malrotation?
- normal echogenicity - hilum not orientated anteriomedially
64
What is kidney hypoplasia?
- Abnormally small - Renal function proportional to renal size - Small collecting system - Narrowed ureters/vessels
65
What are S&S of unilateral hypoplasia?
- asymp - hypertension
66
What are S&S of bilateral hypoplasia?
- severe clinical symptoms - renal insufficiency
67
What is the sono app of hypoplasia?
Small, hyperechoic
68
What is unilateral multicystic dysplastic kidney?
- Non-hereditary, pedi condition - Cysts grow instead of renal tissue, non-functional
69
What is the MC form of cystic disease and the MC palpable mass in neonates?
Unilateral multicystic dysplastic kidney
70
Bilateral multicystic dysplastic kidney is
Incompatible with life
71
What are S&S of unilateral multicystic dysplastic kidney?
- polyuria - HTN - infection - assoc with risk of malignancy
72
What is the sono app of unilateral multicystic dysplastic kidney?
- multiple cysts of varying size - no renal parenchyma surrounding cysts - enlarged kidney in childen - small kidney in adults
73
What is medullary sponge kidney?
- Rare, non-hereditary disease - Small cysts form either on tubules or the collecting ducts
74
Who is medullary sponge kidney MC in?
Children
75
What are S&S of medullary sponge kidney?
- asymp - hematuria - infections - pain - hydronephrosis
76
What is the sono app of medullary sponge kidney?
- Normal/small kidneys, echogenic parenchyma (cysts too small on US) - Small cysts in medulla & cortex with echogenic parenchyma
77
What is medullary cystic disease?
- Autosomal recessive disease - Small cysts result in fibrosis/scarring of parenchyma & tubules
78
Who does medullary cystic disease commonly affect?
Young adults
79
What are the S&S of medullary cystic disease?
- normal renal function, can lead to failure - anemia - salt loss - azotemia - polyuria - pain - infection
80
What is the sono app of medullary cystic disease?
- Normal or small echogenic kidneys with small cysts (<2 cm) - widening of renal sinus
81
What is infantile polycystic kidney disease?
- Autosomal recessive - Rare - Dilation of collecting tubules which leads to renal failure
82
What are the 4 types of IPCKD?
- perinatal - neonatal - infantile - juvenile
83
What are S&S of IPCKD?
- renal insufficiency - lung hypoplasia - portal HTN - hepatic fibrosis - GI bleed
84
What is the sono app of IPCKD?
- enlarged, echogenic kidneys - small cysts not visualized - no corticomedullary differentiation
85
What is adult polycystic kidney disease?
- autosomal dominant - Bilateral disease with multiple cysts in cortex & medulla
86
What are S&S of adult polycystic kidney disease?
- 40s-50s, by 60 end stage renal disease - HTN - renal failure - pain, fever, chills - uremia - palp mass - polycythemia - hematuria
87
What is the sono app of adult polycystic kidney disease?
- enlarged kidneys - multiple cysts varying size - loss of reniform shape - atypical cysts due to hemorrhage/infection - cysts also in liver, panc, spleen
88
What is the genetic difference between infantile and adult polycystic kidney disease?
Infantile: autosomal recessive Adult: autosomal dominant
89
What is acute pyelonephritis?
Acute inflammation of renal tissue
90
What are S&S of acute pyelonephritis?
- flank pain - fever
91
What is the sono app of acute pyelonephritis?
- normal appearance - focal or diffuse: - increase in size - areas of increased/decreased echogenicity - absence of perfusion with doppler - loss of corticomedullary differentiation - compression of renal sinus - uni or bilateral
92
What is emphysematous pyelonephritis?
Life-threatening infection of renal parenchyma with gas formation in tissue or collecting system
93
What are S&S of emphysematous pyelonephritis?
- fever - flank pain - dehydration - acidosis - electrolyte imbalance
94
What is the sono app of emphysematous pyelonephritis?
Echogenic gas within parenchyma and collecting system
95
What is chronic pyelonephritis?
Interstitial nephritis from ongoing or recurring UTIs - swelling between tubules
96
What are S&S of chronic pyelonephritis?
- asymp - renal failure
97
What is the sono app of chronic pyelonephritis?
- uni or bilateral - focal area of cortical thinning and increased echogenicity
98
What is acute tubular necrosis?
- Damage and/or necrosis of renal tubules - Bilateral condition
99
What are S&S of ATN?
- AKI - oliguria - uremia - electrolyte imbalance
100
What is the sono app of ATN?
- normal appearance - bilateral enlargement - increased parenchyma echogenicity
101
What is pyonephrosis?
Pus within collecting system
102
What are S&S of pyonephrosis?
- fever - flank pain
103
What is the sono app of pyonephrosis?
- hydronephrosis - mobile echogenic debris within collecting system
104
What is acute glomerulonephritis?
- Accumulation of inflammatory elements - Necrosis of glomeruli
105
What are the S&S of acute glomerulonephritis?
- hematuria - HTN - azotemia
106
What is the sono app of acute glomerulonephritis?
- Normal/enlarged kidneys - Variable echogenicity of cortex - Normal medulla
107
What is renal candidiasis?
- Fungal infection - Immunocompromised patients
108
What are S&S of renal candidiasis?
Worsening symptoms of chronically ill patients
109
What is the sono app of renal candidiasis?
- multiple focal abscesses of varying echogenicity throughout parenchyma - focal echogenic masses within collecting system
110
What is renal schistosomiasis?
Parasitic infection
111
What are S&S of schistosomiasis?
Hematuria
112
What is the sono app of schistosomiasis?
- normal - hydronephrosis - bladder wall thickening/calcs - bladder wall granuloma
113
What is renal abscess?
Focal collection of purulent material
114
What are S&S of abscess?
- fever - pain - localized tenderness
115
What is the sono app of abscess?
- variable echogenicity - acoustic enhancement/shadowing - central fluid with peripheral hyperemia
116
What is cortical cyst?
Benign serous filled sac
117
What are complications of cortical cyst?
- hemorrhage - infection
118
What are S&S of cortical cyst?
- asymp - pain - palp mass - fever, elev WBC
119
What is the sono app of cortical cyst?
- typically in cortex - enhancement - layering - wall calcs
120
What is the sono app of simple cortical cyst vs complex cortical cyst?
Simple: anechoic, smooth walls, no calcs/nodules/septations Complex: varying echogenicity, septations
121
What is parapelvic cyst?
Benign, serous filled sac in renal hilum
122
What are S&S of parapelvic cyst?
- asymp - HTN - hematuria - hydro
123
What is the sono app of parapelvic cyst?
- hilar/sinus location - anechoic - well-defined walls - enhancement - possible internal echoes
124
What is acquired cystic kidney disease?
Patients undergoing dialysis develop multiple cysts in native and allograft kidneys
125
What are S&S of acquired cystic kidney disease?
- asymp - increased risk of tumor development
126
What is the sono app of acquired cystic kidney disease?
- multiple cysts of varying size - variable echogenicity of kidney - bilateral - cortical thinning
127
What is angiomyolipoma?
AKA renal hamartoma Tumor composed of fat, blood vessels, and smooth muscle tissue
128
What are S&S of angiomyolipoma?
- asymp - hematuria - HTN - flank pain
129
Who is angiomyolipoma more common in?
Females
130
Angiomyolipoma are more likely to hemorrhage at what size?
> 4 cm
131
What is the sono app of angiomyolipoma?
- hyperechoic mass in parenchyma - variable echogenicity if hemorrhaged - variable size
132
What is renal adenoma?
Tumor derived from glandular epithelium
133
What are S&S of adenoma?
- asymp - painless hematuria
134
What is the sono app of adenoma?
- well-defined - iso/hypoechoic cortical mass
135
What is oncocytoma?
- Benign tumor composed of oncocyte & epithelial cells - May be premalignant with increased risk of malignancy
136
Who is more likely to develop an oncocytoma?
Males later in life
137
What is the sono app of oncocytoma?
- solid - variable size/echogenicity - difficult to differentiate from malignancies
138
What is mesoblastic nephroma?
- Pedi tumor composed of mesoderm tissue - Benign counterpart of nephroblastoma
139
What are S&S of mesoblastic nephroma?
- palp flank mass - HTN
140
What is the sono app of mesoblastic nephroma?
- variable echogenicity - possible areas of cystic degeneration - possible calcs
141
What is renal cell carcinoma?
Cancerous tubular cells of renal parenchyma
142
What is renal cell carcinoma AKA?
hypernephroma
143
What are S&S of RCC?
- pain - hematuria - palp mass
144
What is the sono app of RCC?
- solid mass of variable echogenicity - partially exophytic - calcs - possible echogenic mass in RV, IVC, and contralateral kidney - hypervascular
145
What is nephroblastoma?
Pediatric malignancy composed of embryonal elements
146
What is nephroblastoma AKA?
Wilm's tumor
147
What are S&S of nephroblastoma?
- fever - hematuria - HTN - palp flank mass
148
What is the sono app of Wilm's tumor?
- homogenous, echogenic mass - may be hypoechoic or cystic - large - calcs
149
What pathology is nephroblastoma associated with?
horseshoe kidney
150
What is the sono app of metastatic disease to kidneys?
- hypo/hyper masses - single/multiple - diffusely hypoechoic
151
What is hydronephrosis?
Dilation of renal pelvis and calyces due to obstruction of outflow of urine
152
What are the causes of hydronephrosis?
Congenital: anatomic variants, abnormal position, PCKD, etc Intrinsic: stones, tumors Extrinsic: trauma, infections
153
What is the sono app of hydronephrosis?
- mild to sever fluid filled pelvocaliectasis - hydroureter - cortical thinning - non-vis of affected urinary jet - increased resistive index
154
What is grade I hydro?
slight blunting of calyceal fornices
155
What is grade II hydro?
Blunting and enlargement of calyceal fornices but easily seen shadows of papillae
156
What is grade III hydro?
Rounding of calyces with obliteration of papillae
157
What is grade IV hydro?
Extreme calyceal ballooning
158
What is renal calculi?
- Focal concentrations of calcium, struvite, uric acid, or cystine - Renal parenchyma or collecting system
159
Who are renal calculi more common in?
Males
160
What are S&S of calculi?
- asymp - acute pain - hematuria
161
What is the sono app of calculi?
- hyperechoic foci - shadowing - twinkle artifact - obstructive hydro - mobile in bladder - echogenic focus in dilated distal ureter
162
What is a staghorn calculus?
Occupies entire collecting system
163
What is nephrocalcinosis?
- Increased calcium levels in blood and/or urine - Deposits within kidney parenchyma - Occurs bilaterally
164
Who is nephrocalcinosis common in?
Infants
165
What is trauma to kidneys?
Assault to urinary tract from blunt force, penetrating trauma or rupture of neoplasm
166
What does renal trauma result in?
- Rupture of kidney and capsule - Subcapsular hematoma - Parenchymal laceration - Urinoma
167
What are S&S of renal trauma?
- Pain - Decreased hematocrit - Hematuria - Oliguria - HTN
168
What is the sono app of trauma to kidneys?
- Free fluid within abdomen - Hematoma located along surface - Diffusely heterogenous parenchyma
169
What is renal infarction?
Necrosis of tissue due to occlusion of arterial supply
170
What are S&S of renal infarction?
- asymp - localized pain
171
What is the sono app of infarction?
- Focal or diffuse - Acute: hypoechoic - Chronic: hyperechoic, small size, capsular retraction or scarring
172
What is renal artery stenosis?
- Luminal narrowing of renal artery - Usually caused by plaque
173
What are S&S of renal artery stenosis?
**HTN**
174
What is the sono app of renal artery stenosis?
- normal - decreased size of affected kidney - increased cortical echogenicity
175
What is renal artery occlusion?
Obstruction of arterial lumen
176
What are S&S of renal artery occlusion?
- asymp - flank pain - hematuria
177
What is the sono app of renal artery occlusion?
- decrease in kidney size after acute phase - increase in cortical echogenicity - absence of doppler flow distal to occlusion
178
What is renal vein thrombosis?
Presence of obstructive or non-obstructive thrombus in renal vein
179
What are S&S of renal vein thrombosis?
- asymp - flank pain
180
What is the sono app of renal vein thrombosis?
- increase size during acute phase - decrease size after acute phase - varying echogenicity of kidney - echogenic material within vein - possible IVC involvement - absence of flow in vein
181
What is the sono app of cortical calcium deposit?
- diffuse or focal increased cortical echogenicity - shadowing
182
What is acute kidney injury/chronic renal failure?
- Impairment of kidney function - Inability to maintain normal physiologic processes
183
What are the types of AKI?
prerenal, renal, postrenal
184
What are S&S of AKI?
- oliguria - increased BUN & creatinine - proteinuria, uremia - anemia - HTN
185
What is the sono app of AKI?
- Starts with normal appearance, then decreased size, cortical thinning, hyperechoic - Hydronephrosis

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