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The GU system Flashcards

1
Q

How many weeks for optimal kidney evaluation vs. being able to thoroughly identify kidneys?

A
  1. Optimally at 20 weeks
  2. Thorough evaluation at 22 weeks
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2
Q

Kidney length?

A
  1. 2cm at 20 weeks
  2. 4cm at term
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3
Q

When can the bladder be seen on US?

A

11 weeks and definitely by 13 weeks

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4
Q

T or F? Unilateral renal agenesis is considered common?

A

TRUE

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5
Q

What may fill the place of the kidney in cases of agenesis?

A

Adrenal gland

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6
Q

Sonographic features of an ectopic kidney?

A
  1. Smaller
  2. Malrotated
  3. Irregular shape
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7
Q

In crossed renal ectopia, what kidney is more likely to cross over?

A

Left to right crossover - where the upper pole of the left crossed kidney fuses to the lower pole of the right kidney

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8
Q

US finding in crossed renal ectopia?

A
  1. Hydronephrosis
  2. Dilated calyces
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9
Q

What is the isthmus in a horseshoe kidney?

A

The connecting piece to each kidney and is the key feature in diagnosing horseshoe kidney

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10
Q

T or F? The horseshoe kidney is associated with other non-urologic abnormalities?

A

True

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11
Q

What can pelvic dilation depend on?

A
  1. Fetal bladder filling
  2. Hydration
  3. Patient position
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12
Q

When hydronephrosis is detected, at how many weeks GA would a follow-up be?

A

32 weeks

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13
Q

What does APRPD stand for?

A

Anterior-posterior renal pelvic diameter

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14
Q

What is the most common cause of congenital obstructive hydronephrosis?

A

UPJ

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15
Q

Difference in sonographic findings of UPJ vs. UVJ

A

UPJ will have dilated calyces and renal pelvis but not a dilated ureter or bladder

UVJ will have dilation including the ureter without bladder dilation

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16
Q

What measurement is classified as megaureter?

A

> 7mm from 30 weeks onward

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17
Q

What are ureteroceles most commonly associated with?

A

Duplicated collecting system

Ectopic ureter insertion

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18
Q

What does LUTO stand for?

A

Lower urinary tract obstruction

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19
Q

What sonographic features are seen in bilateral renal agenesis? (2)

A
  1. Anhydramnios
  2. Empty bladder
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20
Q

What are the most common causes of LUTO?

A
  1. PUV
  2. Urethral atresia
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21
Q

What is urethral atresia characterized by?

A
  1. Anhydramnios
  2. Largely distended bladder
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22
Q

Adults with unilateral renal agenesis are shown to have increased rates of?

A

Chronic kidney disease and end-stage renal disease (ESRD) by 30 yrs.

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23
Q

What does MMIHS stand for?

A

Megacystitis microcolon intestinal hypoperistalsis syndrome - is lethal within the first year of life

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24
Q

What abnormality demonstrates the “keyhole” sign?

A

PUV

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25
What are associated findings with PUV?
1. Hydronephrosis 2. Hydroureter 3. Thickened bladder wall 4. Dilated posterior urethra
26
Prune Belly Syndrome Triad
1. Distended abdominal wall (absence of abdominal wall musculature) 2. Urinary obstruction - megacystitis 3. Bilateral cryptorchidism
27
What syndrome presents laxity/distention of the abdominal wall?
Prune Belly Syndrome
28
What is the most common cause of perinatal death?
Pulmonary hypoplasia due to oligohydramnios
29
ARPKD is also known as?
Infantile PKD
30
ADPKD is also known as?
Adult PKD and usually asymptomatic for 30-40 years
31
What is the most common cystic disease in pregnancy?
ARPKD/infantile PCKD
32
Sonographic finding of ARPKD and ADPKD
1. Bilateral enlargement 2. Echogenic kidneys Cannot see the cysts on ultrasound as they are only 1-2mm
33
What is the most common inherited kidney disease?
ADPKD
34
What is LUTO characterized by?
1. Bilateral hydronephrosis 2. Enlarged bladder
35
What kidney anomaly has multiple non-communicating cysts with dysplastic parenchyma surrounding it?
MCDK
36
Sonographic features of MCDK
Multiple, large anechoic cysts of varying size
37
In what renal anomaly is the affected kidney reported to involute?
MCDK
38
Most common cause of hyperechoic kidneys?
Obstructive cystic disease
39
Sonographic findings of obstructive cystic dysplasia?
1. Oligohydramnios 2. Moderately enlarged kidneys 3. Small cysts 3. Thinned walls 4. Echogenic cortex
40
T or F? Simple renal cysts communicate with the renal pelvis
False: No communication
41
T or F? Simple renal cysts tend to spontaneously resolve
True
42
Most common benign renal neoplasm?
Congenital mesoblastic nephroma
43
Sonographic features of mesoblastic nephroma
1. Very large 2. Solid or cystic 3. Well-defined
44
T or F? Mesoblastic nephromas occur exclusively in the second trimester?
False: They occur exclusively in the third trimester
45
Mesoblastic nephromas are commonly associated with?
1. Polyhydramnios 2. Premature labour
46
In what trimester are adrenal glands best visualized?
Third trimester
47
Sonographic findings of adrenal glands?
Hyperechoic medulla with a hypoechoic cortex
48
Where do neuroblastomas originate?
Adrenal glands
49
Why do neuroblastomas have a good prognosis?
They tend to spontaneously regress
50
What are the most common abnormalities seen in the pelvis?
1. Internal pelvic masses 2. Sacrococcygeal teratoma
51
What is the most common neoplasm in the fetal pelvis?
Sacrococcygeal teratoma
52
What abnormality can cause dystocia?
Sacrococcygeal teratoma
53
The urachus connects the urinary bladder to the what?
Allantois
54
What does the urachus eventually become after obliteration?
Median umbilical ligament
55
What are the most common urachal abnormalities?
Urachal cyst and sinus
56
What is the leading complication of urachal anomalies?
Infection
57
The two cancers of adenocarcinoma and TCC are associated with what GU anomaly?
Urachal anomalies
58
Sonographic features of bladder exstrophy?
1. Wide pubis 2. Low umbilicus 3. Small genetalia 4. Exterior bladder
59
What does the cloaca divide into?
Bladder, rectum, genetalia
60
What is the OEIS complex?
AKA cloacal extrophy O - omphalocele E - exterior bladder I - imperforate anus S - spinal anomalies
61
If the genital nub is facing at a caudal angle, is it male or female?
Female
62
If the genital nub is facing at a cranial angle, is it male or female?
Male
63
What structure is seen on ultrasound when determining a female?
Labia
64
Can repeat exams be scheduled for determining gender?
No, not for that sole purpose
65
Assessment of genetalia is examined in what trimester?
Second trimester routine exam
66
Sonographic findings of hypospadias
1. Penile shortening 2. Ventral urinary stream 3. "Tulip sign" - small, ventrally curved penis
67
What abnormality is seen with the "Tulip sign"?
Hypospadias
68
On what side do inguinoscrotal hernias occur on primarily?
Right
69
What is the most common intraabdominal tumor in female fetuses and neonates?
Ovarian cysts
70
Why may fetal ovarian cysts develop?
1. Response to maternal hormones 2. Hypothyroidism 3. Diabetes
71
What does DSD stand for?
Disorders of sex development
72
What does AIS stand for?
Androgen insensitivity syndrome
73
What is the chromosomal makeup in AIS?
46 XY - resulting in a normal female phenotype
74
Pt comes in for an ultrasound at 18 weeks GA. SF show anhydramnios and no detection of the bladder. What is the most likely diagnosis?
Bilateral renal agenesis

OB 2 (20 decks)

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