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ARDMS ABD REVIEW > Urinary Tract > Flashcards

Urinary Tract Flashcards

1
Q

Which of the following is a childhood, autoimmune disease that results in the development of purple spots in the skin and possible renal failure?

Henoch-Schoblein purpura
azotemia
von hippel-lindau syndrome
xanthogranulomatous pyelonephritis

A

Henoch-Schoblein purpura

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2
Q

what is the functional unit of the kidney?

nephron
medulla
cortex
bowman capsule

A

nephron

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3
Q

which would be most indicative of renal artery stenosis?

decreased cortical echogenicity
renal:AO ratio greater than 3.5
enlarged kidney
tardus-parvus waveform upstream to the stenosis

A

renal:AO ratio greater than 3.5

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4
Q

the kidneys are:

intraperitoneal organs
retroperitoneal organs
both intraperitoneal & retroperitoneal
neither

A

retroperitoneal

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5
Q

the protective capsule of the kidneys is referred to as:

glisson capsule
perirenal capsule
renal capsule
renal cortex

A

renal capsule

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6
Q

the vessel located anterior to the abdominal AO and posterior to the SMA is the:

celiac artery
LRA
RRV
LRV

A

LRV

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7
Q

which would NOT be a typical clinical feature of renal transplant failure?

oliguria
proteinuria
hypotension
elevated creatinine

A

hypotension

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8
Q

enlargement of the unaffected contralateral kidney with unilateral renal agenesis or compromised renal function is referred to as:

dromedary hypertrophy
renal hypoplasia
supernumerary kidney
compensatory hypertrophy

A

compensatory hypertrophy

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9
Q

a bulge on the lateral border of the kidney is referred to as:

duplicated kidney
renal hypoplasia
dromedary hump
supernumerary kidney

A

dromedary hump

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10
Q

the most common congenital anomaly of the urinary tract is:

horseshoe kidney
duplicated collecting system
renal agenesis
renal hypoplasia

A

duplicated collecting system

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11
Q

a renal scar most likely appears as:

a hypoechoic mass in the renal parenchyma

a linear anechoic space in the renal cortex

a hyperechoic, rounded structure within the renal parenchyma that shadows

an echogenic area that extends from the renal sinus through the renal parenchyma

A

an echogenic area that extends from the renal sinus through the renal parenchyma

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12
Q

what is the most common location of an ectopic kidney?

thoracic cavity
pelvis
contralateral fossa
LUQ

A

pelvis

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13
Q

all of the following are clinical findings of ARF except:

hematuria
hypertension
oliguria
decreased BUN and creatine

A

decreased BUN and creatine

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14
Q

which is true regarding a duplex collecting system with complete urethral duplication?

the upper pole of the kidney suffers from reflux

the lower pole suffers from obstruction because of a varicocele

the upper pole suffers from obstruction because of a ureterocele

the lower pole suffers from reflux and hypertrophy

A

the upper pole suffers from obstruction because of a ureterocele

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15
Q

which is the most common cause of CRF?

HTN
diabetes mellitus
ARPKD
acute tubular necrosis

A

diabetes mellitus

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16
Q

what renal cystic disease would be most likely caused by, and thus associated with hemodialysis?

MCDK
ADPKD
acquired renal cystic disease
ARPKD

A

acquired renal cystic disease

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17
Q

sonographically, compared to normal kidneys, those affected by CRF will appear:

normal in size with a decreased echogenicity

smaller in size and hypoechoic

larger in size and more echogenic

smaller in size and more echogenic

A

smaller in size and more echogenic

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18
Q

renal cysts that project out away from the kidneys are termed:

exophytic
perapelvic
cortical
peripelvic

A

exophytic

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19
Q

A female presents with a history of leukocytosis, dysuria, lower abdominal pain, and hematuria. Sonographically, the kidneys appear normal, although the bladder wall measures 6mm on the distended state. What is the most likely diagnosis?

glomerulonephritis
xanthogranulomatous pyelonephritis
cystitis
TCC of bladder

A

cystitis

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20
Q

the inherited disorder associated with the development of tumors of the CNS and orbits, renal cysts, and adrenal tumors is:

tuberous sclerosis
tuberculosis
von hippel-lindau syndrome
MCDK

A

von hippel-lindau syndrome

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21
Q

what is the most likely location of TCC in the kidney?

cortex
medulla
minor calyx
renal pelvis

A

renal pelvis

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22
Q

which is the most common cause of ARF?

HTN
diabetes
ARPKD
acute tubular necrosis

A

acute tubular necrosis

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23
Q

all of the following are characteristics of a complex cyst EXCEPT:

internal echoes
smooth walls
mural nodules
septations

A

smooth walls

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24
Q

which would most likely present with a clinical finding of hematuria?

hemorrhagic renal cyst
milk of calcium renal cyst
simple renal cyst
angiomyolipoma

A

hemorrhagic renal cyst

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25
Q

which of the following would be considered the most common solid renal mass?

renal hematoma
angiomyolipoma
oncocytoma
hypernephroma

A

angiomyolipoma

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26
Q

infantile polycystic kidney disease may also be referred to as:

ARPKD
ADPKD
MCDK
acquired renal cystic disease

A

ARPKD

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27
Q

which of the following best describes the sonographic appearance of a kidney affected by ARPKD?

bilateral enlarged, echogenic kidneys

unilateral, smooth-walled, noncommunicating cysts of varying sizes located within the renal fossa

small, echogenic kidneys

numerous, large, complex renal cysts

A

bilateral enlarged, echogenic kidneys

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28
Q

the systemic disorder associated with epilepsy that leads to the development of solid tumors in various organs, including angiomyolipomas of the kidneys is:

tuberous sclerosis
tuberculosis
von hippel-lindau syndrome
MCDK

A

tuberous sclerosis

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29
Q

what is the most common clinical finding of a simple renal cyst?

hematuria
quadrant pain
elevated BUN
asymptomatic

A

asymptomatic

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30
Q

suspicion of cortical thinning should occur when the renal cortex measures:

greater than 2mm
less then 1cm
greater than 5mm
less than 3cm

A

less than 1cm

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31
Q

which is NOT considered an extrinsic cause of hydronephrosis?

ureteral stricture
pregnancy
neurogenic bladder
uterine leiomyoma

A

ureteral stricture

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32
Q

which would be a common finding in a patient undergoing peritoneal dialysis?

hemorrhage
ascites
RA stenosis
RV thrombosis

A

ascites

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33
Q

the presence of purulent material within the renal collecting system is termed:

pylotosis
pyelonephritis
pyonephrosis
emphysematous pyelonephritis

A

pyonephrosis

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34
Q

the most common cause of fungal urinary tract infections is:

candida albicans
RCC
renal tract obstruction
urolithiasis

A

candida albicans

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35
Q

clinical findings of glomerulonephritis include all of the following EXCEPT:

proteinuria
throat infection
azotemia
hypercalcemia

A

hypercalcemia

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36
Q

which is NOT considered an intrinsic cause of hydronephrosis?

ureterocele
urethritis
urolithiasis
ureteropelvic junction obstruction

A

urethritis

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37
Q

clinical findings of nephrocalcinosis include all of the following EXCEPT:

urinary tract infections
urinary calculi
hyperparathyroidism
weight loss

A

weight loss

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38
Q

which is associated with the development of cysts within the pancreas and liver?

ARPKD
ADPKD
MCDK
acquired renal cystic disease

A

ADPKD

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39
Q

a stone that completely fills the renal pelvis is referred to as:

calculus granulosis
staghorn calculus
twinkle stone
nephrocalcinotic calculus

A

staghorn calculus

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40
Q

what is the most common location for a urolithiasis to become lodged?

ureteropelvic junction
midureter
urethra
ureterovesicular junction

A

ureterovesicular junction

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41
Q

You are scanning a patient and notice that the right and left kidneys are attached at their lower poles. What anomaly is present?

duplicated collecting system
supernumerary kidney
ureterocele
pelvic kidney
horseshoe kidney

A

horseshoe kidney

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42
Q

which describes the normal echogenicity of the renal cortex?

kidney is normally hyperechoic in comparison to the spleen and liver

kidney echogenicity is always hypoechoic compared to the spleen and liver

normal kidney is never isoechoic with the liver

echogenicity of the normal kidney is frequently isoechoic with the liver and spleen

echogenicity of the kidney varies and should not be compared to the liver

A

echogenicity of the normal kidney is frequently isoechoic with the liver and spleen

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43
Q

which would most likely cause a spleen propagation artifact?

angiomyolipoma
RCC
renal pseudoaneurysm
TCC
adenoma

A

angiomyolipoma

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44
Q

You are performing a sonogram on a patient with bilaterally small kidneys. What is the normal range in size for a kidney?

2-4 cm
4-7 cm
9-14 cm
13-17 cm

A

9-14cm

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45
Q

During a renal sonogram, you notice a 1.5cm thickening of the left lateral renal cortex. This most likely represents:

column of bertin
angiomyolipoma
dromedary hump
medullary pyramid
hilar vessels

A

dromedary hump

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46
Q

You have detected compensatory hypertrophy of the right kidney in a 35 year old male. This finding is associated with:

nephrectomy
renal agenesis
renal hypoplasia
renal atrophy
all of the above

A

all of the above

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47
Q

which of the following statements is NOT true regarding normal anatomy of the kidneys?

kidneys are retroperitoneal in location

right kidney is located slightly inferior compared to the left

tail of the pancreas is in contact with the lateral dorsal aspect of the left kidney

superomedial aspect of the right kidney is in contact with the adrenal gland

superior pole of each kidney is slightly medial compared to the inferior pole

A

tail of the pancreas is NOT in contact with the lateral dorsal aspect of the left kidney

48
Q

what is the normal appearance of the central sinus of the kidney?

highly echogenic compared to the renal cortex

hypoechoic compared to the renal cortex

isoechoic compared to the renal cortex

isoechoic to the medullary pyramids

hypoechoic compared to the liver

A

highly echogenic compared to the renal cortex

49
Q

what lab work is elevated with renal failure?

serum creatinine
urine creatinine
serum bilirubin
serum lipase
AFP

A

serum creatinine

50
Q

what are the sonographic criteria of a simple cyst?

anechoic, acoustic enhancement, sharply defined smooth far wall, round or ovoid shape

hyperechoic, acoustic enhancement, sharply defined smooth far wall, round or ovoid shape

hypoechoic, acoustic attenuation, sharply defined smooth far wall, round or ovoid shape

isoechoic, acoustic attenuation, sharply defined smooth far wall, round or ovoid shape

anechoic, acoustic refraction, sharply defined smooth far wall, round or ovoid

A

anechoic, acoustic enhancement, sharply defined smooth far wall, round or ovoid shape

51
Q

which is NOT a potential cause of hydronephrosis?

ureteral stone
large uterine fibroid
ureteropelvic junction obstruction
acute pyelonephritis
ovarian mass

A

acute pyelonephritis

52
Q

A questionable mass is seen between the renal pyramids on the right kidney. You suspect this is a column of Bertin “pseudomass.” Which sonographic features help distinguish this from a true pathological mass?

isoechogenicity with the rest of the renal cortex

continuity with the renal cortex

lack of mass effect or splaying of central renal sinus fat

normal vascularity by color doppler

all of the above

A

all of the above

53
Q

which is NOT a sign of MCDK?

multiple variable sized cysts
nonmedial location of the largest cyst
dilated ureter
no identifiable renal sinus
brightly echogenic tissue interfaces between cysts

A

dilated ureter

54
Q

You are performing an ultrasound exam on a patient with crossed renal ectopic. Which of the following describes your findings?

both kidneys are on the same side of the abdomen

one of the kidneys is located in the pelvis

one of the kidneys is located in the thoracic cavity

the kidneys are fused together at the upper pole

a small third kidney is located above one of the normal kidneys

A

both kidneys are on the same side of the abdomen

55
Q

which malignant tumor is most common in children ages 2 to 5 years old?

renal hamartoma
Wilm’s tumor
RCC
TCC
renal lymphoma

A

Wilm’s tumor

56
Q

which part of the kidney contains fat, calyces, infundibuli of the collecting system, and vessels?

medulla
cortex
sinus
pyramid
Gerota’s fossa

A

sinus

57
Q

During routine surveillance of the urinary bladder, you detect the presence of periodic ureteral “jets.” This is a sign of:

ureteral stone
TCC
ureteral spasm
ureteral compression
normality

A

normality

58
Q

what preparation should you require of your patients scheduled for renal sonograms?

fasting for 24 hours prior to exam

ingestion of 100mg simethicone 5mins before exam

water enema

moderate hydration with no other specific prep

fatty meal within 30mins of exam

A

moderate hydration with no other specific prep

59
Q

You are scanning a 31 year old patient with HTN and impaired renal function. You detect enlarged kidneys with cysts that are too numerous to count. Which of the following is most likely?

MCDK
medullary cystic disease
PKD
parapelvic cysts
multiple simple cysts

A

PKD

60
Q

You have detected a solid mass in the right kidney of a 47 year old male. You should tailor your exam to evaluate which of the following?

extension of tumor into renal vein
search for liver metastasis
search for retroperitoneal adenopathy
A and B only
all of the above

A

all of the above

61
Q

An ultrasound exam reveals a solid, hyperechoic mass in a 46 year old patient with tuberous sclerosis. This most likely represents:

RCC
Wilm’s tumor
renal hamartoma
angiomyolipoma
renal lymphoma

A

angiomyolipoma

62
Q

where is the isthmus of a horseshoe kidney located?

in the iliac fossa
anterior to the abdominal AO
pouch of douglas
morison’s pouch
posterior to the abdominal AO

A

anterior to the abdominal AO

63
Q

what is the ultrasound appearance of ureteropelvic junction obstruction?

dilated ureter and collecting system to the level of the urinary bladder

pelvicaliectasis to the level of the junction of the renal pelvis and ureter

dilated ureter with normal intrarenal collecting system

pelvicaliectasis to the level of the distal ureter

ureteropelvic junction obstruction cannot be detected sonographically

A

pelvicaliectasis to the level of the junction of the renal pelvis and ureter

64
Q

what is the most common ultrasound appearance of acute pyelonephritis?

normal appearance
irregular renal surface contour
mottled appearance of both kidneys
focal hypoechoic masses throughout the kidney
gas within the renal parenchyma

A

normal appearance

65
Q

a renal mass that is highly echogenic due to its high-fat content is:

RCC
wilm’s tumor
renal harmatoma
angiomyolipoma
renal lymphoma

A

angiomyolipoma

66
Q

what type of waveform do you expect to see in the normal main RA?

high resistance with prominent systolic flow and little diastolic flow

continuous with little differentiation between systole and diastole

high impedance with no diastolic component

low resistance with forward flow throughout the cardiac cycle

prominent early systolic peak with retrograde flow in early distole

A

low resistance with forward flow throughout the cardiac cycle

67
Q

what is the most likely etiology of the bladder wall thickening?

muscular hypertrophy
endometriosis
hematoma
RCC
oncocytoma

A

muscular hypertrophy

68
Q

A patient with a history of chronic medial renal disease has been referred for abdominal ultrasound. Which of the following describes the renal appearance you expect to see?

enlarged hypoechoic kidneys
small hyperechoic kidneys
normal appearance of kidneys
small hypoechoic kidneys
normal sized kidneys with calcified collecting system

A

small hyperechoic kidneys

69
Q

what is the ultrasound appearance of nephrocalcinosis?

normal sized kidneys with focal, wedge-shaped, hypoechoic mass

multiple hypoechoic masses throughout the kidney

echogenic kidney with calcified capsule

highly echogenic renal pyramids with or without posterior acoustic shadowing

cystic masses containing tiny echogenic foci situated throughout the kidney

A

highly echogenic renal pyramids with or without posterior acoustic shadowing

70
Q

which is a cause of false-positive determination of hydronephrosis?

overdistention of the bladder
parapelvic cysts
prominent hilar vessels
large extrarenal pelvis
all of the above

A

all of the above

71
Q

During a routine abdomen and pelvic ultrasound study, you detect a small round, cystic structure projecting into the urinary bladder. This most likely represents:

urinoma
ureterocele
TCC
papillary necrosis
extrarebal pelvis

A

ureterocele

72
Q

You are scanning a 69 year old male with hematuria. Your ultrasound findings include right sided hydronephrosis and a mass within the urinary bladder. Which most commonly occurs within the urinary bladder?

TCC
RCC
renal lymphoma
renal hamartoma
oncocytoma

A

TCC

73
Q

During a sonographic evaluation of a 2 week old renal transplant, you detect a fluid collection with septations and internal debris adjacent to the kidney. This most likely represents:

lymphocele
urinoma
ureterocele
hematoma
abscess

A

lymphocele

74
Q

which intrarenal arteries course alongside the renal pyramids?

segmental
interlobar
arcuate
intralobular
vasa recta

A

interlobar

75
Q

which describes the normal course of the LRV?

retroaortic
between the SMA and AO
anterior to the SMA and IVC
posterior to the IVC
between the SMA and splenic vein

A

between the SMA and AO

76
Q

what is the normal diameter of the renal cortex?

< 3mm
3-6mm
6-9mm
> or = 10mm
cannot be measured sonographically

A

> or = 10mm

77
Q

Ultrasound imaging reveals left sided hydronephrosis in a 38 year old woman with vague abdominal pain. You should tailor your exam to rule out:

ureteral calculi
pelvic mass
A and B
all of the above

A

all of the above

78
Q

what is the purpose of scanning the urinary bladder to identify ureteral “jets”?

rule out the presence of urinoma
determine if a ureter is obstructed
determine if bladder outlet obstruction is present
search for bladder carcinoma
identify the urethra

A

determine if a ureter is obstructed

79
Q

which ultrasound appearance is associated with renal lymphoma?

small, echogenic kidneys with hyper dense pyramids

cystic masses of varying sizes throughout both kidneys

multiple, bilateral, hypoechoic masses in enlarged kidneys

single, large, hyperechoic mass

unilateral wedge-shaped hypoechoic mass

A

multiple, bilateral, hypoechoic masses in enlarged kidneys

80
Q

what arteries course on top of the renal pyramids and give rise to the tiny intralobular arteries?

segmental
interlobar
arcuate
vasa recta
capsular

A

arcuate

81
Q

You detect a discrete echogenic focus without shadowing in the left kidney and suspect the presence of a renal calculus. Which of the following is most helpful in improving visualization of posterior acoustic shadowing?

high frequency transducer
lower frequency transducer
smaller aperture transducer
increased frame rate
increased dynamic range

A

higher frequency transducer

82
Q

You detect the presence of free fluid in the space between the liver and right kidney. What is the name for this anatomic location?

pouch of douglas
morison’s pouch
cul-de-sac
space of disse
forman if winslow

A

morison’s pouch

83
Q

what is the indication for a doppler renal study to rule out RA stenosis?

hematuria
increased serum creatinine
leukocytosis and fever
uncontrolled HTN
anemia, progressive azotemia, and polyuria

A

uncontrolled HTN

84
Q

You are performing a doppler evaluation to rule out RA stenosis. You will compute a ratio comparing the velocity in the RA to what vessel?

abdominal AO
SMA
CHA
celiac trunk
IMA

A

abdominal AO

85
Q

You are performing a follow up ultrasound study on a patient with a large left renal cyst. Which most accurately describes the prevalence of renal cysts?

<1% of people over age 50
15% of people over age 50
30% of people over age 50
50% of people over age 50
100% of people over age 50

A

50% of people over age 50

86
Q

which is NOT true regarding ADPKD?

liver cysts may be present in up to 30% of patients

high BP is common

cysts may be complicated by bleeding or infection

frequently only one kidney is involved

progressive renal failure is common

A

frequently only one kidney is involved
is NOT true

87
Q

which is usually diagnosed in early childhood or in utero?

ADPKD
MCDK
acquired cystic kidney disease
parapelvic cysts
A and B

A

MCDK

88
Q

Doppler analysis of intrarenal waveforms performed during renal sonography reveals a RI of 1.0. This finding is consistent with:

A. normality
B. chronic medial renal disease
C. RV thrombosis
D. renal obstruction
B,C, and D

A

B, C, and D

89
Q

During a renal exam, you identify only one kidney. What should you do?

inform the patient if your finding and advise a thorough medical exam to detect other abnormalities

scan in the pelvis area to rule out the presence of a pelvic kidney

perform an endovaginal exam to look for bicornuate uterus

scan the patient in an upright position

perform a compete dopple study of the solitary lidneh

A

scan in the pelvis area to rule out the presence of a pelvic kidney

90
Q

which would be most helpful in delineating ureteral “jets”?

have the patient perform a valsalva maneuver

scan the patient in both inspiration and expiration

examine the urinary bladder with color doppler

increase the transducer frequency

give the patient a fatty meal

A

examine the urinary bladder with color doppler

91
Q

You are scanning a patient post biopsy and discover a cystic mass in the kidney. What should you do?

nothing, cystic masses are very common

evaluate the cyst with color doppler

have the patient return in 2 weeks for a follow up study

scan the patient in a prone position

compress the mass with probe pressure

A

evaluate the cyst with color doppler

92
Q

which results from an ascending urinary tract infection?

horseshoe kidney
acute tubular necrosis
glomerulonephritis
pyelonephritis
nephrocalcinosis

A

pyelonephritis

93
Q

You are having difficulty identifying the renal arteries in a patient referred for questionable RA stenosis. Which vessel below is most helpful as a landmark for the location of the RAs?

celiac trunk
SMA
splenic vein
IMA
common HA

A

SMA

94
Q

You are scanning a patient with right flank pain and known PKD. You suspect the presence of hemorrhage within one of the renal cysts. What is the sonographic appearance of this finding?

ultrasound cannot be used to detect hemorrhage within a renal cyst

low-level echoes within the cyst

multiple bright foci with posterior acoustic shadowing distal to the cyst

solid appearing nodule with increased attenuation

all of the above

A

low-level echoes within the cyst

95
Q

A patient has been referred to your ultrasound lab for evaluation of a new renal transplant. Where should you look?

morison’s pouch
LUQ
pouch of douglas
RLQ
RUQ

A

RLQ

96
Q

Ultrasound findings in a patient with HTN include a left kidney measuring 6.8cm and a right kidney measuring 11.7cm. Which is most consistent with these findings?

acute pyelonephritis in the left kidney
acute glomerulonephritis in the right kidney
occlusion of the left main renal artery
amyloidosis of the right kidney
renal agenesis

A

occlusion of the left main renal artery

97
Q

what doppler parameter should you measure to look for rejection in a renal transplant?

pulsatility index
resistive index
renal-aortic ratio
systolic-diastolic ratio
acceleration index

A

resistive index

98
Q

You detect irregular thickening of the bladder wall in a 53 year old male with hydronephrosis and a dilated ureter. Which would you suspect?

RCC
ureterocele
bladder outlet obstruction
TCC
endometriosis

A

TCC

99
Q

which would help in identification of the RRV?

RRV lies inferior and posterior to the RA

RRV courses underneath the IVC

RRV courses anterior to the abdominal AO

RRV divides into a circumaortic ring before draining into the IVC

RRV lies anterior to the RA

A

RRV lies anterior to the RA

100
Q

where are the ureteral orfices in the urinary bladder?

each lateral edge

superior and anterior border

base of the trigone along the posterior aspect

inferior and anterior to the trigone

at the bladder base, inferior at the apex of the trigone

A

base of the trigone along the posterior aspect

101
Q

which view provides the best color doppler evaluation of the intrarenal vasculature?

patient supine, anterior view through liver

patient supine, coronal view through liver

patient prone, oblique view through back musculature

patient in posterior oblique position, coronal view through posterior axillary line

patient upright, anterior view through liver

A

patient in posterior oblique position, coronal view through posterior axillary line

102
Q

During color doppler evaluation of the kidney, inadequate fill of the intrarenal vasculature is seen. What doppler parameter will you make to improve sensitivity to flow?

decrease PRF
increase wall filter
decrease packet size
decrease color gain
decrease color resolution setting

A

decrease PRF

103
Q

You are scanning the bladder and notice multiple artifactual bands in the near field at the anterior bladder wall. What is the source of these echoes?

acoustic speckle
reverberation artifact
comet tail artifact
mirror image artifact
multi path artifact

A

reverberation artifact

104
Q

what feature is indicative of an atypical cyst?

internal septations
wall calcification
internal echoes
irregular walls
all of the above

A

all of the above

105
Q

what is the accepted treatment for a simple renal cyst?

surgical removal
aspiration
fine needle biopsy
core biopsy
no further evaluation required

A

no further evaluation required

106
Q

You are performing an ultrasound exam on a patient who has been on dialysis for 4 years. Which describes the typical appearance of the kidney in these cases?

bilateral renal enlargement with increased echogenicity

bilateral small, echogenic kidneys with multiple cysts of varying sizes

bilateral small, hypoechoic kidneys with increased corticomedullary distinction

normal appearing kidneys bilaterally

all of the above sonographic appearances are common in this scenario

A

bilateral small, echogenic kidneys with multiple cysts of varying sizes

107
Q

A patient is referred for ultrasound evaluation to take out the presence of renal malignancy. What is the most common renal malignancy in adults?

oncocytoma
TCC
angiomyolipoma
RCC
adenoma

A

RCC

108
Q

You are performing a follow up study on a patient diagnosed with emphysematous pyelonephritis. Which best describes the sonographic appearance of this condition?

multiple echogenic foci within the renal sinus or parenchyma with “dirty” posterior acoustic shadows

multiple distinct hyperechoic foci with discrete, well-defined posterior acoustic shadows

multiple indistinct, hazy foci within the renal sinus with posterior acoustic enhancement

large area of posterior acoustic shadowing which is not associated with any defined echoes

focal, wedge-shaped hypoechoic masses with posterior acoustic enhancement throughout the kidney

A

multiple echogenic foci within the renal sinus or parenchyma with “dirty” posterior acoustic shadows

109
Q

which describes the normal waveform of the main RA?

triphasic
high resistance
low resistance
phasic
bidirectional

A

low resistance

110
Q

the renal arteries arise from the AO closest to the origin of which arteries?

SMA
celiac trunk
IMA
common iliac arteries
common hepatic

A

SMA

111
Q

the LRA is normally located immediately posterior to which of the following?

LRV
PV
common hepatic artery
splenic artery
none of the above

A

LRV

112
Q

A patient has been referred to the ultrasound department with a history of medullary nephrocalcinosis. What do you expect to see?

a calcified renal capsule
a calcified ureter
a calcified urinary bladder
calcified pyramids
all of the above

A

calcified pyramids

113
Q

what is the sonographic appearance of a subcapsular hematoma?

free fluid in morison’s pouch

perirenal fluid collection that flattens the underlying renal contour

a linear defect that extends throughout the kidney

an intrarenal fluid collection within the renal collecting system

a subcapsular hematoma will not be visible by ultrasound

A

perirenal fluid collection that flattens the underlying renal contour

114
Q

which normally occurs in renal transplants compared to the immediate postoperative study?

hypertrophy
increased echogenicity
hydronephrosis
shrinkage
calcified pyramids

A

hypertrophy

after transplant, the renal allograft volume may increase 5-15% in the first two weeks

115
Q

You are performing a doppler study of a renal transplant to rule out stenosis of the RA. The RA is usually anatomosed to which artery?

internal iliac artery
external iliac artery
common iliac artery
abdominal AO
IMA

A

external iliac artery

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