URR 44 Flashcards
(100 cards)
1
Q
75% of patients with ADPKD have:
A
systemic hypertension
2
Q
What other organs can be involved with ADPKD?
A
liver
pancreas
spleen
3
Q
ADPKD is associated with ___ aneurysm formation
A
berry
4
Q
ADPKD usually presents at age __-__ years
A
30
40
5
Q
ADPKD is more common in:
A
females
6
Q
___ occurs later in the ADPKD process
A
renal failure
7
Q
Possible abnormal labs with ADPKD
A
proteinuria
azotemia
hematuria
8
Q
bilateral renal enlargement due to cyst formation
A
ADPKD
9
Q
Diagnostic criteria for ADPKD for a patient <30 years
A
family history of ADPKD with 2 or more cysts present
10
Q
Diagnostic criteria for ADPKD for patients aged 30-59 years
A
2 or more cysts in each kidney
11
Q
Diagnostic criteria for ADPKD in patients aged >60 years
A
4 or more cysts in each kidney
12
Q
Unilateral cystic formation is seen with:
A
MCDKD
13
Q
Bilateral cyst formation is seen with:
A
ADPKD
14
Q
ARPKD
A
autosomal recessive polycystic kidney disease
15
Q
ARPKD is an inherited disorder, meaning:
A
parent is a carrier (does not have the disorder) and has a defective gene
16
Q
An autosomal recessive disorder requires:
A
two abnormal genes in a pair for the abnormality to develop
17
Q
4 types of ARPKD
A
perinatal
neonatal
infantile
juvenile
18
Q
ARPKD has marked ____ dysfunction
A
renal
19
Q
ARPKD is associated with ____ and ____ in perinatal form
A
lung hypoplasia
death
20
Q
If ARPKD is detected in utero, it is usually due to:
A
oligohydramnios
21
Q
____ and ____ are common in juvenile form of ARPKD
A
hepatic fibrosis
portal hypertension
22
Q
ARPKD is a ___ disorder
A
fatal
23
Q
bilateral renal enlargement; echogenic kidneys; loss of corticomedullary dysfunction
A
ARPKD
24
Q
MCDKD
A
Multicystic dysplastic kidney disease
25
MCPKD is caused by insult that occurs between week __ and __ of fetal development
14
18
26
90% of cases of MCDKD are associated with urinary obstruction during embryogenesis, usually related to:
ureteropelvic obstruction
27
MCPKD is related to ___, ____, and ____ causes
maternal cocaine use
anti-seizure medications
genetic
28
MCPKD is more common in:
males
29
MCPKD is more commonly unilateral or bilateral
unilateral
30
What are the effects of bilateral MCPKD?
fatal early in life
31
Most common cause of an abdominal mass in newborns
MCPKD
32
Most common form of cystic disease in infants
MCPKD
33
MCPKD is ____ involvement of the kidney
diffuse
34
Poor renal function of MCPKD kidney BUT may not be detected in lab testing due to:
compensatory response of normal kidney
35
MCPKD is associated with ____ and increased risk of ____ formation
hypertension
nephroblastoma
36
multiple cysts replace functional tissue; renal sinus absent; malformed kidney; little or no parenchyma; kidney size usually decreases as cysts replace parenchyma; cysts may calcify over time
MCPKD
37
Chronic renal failure
acquired cystic disease
38
___% of dialysis patients have acquired cystic disease
90
39
Acquired cystic disease usually occurs after __-__ years of dialysis
3
4
40
Acquired cystic disease shows an increased risk of:
renal cell carcinoma
41
With acquired cystic disease, ____ and ____ may be seen
internal hemorrhage
hematuria
42
bilateral atrophied kidneys
little to no visible parenchyma
multiple cyst formation (>3 cysts); cysts vary in size and number
acquired cystic disease
43
Medullary sponge kidney is an autosomal ____ defect.
recessived
44
dilated collecting tubules in pyramids with calcium deposition; may be focal or dffuse
Medullary Sponge Kidney
45
Medullary Sponge Kidney is caused by ____ and ____
urinary stasis
multiple urinary tract infections
46
Medullary Sponge Kidney is usually diagnosed at age __-__ years
30
40
47
Symptoms of medullary sponge kidney
asymptomatic
no effect on renal function or related lab values
48
Medullary Sponge Kidney is associated with ___, ___,. ___. ___, ___
Caroli disease
ARPKD
hyperparathyroidism
pyloric stenosis
Ehlers Danlos Syndrome
49
pyramids dilated and may be echogenic; thinned cortex; with and without shadowing
Medullary sponge kidney
50
associated with nephrocalcinosis
Medullary Sponge Kidney
51
calcium deposits in the parenchyma
nephrocalcinosis
52
Nephrocalcinosis is most commonly the:
medulla/pyramids
53
Cortical nephrocalcinosis is related to ____, ____, and ____
chronic transplant rejection
sickle cell disease
chronic glomerulonephritis
54
Medullary nephrocalcinosis is related to ___, ____, ____, ___
hyperparathyroidism
renal tubular acidosis
medullary sponge kidney
Wilson disease
55
Nephrocalcinosis will result in elevated ____ levels
serum calcium
56
Nephrocalcinosis may result in ___ if associated with medical renal disease
renal failure
57
multiple echogenic renal pyramids; difficult to differentiate from stones
medullary nephrocalcinosis
58
Multiple echogenic foci in the renal cortex; difficult to differentiate from stones
cortical nephrocalcinosis
59
What type of simple cyst bulges into the central sinus of the kidney and does not connect to collecting system?
a. peripelvic
b. parapelvic
c. cortical
d. pyelogenic
b
60
All the following are characteristics of a simple cyst, except:
a. anechoic
b. through transmission
c. round with smooth borders
d. posterior shadowing
d
61
All of the following are malignant characteristics of a cyst, except:
a. thick and/or irregular septations
b. posterior enhancement
c. calcification within the septations
d. wall nodularity
b
62
How is a cystic nephroma differentiated from renal cell carcinoma?
a. hyperechoic, thick, fibrous capsule surrounding a cystic nephroma is not present with RCC
b. presence of internal vascularity with a cystic nephroma is not present with RCC
c. RCC has numerous punctate calcifications not seen in a cystic nephroma
d. RCC is hypoechoic and a cystic nephroma is hyperechoic
a
63
How is the echogenic debris in a milk of calcium cyst differentiated from a renal calculus?
a. renal calculi are more echogenic than the debris in a milk of calcium cyst
b. renal calculi will demonstrate mobility with changes in patient position, but the debris in a milk of calcium cyst with not move
c. Renal calculi will not demonstrate mobility with changes in patient position, but the debris in a milk of calcium cyst will move
d. renal calculi are less echogenic than the debris in a milk of calcium cyst
c
64
An autosomal dominant disorder will be present:
a. in every generation
b. in every other generation
c. only when the other parent also has the same gene
d. only in females
a
65
Most patients with autosomal dominant polycystic disease also have:
a. diabetes
b. systemic hypertension
c. pulmonary hypertension
d. portal hypertension
b
66
An autosomal recessive disorder will be present:
a. in every generation
b. in every other generation
c. only when the other parent also has the same gene
d. only in female patients
c
67
All the following describe autosomal recessive polycystic disease?
a. bilateral enlargement
b. fatal early in life
c. echogenic kidneys
d. all the above
d
68
Multicystic Dysplastic Kidney Disease is:
a. most commonly seen in females
b. associated with compensatory enlargement of the unaffected kidney
c. usually bilateral
d. the most common cystic kidney disorder in adults
b
69
All of the following is a sonographic characteristic of Multicystic Dysplastic kidney disease, except:
a. multiple cysts replace functional tissue
b. prominent renal sinus
c. little or no parenchyma
d. unilateral cyst fomration
b
70
How will the kidneys be demonstrated in a patient with a long history of dialysis?
a. enlarged with numerous cysts
b. calculi formation within the renal pyramids
c. thin cortex with multiple small cysts
d. moderate to severe hydronephrosis
c
71
What causes medullary sponge kidney?
a. an insult in early pregnancy
b. one parent with a defective gene
c. maternal analgesic abuse
d. two parents with a defective gene
a
72
Which of the following describes the sonographic appearance of medullary sponge kidney?
a. dilated, echogenic pyramids with thinned cortex
b. multiple <1cm cysts consume the parenchyma
c. multiple <1cm cysts consume the sinus, thinned cortex
d. large staghorn calculus causes chronic obstruction
a
73
Which of the following is a clinical finding of nephrocalcinosis?
a. elevated hematocrit
b. elevated serum calcium
c. leukocytosis
d. leukopenia
b
74
Most infections occur in the ___ and ascend into the kidneys
bladder
75
Urinary tract infections are most commonly caused by:
bacterial from the intestinal tract
76
bilateral inflammation of glomeruli
acute glomerulonephritis
77
Acute glomerulonephritis frequently occurs as a late complication of ___
pharyngitis
78
Acute glomerulonephritis is also caused by other types of infections, ____, ___, ____
autoimmune response
medications
toxins
79
Acute glomerulonephritis has a sudden onset of ___, ___, ___
hematuria
proteinuria
azotemia
80
Symptoms of acute glomerulonephritis
foggy urine
fever
sore throat
joint pain
peripheral edema
oliguria
anemia
hypertension
81
Acute glomerulonephritis is more common in ___ and ____
children
males
82
Lab testing acute glomerulonephritis
increased serum BUN and creatinine
hematuria
proteinuria
decreased GFR
83
bilateral renal enlargement; may see increased cortical echogenicity with prominent pyramids; increased resistive index; ischemia or infarction causes hypoechoic foci in cortex
Acute glomerulonephritis
84
irreversible and progressive fibrosis of glomerulonephritis
chronic glomerulonephritis
85
Chronic glomerulonephritis usually progresses to ____
end stage renal failure
86
Chronic glomerulonephritis can lead to significant ____
proteinuria
87
causes the kidneys to atrophy with a significant increase in echogenicity; small, smooth echogenic kidneys
chronic glomerulonephritis
88
Inflammation of renal collecting system
acute pyelonephritis
89
Acute pyelonephritis is caused by:
bacteria from an ascending UTI
90
Acute pyelonephritis is most commonly caused by what bacteria?
E. Coli
91
Acute pyelonephritis is usually seen in ___ aged __-__ years
females
15
35
92
Is acute pyelonephritis usually unilateral or bilateral?
unilateral
93
Lab testing associated with acute pyelonephritis
increased white blood cell count
bacteria and pus in urine
94
Acute pyelonephritis symptoms sudden onset of ___, ___, ___, ____, ___
flank pain
fever
chills
urinary frequency
dysuria
95
How is acute pyelonephritis normally treated?
antibiotics
96
most patients have normal kidneys on US, loss of distinction between renal cortex and medulla, diminished sinus echoes in affected kidney/segment
acute pyelonephritis
97
unilateral or bilateral renal enlargement with diffuse swelling; loss of corticomedullary definition; calyceal clubbing
diffuse acute pyelonephritis
98
normal renal size with a focal, indistinct, hypoechoic wedge shaped segment of parenchyma; similar in appearance to renal infarct
Focal acute pyelonephritis
99
nephritis associated with urinary reflux and stasis
chronic pyelonephritis
100
Chronic untreated bacterial infection in the kidneys; begins in childhood
chronic pyelonephritis
