URR 46 Flashcards
(100 cards)
1
Q
Lab testing associated with acute renal failure
A
increased potassium
BUN and creatinine levels
2
Q
Symptoms of acute renal failure
A
hypovolemia
hypertension
peripheral edema
hematuria
oliguria
3
Q
kidneys may be normal or increased echogenicity compared to liver/spleen; kidneys are normal in size or slightly enlarged; possible bilateral hydronephrosis; >0.7 abnormal RI
A
acute renal failure
4
Q
Bilateral hydronephrosis indicates ____
A
postrenal failure
5
Q
Abnormal renal parenchymal RI
A
> 0.7
6
Q
> 0.7 RI abnormal and indicates ____
A
intrinsic failure
7
Q
Chronic renal failure is also known as
A
medical renal disease
8
Q
Most common cause of chronic renal failure
A
diabetes mellitus
9
Q
Causes of chronic renal failure
A
diabetes mellitus
renal vascular disease
chronic pyelonephritis
tuberculosis
lupus
10
Q
Labs associated with chronic renal failure
A
increased serum levels of BUN and creatinine
hyperkalemia
11
Q
Considered end stage renal failure when kidney function is __% or less
A
10
12
Q
In chronic renal failure, the kidneys are ___ in size and very echogenic due to ____
A
small
atrophy
13
Q
In chronic renal failure the cortex is thinned (<__mm) with loss of corticomedullary definition
A
10
14
Q
Chronic renal failure may require ___
A
dialysis
15
Q
used to remove excess waste products and water from the body when kidneys can no longer do it
A
dialysis
16
Q
Dialysis helps the body ____ and ___ and ___ levels
A
control blood pressure
sodium
potassium
17
Q
aids in maintaining the proper balance of fluid in the body
A
dialysis
18
Q
Patients in need of dialysis may experience symptoms of ___ and ___; ___, ____, ___, and ____
A
hypertension
uremia
nausea
vomiting
swelling
fatigue
19
Q
Process of hemodialysis
A
AVF created by connecting an artery and a vein, usually in the arm
Dialysis machine connected to patient using two separate needles
blood is removed from the body, sent through the machine, and returned to the body through the AVF
20
Q
____ dialysis is used for patients with some residual kidney function
A
peritoneal
21
Q
With peritoneal dialysis, eventually renal function will decline to a point that ____ will be needed instead
A
hemodialysis
22
Q
A
23
Q
Dialysis that can be performed by patient at home
A
peritoneal dialysis
24
Q
Contraindications for peritoneal dialysis
A
abdominal wall scarring
hernia
inflammatory bowel disease
diverticulitis
25
Peritoneal dialysis patients commonly demonstrate ___ in the abdomen
ascites
26
What renal infection frequently occurs as a late complication of pharyngitis?
a. acute pyelonephritis
b. emphysematous pyelonephritis
c. xanthogranulomatous pyelonephritis
d. acute glomerulonephritis
d
27
Which of the following is a symptom of acute glomerulonephritis?
a. foggy urine
b. hematuria
c. proteinuria
d. all the above
d
28
Acute glomerulonephritis presents as ____, while Chronic Glomerulonephritis presents as ___.
a. bilateral renal enlargement, unilateral renal enlargement
b. bilaterally increased renal echogenicity, bilaterally decreased renal echogenicity
c. bilateral renal enlargement, bilateral renal atrophy
d. bilaterally decreased renal echogenicity, bilaterally increased renal echogenicity
c
29
What causes acute pyelonephritis?
a. ascending bacterial infection
b. throat infection
c. descending bacterial infection
d. renal calculi causing obstruction
a
30
Which of the following is a sign of acute pyelonephritis?
a. loss of corticomedullary definition
b. diminished sinus echoes in affected kidney
c. calyceal clubbing
d. all the above
d
31
All the following are characteristics of emphysematous pyelonephritis, except?
a. commonly caused by E. Coli
b. abscess formation with intrarenal air
c. areas of ring down and/or dirty posterior shadowing
d. multiple renal calculi within the parenchyma
d
32
Which of the following renal infections is a critical finding that requires an emergency nephrectomy?
a. HIV nephropathy
b. emphysematous pyelonephritis
c. Acute pyelonephritis
d. chronic pyelonephritis
b
33
___ are more common in women and diabetics.
a. hydronephrosis and xanthogranulomatous pyelonephritis
b. acute pyelonephritis and chronic pyelonephritis
c. xanthogranulomatous pyelonephritis and emphysematous pyelonephritis
d. acute glomerulonephritis and chronic glomerulonephritis
c
34
Staghorn calculus and hydronephrosis are commonly seen with
a. xanthogranulomatous pyelonephritis
b. emphysematous pyelonephritis
c. acute pyelonephritis
d. mycetoma formation
a
35
Mycetoma formation is associated with:
a. renal calculi formation
b. papillary necrosis
c. candidiasis infection
d. renal cyst formation
c
36
Mycetoma formation is associated with which of the following?
a. long term use of indwelling urinary catheters
b. those with history of IV drug use
c. Long term steroid or antibiotic therpay
d. all the above
d
37
___ refers to a renal abscess that forms in the parenchyma caused by hematogenous spread of staphylococcus aureus.
a. carbuncle
b. mycetoma
c. malakoplakia
d. HIV nephropathy
a
38
What acoustic artifact is associated with a renal abscess caused by a bacterial infection?
a. mirror image
b. ring down
c. propagation speed
d. posterior enhancement
b
39
When evaluating a suspected renal hematoma, it is most important to document the location of the hematoma relative to:
a. the liver/spleen
b. diaphragm
c. renal capsule
d. renal hilum
c
40
How is an intracapsular fluid collection differentiated from an extracapsular fluid collection of the kidney?
a. presence or absence of debris in the fluid
b. presence or absence of septations in the fluid
c. presence or absence of parenchymal distortion
d. all the above
c
41
What sonographic characteristic indicates a lymphocele is present and not a urinoma?
a. a lymphocele has septations in the fluid
b. a lymphocele has shadowing echogenic foci floating in the fluid
c. a lymphocele is located at the hilum, but a urinoma is located in Morison pouch
d. a lymphocele is located in the Morison pouch, but a urinoma is located at the hilum
a
42
Which of the following is a cause of bilateral hydronephrosis?
a. extrinsic compression from mass
b. malformed ureterovesicular junction
c. prostate enlargement
d. ureteropelvic obstruction by staghorn calculus
c
43
Which of the following is a cause of unilateral hydronephrosis?
a. bladder mass
b. urethral obstruction
c. pregnancy
d. ureteropelvic obstruction by staghorn calculus
d
44
Which of the following would assist in determining the level of obstruction with hydronephrosis?
a. pre and post void bladder images
b. PW Doppler evaluation of the parenchymal arteries
c. PW Doppler evaluation of the main renal arteries
d. all the above
a
45
In cases of significant hydronephrosis, Doppler evaluation of the parenchymal arteries should be performed to obtain what value?
a. peak systolic velocity
b. acceleration time
c. pulsatility index
d. resistive index
d
46
How is pyonephrosis differentiated from hydronephrosis?
a. presence or absence of debris in the dilated calyces
b. presence or absence of a fever
c. presence or absence of leukocytosis
d. all the above
d
47
What is the most common cause of acute renal failure?
a. acute tubular necrosis
b. hydronephrosis
c. renal artery stenosis
d, pyelonephritis
a
48
Which of the following describes acute renal failure?
a. sudden onset of oliguria
b. recent onset of peripheral edema
c. critical finding that is reversible if diagnosed eary
d. all the above
d
49
While the affected kidney may appear normal sonographically with acute renal failure, how is chronic renal failure identified?
a. unilateral or bilateral kidney enlargement
b. increased echogenicity and decreased thickness of the cortex
c. decreased echogenicity and increased thickness of the cortex
d. low RI values from Doppler evaluation
b
50
Hemodialysis uses a catheter inserted into the ___, while peritoneal dialysis uses a catheter inserted into the ____.
a. artery, vein
b. vein, artery
c. arm blood vessels, abdomen
d. abdomen, arm blood vessels
c
51
Calculi are most commonly composed of:
calcium
52
Urolithiasis/nephrolithiasis can cause ___ and ___
obstruction
hydronephrosis
53
Urolithiasis/nephrolithiasis is most common in ___
men
54
The most common site for obstruction in the urinary tract is:
uretervesicular junction
55
Symptoms of Urolithiasis/nephrolithiasis
hematuria
radiating flank pain
mobile pain
renal colic
56
sharp pain that radiates from the flank to the groin
renal colic
57
In most cases, Urolithiasis/nephrolithiasis is idiopathic but can be associated with __, ___, ____, ___
dehydration
urinary stasis
hyperparathyroidism
hyercalciuria
58
renal abnormalities that mimic calculi
renal artery calcification
intrarenal gas
calcified sloughed papilla
59
used to shatter kidney stones into "manageable size pieces to allow the patient to pass them normally
lithotripsy
60
used to allow renal calculi to pass through the ureters and out of the body
ureteral stenting
61
___ for kidneys stones and ureteral stones are temporary and removed after stones have passed
ureteral stents
62
Sonographic appearance of renal calculi
highly echogenic mass with posterior shadowing
63
Renal calculi can be in ___, ___, or ____
pelvis
ureter
kidney
64
large stone in renal pelvis
staghorn calculus
65
What artifacts are useful in identifying renal calculi?
posterior shadowing
twinkle artifact
66
Absent, asymmetrical or continuous low level jet indicate:
obstruction between calyces and bladder
67
atherosclerosis in cortical vessels; punctate or linear calcifications; may or may not shadowing depending on size; not related to hydronephrosis or urinary obstruction
renal vascular calcifications
68
An angiomyolipoma is also known as:
hamartoma
69
benign fatty tumor in the kidney
angiomyolipoma
70
most common benign solid tumor of the kidney
angiomyolipoma
71
Agiomyolipomas are most common in the ___ kidney
right
72
Angiomyolipomas are usually seen in __ aged __-__ years
females
40
60
73
Clinical symptoms of angiomyolipomas
usually asymptomatic
74
Formation of multiple bilateral angiomyolipomas is usually associated with:
tuberous sclerosis
75
If an angiomyolipoma grows to over ___, embolization or partial nephrectomy may be necessary
4cm
76
homogeneous and round; hyperechoic cortical mass; 30% demonstrate acoustic shadowing; can demonstrate propagation speed artifact due to slower acoustic velocity in fatty mass
angiomyolipoma
77
Ischemia of the medullary pyramids causes ___ and ____
papillary necrosis
sloughed papilla
78
Sloughed papilla are identified in the urine and can cause ____
urinary obstruction
79
Causes of papillary necrosis include ___, ___, ____, ____, ____, ____
analgesic abuse
diabetes mellitus
obstruction
infections
renal vein thrombosis
CHF
80
#1 cause of papillary necrosis
analgesic abuse
81
Papillary necrosis is more common in ___ and ___
women
diabetics
82
Clinical symptoms of papillary necrosis
fever
flank pain
hypertension
hematuria
dysuria
83
Lab testing associated with papillary necrosis
papilla
red blood cells
bacteria
pus
protein
all in urine
84
usually occurs bilaterally, swollen pyramids, clubbing of the calyces, echogenic material and calcification, within the collecting system; triangular cystic areas in the cortex
papillary necrosis
85
blunted calyces with overlying parenchymal scarring
clubbing of the calyces
86
benign; accumulation of fat in the renal sinus and replacement of the cortical tissue; no pathologic significance
sinus lipomatosis
87
sinus becomes increasing echogenic, thinned cortex
sinus lipomatosis
88
small benign fatty tumor; usually <5mm diameter if within parenchyma
renal lipoma
89
hyperechoic to renal cortex; hypoechoic to renal sinus; usually smooth, well defined borders; may cause propagation speed artifact due to slower speed of found in fat
renal lipoma
90
common benign cortical tumor that is usually asymptomatic with painless hematuria
adenoma
91
echogenic, cortical mass; homogeneous, small, rounded; well defined margins; demonstrates sound attenuation and may cause shadowing; may demonstrate calcifications
renal adenoma
92
usually benign renal mass, found in other organs as well, usually asymptomatic
oncocytoma
93
Oncocytomas can also form in the ____, ___, ____, and ____
parathyroid
thyroid
adrenal glands
salivary glands
94
Oncocytomas are most common in ___ aged ___-___ years
men
70
80
95
usually a hypoechoic solid mass; can have varied echogenicity; may see a central scar; difficult to differentiate from renal cell carcinoma; requires biopsy
oncocytoma
96
benign renal mass; most common renal mass identified in the neonatal period
mesoblastic nephroma
97
It utero, it is described as a lateral abdominal mass that replaces the kidney with polyhydramnios; large, solid, homogeneous mass
mesoblastic nephroblastoma
98
What is the most common site for obstruction by a renal calculus?
a. uteropelvic junction
b. ureterovesicular junction
c. distal urethra
d. renal papilla
b
99
The presence of ___ in the urine is most suggestive of possible obstruction caused by renal calculi?
a. calcium
b. protein
c. red blood cells
d. bilirubin
c
100
What system setting can be adjusted to better demonstrate posterior shadowing from a renal stone?
a. increase gain
b. increasing dynamic range
c. deactivate spatial compounding
d. Deactivate harmonic imaging
c
