Abdomen 1 Final - Kidneys and Urinary Tract
A 38-year-old woman is referred for a sonogram because of a family history of "kidney problems." The kidneys appear enlarged with five cysts on the right kidney and four on the left kidney. Each cyst measures 2 to 3 cm in diameter. These findings are consistent with:
ADPKD
An 8-year-old boy undergoes a renal sonogram. The patient has recent fever, sore throat, foggy appearance to his urine, joint pains, and costovertebral tenderness. Laboratory test results show increased BUN and creatinine levels, hematuria, and proteinuria. Sonographically, the kidneys appear enlarged bilaterally. The left kidney shows irregular cortical echotexture. These findings are most consistent with which of the following?
Acute glomerulonephritis
Results from cellular damage to the glomeruli; results in enlarged, poorly functioning kidneys
Acute glomerulonephritis
Associated with scarlet fever and diptheria
Acute interstitial nephritis
Appears as increased cortical echogenicity with spared pyramids; most commonly seen with chronic glomerulonephritis
Cortical nephrocalcinosis
The fibrous sheath of tissue around the kidney and adrenal gland is:
Gerota's fascia
Secretion and reabsorption takes place in the
Loop of Henle
A developmental anomaly that occurs in the medullary pyramids and consists of cystic dilatation of the collecting ducts
Medullary sponge kidney
Which of the following statements is true of autosomal recessive polycystic kidney disease?
Microcysts cause a hyperechoic sonographic appearance
A 65-year-old woman has an incidental finding of three irregularly shaped, noncommunicating cystic regions within the right renal sinus that is seen in both longitudinal and transverse scan planes. Which of the following describes the most likely condition seen in this patient?
Parapelvic cysts right kidney
Hematuria is associated with:
RCC
Medullary sponge kidney is:
a common cause of nephrocalcinosis
[_____] can be reversible.
acute renal failure
An example of intrinsic (or parenchymal) renal disease would be:
acute tubular necrosis
The most common cause of medical or "renal" ARF is [_____________].
acute tubular necrosis
Blood goes in...
afferent arteriole
Emphysematous pyelonephritis will demonstrate an abnormal collection of [____________]with in the parenchyma.
air
A solid renal mass that is benign and associated with tuberous sclerosis is [_____]
angiomyolipoma
Prerenal stages of renal failure are caused by [x] disease; renal stages may be caused by [y] diseases, and postrenal stages of renal failure are usually the result of [z]
arterial, parenchymal, outflow obstruction
The arcuate arteries of the kidneys are located:
at the base of the pyramids
What are the labratory findings used to determine renal disease or disfuntion?
blood urea nitrogen, specific gravity, and creatinine
Cortical tissue separating the renal pyramids; a hypertrophied one may mimic a renal mass: _____
column of bertin
The presence of two separate collecting systems in the same kidney
complete duplication
Loss of the [____________________]is a finding associated with renal failure.
corticomedullary junction
The main urinalysis lab value that measures the kidneys' ability to remove nitrogenous waste is _______________. Another one is BUN.
creatinine
Both kidneys are located on the same side
cross fused renal ectopia
Most [_______] tumors are homogeneous and hypoechoic, but can also cause diffusely enlarged kidneys.
cystic
A normal variant that occurs (usually) on the left kidney as a bulge on the lateral border: ____________________
dromedary hump
Two collecting systems in the kidney, including two ureters: ____________________
duplex collecting system
The echogenicity of kidneys in ARF is typically normal or [____________].
echogenic
Refers to a kidney located outside the normal position, most often in the pelvic cavity: ____________
ectopic kidney
Blood goes out...
efferent arteriole
Which of the following best describes the classic sonographic appearance of the kidneys in a patient with infantile polycystic disease?
enlarged, echogenic kidneys
Occasionally, the renal pelvis is located or extends outside the kidney where it is no longer obscured by sinus fat: ___________________
extra renal pelvis
The bright appearance to the renal sinus echoes is caused by:
fat, vessels, lymphatics
The formation of urine involves the following 3 procesess: _________ filtration, _________ reabsorption, and ___________ secretion.
glomerular, tubular, tubular
Blood is filtered in the...
glomerulus
One of the main functions of the kidneys is to maintain the body's fluid balance, also called ______________________.
homeostasis
Congenital malformation in which both kidneys are joined together at midline by an isthmus of parenchyma, most commonly at the lower poles: _____________________________
horseshoe kidney
What are the sonographic findings associated with nephrolithiasis?
hyperechoic foci, shadowing, and twinkle artifact
Another name for renal cell carcinoma is [_____]
hypernephroma
Renal fungal infections are associated with patients who have a history of:
immunosuppression
Intrinsic renal disease can alter the sonographic appearance of renal parenchyma in two general ways: 1) An overall [answer-1] in cortical echoes, or the inability to distinguish [answer-2] regions of the kidney.
increase, cortical and medullary
IVP or EXU radiography utilizes an [______] based contrast media.
iodine
Renal ectopia would best refer to a kidney that:
is located in the pelvis
A variant that appears as a small, echogenic, linear or triangular area on the kidney, usually at the junctions of the upper or lower poles: _________________________________
junctional defect
Acute renal vein thrombosis will cause the kidney to appear:
large with increased arterial resistance
Autosomal dominant polycystic kidney disease is associated with renal cysts. Cysts are also known to form in the:
liver, spleen, pancreas
A renal mass that is complex is presumed [_______], unless proven otherwise.
malignant
Renal pyramids are also called the:
medulla
A condition in which the renal pyramids are highly echogenic due to calcification is:
medullary nephrocalcinosis
[______] can result in hyperechoic renal pyramids because of static urine and calcification build-up.
medullary sponge kidney
Non-communicating cystic structures in the left renal fossa, no visible left renal tissue, and a normal right kidney most likely demonstrate in a newborn with a palpable left abdominal mass.
multicystic dysplastic kidney
Creatinine is a by-product of [x] energy metabolism. Decreased urine function results in abnormal concentrations due to impaired [y] filtratration.
muscle, glomerulus
Medullary sponge kidneys can cause calcium deposits in the renal parenchyma. This type of stone formation is called [_____].
nephrocalcinosis
The term for stones specifically within the calyces of the kidneys is [________].
nephrolithiasis
The functional unit of the kidney is the...
nephron
Renal vein thrombosis is associated with this condition: [_____________].
nephrotic syndrome
Azotemia is a term used to describe the condition of excess _____ waste in the blood.
nitrogenous
Acquired cystic disease of dialysis:
occurs in approximately 90% of patients after 5 years of renal dialysis
An uncommon benign renal tumor that sometimes shows a central stellate scar at surgery or CT is a/an[_____]
oncocytoma
Though benign, a/an [_____] will not be distinguishable from renal cell carcinoma.
oncocytoma and adenoma
The initial clinical sign of a urinary tract stone is extreme [answer].
pain
Cells at the apex of the renal pyramids are destroyed; associated with cadaveric kidneys used in renal transplants
papillary necrosis
A middle-aged woman who has recently undergone a kidney biopsy for renal disease developed microscopic hematuria and a decreasing hematocrit level. A renal sonogram is ordered. The left kidney is normal. The right kidney appears normal with the suggestion of a sonolucent crescent at the kidney's edge. This is most consistent with:
perinephric hematoma
Renal disease caused by obstruction is classified as a type of [____________________] failure.
post-renal
A potential cause of urinary obstruction unique to male infants is:
posterior urethral valves
A mildly distended collecting system can be caused by overhydration. [x] scanning techniques are helpful to recognize this condition.
postvoid
Renal artery stenosis is classified as a type of [_____________] failure.
pre-renal
A hypertrophied column of Bertin is defined as:
prominent renal cortex which projects inward between the pyramids
A 29-year-old woman arrives for a renal sonogram. She had a renal sonogram last week in the emergency department but she left before she obtained the results. The prior sonogram revealed an enlarged right kidney with decreased cortical echogenicity that was diagnosed as pyelonephritis. She presents today in the emergency department with worsened symptoms. Today's sonogram reveals an ill-defined anechoic mass with internal echoes and faint dirty shadowing. These findings are most suggestive of which of the following?
renal abscess
A congenitally absent kidney is termed:
renal agenesis
Interruption in the normal development of the kidney resulting in absence of the kidney; may be unilateral or bilateral. If bilateral, it is incompatible with life: ______________________________
renal agenesis
The most common variant of renal vasculature is multiple: _________________________
renal arteries
The most common clinically relevant solid renal tumor is:
renal cell carcinoma
The most common malignant solid renal mass in an adult is [_____]
renal cell carcinoma
When a solid renal mass is detected on a sonogram, which other area(s) should routinely be examined for possible tumor extension?
renal vein, IVC
The main renal artery branches into the ___________________arteries.
segmental
A round, echo-free renal mass that demonstrates through-transmission and sharp walls is the description of a:
simple renal cyst
Deposition of a moderate amount of fat in the renal sinus with parenchymal atrophy
sinus lipomatosis
Diseases that cause damage to the renal tubules affect the ability of the kidney to concentrate urine. This is measure by [answer]
specific gravity
Renal artery stenosis will result in a [____________] waveform in the segmental arteries.
tardus parvus
The portion of the kidney containing the glomerulus is:
the renal corpuscle
Cystitis is an inflammation of:
the urinary bladder
Marked hydronephrosis (Grade IV,) is characterized sonographically by which of the following patterns?
thinning of the parenchyma around the dilated calyces
A patient with a history of smoking presents with painful frequent urination and gross hematuria. A sonogram of the urinary tract demonstrates mild hydronephrosis and an irregular echogenic mass in the anterior wall of the bladder. This is most consistent with:
transitional cell carcinoma
The malignant renal tumor which occurs in the renal pelvis, ureter and bladder is [______]
transitional cell carcinoma
The most common malignant tumor of the urinary bladder is:
transitional cell carcinoma
Multiple angiomyolipomas is the characteristic renal finding associated with:
tuberous sclerosis
In this diagram, there is a contained cystic structure between urinary bladder and the umbilicus. What does this represent?
urachal cyst
A stone lodged at the distal end of the ureter (insertion site at the bladder) can cause an obstruction at the [_______] junction.
ureteral vesical
An ectopic ureter is prone to varying degrees of obstruction at the implantation site. When a cystic expansion of the distal end of the ureter is seen inside the bladder it is called: ______________
ureterocele
The term for stones within the ureters is [______].
ureterolithiasis
Milk of calcium and nephrocalcinosis can develop when which of the following is present?
urine stasis
The term for stones in the urinary tract and collecting system is [______].
urolithiasis
"Hydronephrosis of pregnancy" refers to an enlarged [answer] compressing the ureter; usually on the right side.
uterus
The kidneys adjust the amounts of [answer] leaving the body so that these equal the amounts of substances entering the body.
water and electrolytes
The principle metabolic waste products are [answer]
water,carbon dioxide and nitrogenous wastes
[______] tumor is the most common renal mass of childhood.
wilm's
An unusual infection associated with longstanding obstruction that tends to cause renal stones or staghorn calculus is called [_________].
xanthogranulomatous pyelonephritis