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320 Cards in this Set
- Front
- Back
Pyelonephritis is an ____ or ____ inflammation of the kidneys.
|
acute or chronic
|
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Normal or enlarged kidneys w/ diffuse swelling or focal decreased echoes is an:
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acute inflammation
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When a kidney is smaller, has focal scarring w/ increased echoes in the medulla & cortex it is known as:
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chronic inflammation
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What is the most common renal infective disorder?
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acute pyelonephritis (APN)
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An acute inflammation of renal parenchyma & pyelocaliceal lining is known as:
|
acute pyelonephritis
|
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Acute pyelonephritis is caused by a ____ ____ and is usually secondary to a ____.
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bacterial infection, UTI
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What is the cause of acute pyelonephritis in 85% of cases?
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E. Coli
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What are the common symptoms of acute pyelonephritis?
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flank pain, fever, chills
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What lab values are found with acute pyelonephritis?
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pyuria, bacteriuria, leukocytosis, & microscopic hematuria
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Acute pyelonephritis typically has a ____ appearance.
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normal
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There can be focal or diffuse increase in ____ with increased/decreased ____ w/ acute pyelonephritis.
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size, echogenicity
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There is a loss of _____ definition w/ acute pyelonephritis.
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corticomedullary
|
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What are some common complications of acute pyelonephritis?
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abscess, scarring, septic shock, inadequate renal function
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Patients with acute pyelonephritis usually respond to ____ & have no lasting ____.
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antibiotics, sequelae
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A life threatening infection characterized by gas production w/in the kidneys is:
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emphysematous pyelonephritis
|
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Emphysematous pyelonephritis occurs more freq in ____ & E.coli is the cause in ____% of cases.
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females, 60-70%
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Emphysematous pyelonephritis occurs typically in ____ & ____ ____.
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diabetics (90%) & immune compromised
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What 3 other things can cause emphysematous pyelonephritis?
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high tissue glucose concentration, necrosis, vascular disease
|
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What are the symptoms of emphysematous pyelonephritis?
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fever, flank pain, dehydration, acidosis, lethargy
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With emphysematous pyelonephritis the kidneys appear ____.
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enlarged
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What are 2 complications w/ emphysematous pyelonephritis?
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extension into perirenal space, high mortality rate
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With emphysematous pyelonephritis there is extension into the perirenal space in ____% of cases.
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80%
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What is the most reliable imaging for emphysematous pyelonephritis?
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CT scan
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A rare, serious, debilitating & chronic inflammatory condition of the kidneys assoc w/ long standing UTI's is:
|
xanthogranulomatous pyelonephritis
|
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Xanthogranulomatous pyelonephritis ultimately results in focal or diffuse ____ ____.
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renal destruction
|
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What replaces the parenchyma w/ xanthogranulomatous pyelonephritis?
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lipid-laden macrophages / foam cells
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Xanthogranulomatous pyelonephritis occurs more in ____ & ____.
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females & diabetics
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What is the typical sono appearance of the kidney w/ xanthogranulomatous pyelonephritis?
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enlarged w/ hypoechoic areas, dilated calyces, stones & fluid
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Nephritis resulting from ongoing or recurring UTI's is known as:
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chronic pyelonephritis
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Chronic pyelonephritis is typically ____ & results in ____ ____.
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asymptomatic, renal failure
|
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With chronic pyelonephritis there is a ____ in renal size w/ uni or bilateral focal areas of ____ ____.
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decrease, cortical thinning
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With chronic pyelonephritis the kidneys have ____ echogenicity & ____ of the calyxes.
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increased, clubbing
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Reversible, temporary renal failure secondary to significant reduction in tubular blood flow rate is:
|
acute tubular necrosis (ATN)
|
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What cause the reduction in tubular blood flow rate with ATN?
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drugs or ischemia processes that increase arteriole resistance
|
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What is the most common renal disease to cause renal failure?
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Acute tubular necrosis (ATN)
|
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There is damage/necrosis to the bilateral ____ ____ w/ ATN.
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renal tubules
|
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There is ____ ATN from not enough oxygen or ____ ATN from exposure to drugs.
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ischemic, nephrotoxic
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Severe ____ & problems w/ the body's ____ system are risk factors for ATN.
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dehydration, immune
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There is an ____ imbalance as well as ____ & ____ w/ ATN.
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electrolyte, oliguria & uremia
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In 89% of cases, the ____ appears normal w/ ATN.
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cortex
|
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With ATN, there is bilateral ____ & increased prominance of ____ due to edema.
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enlargement, pyramids
|
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Dopple shows an abnormally elevated ____ w/ ATN.
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RI (>.7)
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Pus in the urinary collecting system secondary to ureteral obstruction is:
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pyonephrosis
|
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With pyonephrosis, ____ is seen as well as mobile echogenicities in the ____ ____.
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hydronephrosis, dilated calyces
|
|
A form of nephritis involving primarily the glomeruli is:
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glomerulonephritis
|
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What are the classifications of glomerulonephritis?
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acute, subacute or chronic
|
|
An accumulation of inflammatory elements and/or necrosis of the glomeruli is:
|
glomerulonephritis
|
|
What is glomerulonephritis usually associated with?
|
autoimmune & other systemic disease processes
|
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What does glomerulonephritis cause?
|
causes blood & protein to be lost in the urine
|
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Glomerulonephritis is discovered w/ an abnormal ____.
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urinalysis
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What does glomerulonephritis cause?
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causes inflammation of the internal kidney structures
|
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What are the symptoms of glomerulonephritis?
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oliguria, fatique, fever, HTN, & swelling
|
|
What lab findings are elevated w/ glomerulonephritis?
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BUN, creatinine, & potassium as well as hematuria & azotemia
|
|
What is azotemia?
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abnormal levels/excess of nitrogen containing compounds (urea, creatinine) in the blood- related to insufficient filtering of the blood by kidneys
|
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With glomerulonephritis the kidneys almost always appear ____.
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normal
|
|
What is candidiasis?
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AKA renal fungal disease
|
|
A systemic fungal infection occuring in immunocompromised, diabetic & cachectic patients is:
|
candidiasis
|
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With candidiasis there are multiple focal ____ throughout the renal ____.
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abscesses, parenchyma
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There are also focal echogenic masses w/in the ____ ____ w/ candidiasis.
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collecting system
|
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What is normally observed w/ candidiasis unless there's an obstruction?
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normal ureteral jets
|
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A parasitic infestation of schistosome organism affecting the bladder & ureters is:
|
schistosomiasis
|
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Schistosomiasis affects ____% of the world population.
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8%
|
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What are the symptoms of schistosomiasis?
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flank pain, dysuria, urinary frequency, decreased bladder capacity
|
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What lab values are associated w/ schistosomiasis?
|
hematuria, albuminuria
|
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The ____ are normal w/ schistosomiasis but there is thickening & calcifications of the ____ ____.
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kidneys, bladder wall
|
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An infestation to the kidney of mycobacterium tuberculosis from an extraordinary source is:
|
urinary tuberculosis
|
|
Urinary tuberculosis occurs more freq in ____ & affects ____% of pulmonary TB patients.
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males, 5-10%
|
|
Urinary tuberculosis is typically ____ causing ____ ____.
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asymptomatic, microscopic hematuria
|
|
Urinary tuberculosis is typically ____.
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unilateral
|
|
What is the sono appearance of acute urinary tuberculosis?
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enlarged kidneys, focal lesions of varying echogenicity
|
|
What is the sono appearance of chronic urinary tuberculosis?
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decreased size (eventually shrunken & calcified), varying appearance of scarring & obstruction, & echogenic
|
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A focal collection of inflammatory & necrotic debris is an:
|
abscess
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T or F. Diabetics are affected twice as often with a renal abscess.
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TRUE
|
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What are the cause of a renal abscess?
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infection (staph), diabetes, calculi, obstruction
|
|
What lab findings are associated w/ renal abscesses?
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leukocytosis, pyuria, hematuria, bacteremia
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An abscess in the renal parenchyma is known as a ____ ____.
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renal carbuncle
|
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A perforation of an abscess into the surrounding area which may be single or multiple is a ____ abscess.
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perinephric
|
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The echogenicity of an abscess varies depending on ____.
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age
|
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What are the different appearances of a renal abscess?
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anechoic or complex w/ septations, hypoechoic, echogenic, dirty shadow, acoustic enhancement
|
|
Renal parenchymal cortical diseases involve primarily the ____ of the kidneys.
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parenchyma (cortex)
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What is suggestive of renal parenchymal disease?
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proteinuria
|
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Renal cortical disease causes a diffuse ____ in ____ echogenicity.
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increase, cortical
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With chronic disease there is a ____ in renal size with ____ echogenicity.
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decrease, increased
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What lab findings are found w/ parenchymal cortical disease?
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elevated BUN/creatinine, decreased serum calclium, low urine specific gravity, hematuria, and proteinuria
|
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What is wrong with the kidneys w/ renal failure?
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kidneys are unable to filter blood, regulate blood pressure & regulate salt/water balances
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There is an increased incidence of renal failure w/ uncontrolled ____ and/or ____.
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diabetes, hypertension
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Impairment of kidney function resulting in inability of kidneys to maintain normal function is:
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renal failure
|
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What are the 2 types of renal failure?
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acute (ARF) & chronic (CRF)
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Acute renal failure occurs over ____ or ____.
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days or weeks
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What accounts for 75% of acute renal failure?
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ATN, and pre-renal abnormalities
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Chronic renal failure occurs over ____ or ____.
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weeks or months
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With CRF there is chronic ____ & ____ of the kidneys as well as a long standing ____ disease.
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inflammation & infection, vascular
|
|
T or F. Renal failure prevents the removal of accumulated metabolites from the blood.
|
TRUE
|
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What are the 4 types of causes of renal failure?
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prerenal, renal, postrenal, congenital
|
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Prerenal causes of renal failure result in a loss of ____ secondary to ____ causes.
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perfusion, systemic
|
|
What is the most common cause of renal failure?
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intrarenal (renal) causes
|
|
What are some prerenal causes of renal failure?
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renal arterial stenosis,thrombosis, hemorrhage, shock, sepsis, embolization, CHF, liver failure, electrolyte depletion
|
|
What are some intrarenal (renal) causes of renal failure?
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ATN, parenchymal disease, chronic pyelonephritis, necrosis, toxins, infection, ischemia, AIDS
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The least common causes of renal failure are ____ causes.
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postrenal
|
|
What are the postrenal causes of renal failure?
|
obstructive uropathy from bladder tumor, stones, enlarged prostate, injury
|
|
The postrenal cause of renal failure is from ____ ____.
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outflow obstruction
|
|
What are the 3 congenital causes of renal failure?
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polycystic kidney disease, multicystic kidney disease, & medullary cystic kidney disease
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What are the symptoms of acute renal failure?
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oliguria, hypertension, swelling, fatique, shortness of breath
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Acute renal failure is diagnosed by ____ tests which indicate impaired kidney function.
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blood
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What lab values are found w/ renal failure?
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increased BUN/creatinine, decreased serum calcium, proteinuria, anemia, uremia, low urinary specific gravity
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A derivative of creatine found in muscle, blood & urine is ____.
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creatinine
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An amino acid that provides energy to muscles, usually as phosphocreatine is ____.
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creatine
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The kidneys appear ____ in the early stages of renal failure.
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normal
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With acute renal failure the kidneys appear ____ & ____.
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enlagred & inflamed
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There is possible ____ seen w/ renal failure if there is a postrenal obstruction.
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hydronephrosis
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With end stage renal failure (CRF) the kidneys are ____ and less than ____ cm.
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atrophic, 8 cm
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There is increased ____ due to ____ & ____ w/ CRF.
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echogenicity, fibrosis & scarring
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There is a loss of _____ differentiation w/ CRF.
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corticomedullary
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|
What is the gold standard for renal artery stenosis?
|
renal arteriography (but MRA is becoming modality of choice)
|
|
What is the treatment for end-stage renal disease?
|
hemodialysis, peritoneal dialysis, transplantation
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What is hemodialysis?
|
blood is filtered thru machine and returns it to the body
|
|
What is peritoneal dialysis?
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a fluid called dialysate is introduced into the abdomen that captures waste products from the blood & drains them away
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A benign sinus disease characterized by increased fat in the renal sinuses is ____ ____ ____.
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renal sinus lipomatosis
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|
What is the appearance of the kidney w/ renal sinus lipomatosis?
|
enlarged w/ a fibro fatty appearance & decreased cortical thickness
|
|
What is renal sinus lipomatosis associated with?
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obesity, steroid use, chronic UTI, and advanced age
|
|
Renal sinus lipomatosis is ____.
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unilateral
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|
Renal sinus lipomatosis is ____ or has symptoms similar to ____.
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asymptomatic, UTI
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|
Renal sinus lipomatosis can have a ____ effect.
|
mass
|
|
What are the different types of benign renal cysts?
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cortical, hemorrhagic, infected, & parapelvic cysts
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|
A common, benign, simple renal cyst is known as a ____ cyst.
|
coritcal
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|
T or F. The etiology of a cortical cyst is unknown.
|
TRUE
|
|
What are cortical cysts comprised of?
|
serous fluid
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|
Cortical cysts are more common in the age population occuring in ____% of patients over 50 yrs.
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50%
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What is the classic US appearance of a cortical cyst?
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round/oval, smooth thin walls, anechoic, well defined, posterior enhancement
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|
Simple cortical cysts may be located anywhere in the kidney but are most often located in the ____ & bulge thru the ____ ____.
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cortex, renal capsule
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|
What are the 2 complications of a simple cortical cyst?
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hemorrhage & infection
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There is an increased risk of a hemorrhagic cyst in ____ ____ patients.
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polycystic disease
|
|
The appearance of hemorrhagic cysts varies with ____ of clot but may appear ____ w/ ____ ____.
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age, complex w/ internal echoes
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|
With an infected cyst the patient usually always has ____.
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symptoms
|
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What are the symptoms of an infected cyst?
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pain, fever, leukocytosis
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An infected cyst often has ____ ____ & may ____ and contain ____.
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internal echoes, calcify, septations
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|
A thick-walled, complex, renal mass may be the appearance of an ____ ____.
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infected cyst
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|
A fluid-filled mass of lymphatic origin located in the renal hilum is a:
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parapelvic cyst
|
|
Where do parapelvic cysts originate from?
|
renal parenchyma
|
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A parapelvic cyst may become ____ & has no communication with the ____ ____.
|
infected, collecting system
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|
The patient is usually ____ w/ a parapelvic cyst.
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asymptomatic
|
|
What symptoms could a parapelvic cysts cause?
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pain, hematuria, hydro, hypertension
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|
Parapelvic cysts are usually ____ & ____ w/ no ____.
|
multiple & bilateral, flow
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|
Parapelvic cysts may have ____ borders from compression and may ____ the kidney.
|
irregular, obstruct
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|
Parapelvic cysts have a ____ ____ location.
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renal sinus (hilum)
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|
Cysts that originate in the renal parenchyma & extend into the renal sinus are ____ cysts.
|
peripelvic
|
|
Peripelvic cysts may develop from the ____ system or an ____.
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lymphatic, obstruction
|
|
Peripelvic cysts are usually ____, ____ & ____.
|
multiple, small & anechoic
|
|
T or F. Peripelvic cysts do not obstruct the kidney.
|
TRUE
|
|
What is the most common inherited disease in the U.S.?
|
polycystic kidney disease (PKD)
|
|
Children of parents with PKD have a ____% chance of getting the disease.
|
50%
|
|
The 4th leading cause of kidney failure is ____.
|
PKD
|
|
What are the different types of PKD?
|
MDKD, IPKD, APKD, medullary cystic disease, medullary sponge kidney, acquired cystic kidney disease
|
|
MDKD=
|
multicystic dysplastic kidney disease
|
|
IPKD=
|
infantile polycystic kidney disease
|
|
APKD=
|
adult polycystic kidney disease
|
|
A developmental anomaly resulting in multiple renal cysts of varying sizes & fibrosis or renal parenchyma is:
|
multicystic dysplastic kidney disease (MDKD)
|
|
MDKD is not ____ and is usually ____.
|
hereditary, unilateral
|
|
What is the most common infant renal cystic disease?
|
MDKD
|
|
MDKD affects the ____ side more & when it appears bilateral than it is ____.
|
left, fatal
|
|
MDKD affects ____ more are the larger cysts are typically located ____.
|
men, peripherally
|
|
With MDKD there is no communication at the ____.
|
hilum
|
|
What is maintained w/ MDKD?
|
the shape of the kidney
|
|
In 1/3 of MDKD patients, the contralateral kidney is ____ or ____.
|
abnormal or obstructed
|
|
The kidney has a ____ shape.
|
reniform
|
|
With MDKD the ureter in the affected kidney is ____ or ____.
|
absent or atrectic
|
|
MDKD can be asymptomatic or cause recurrent ____.
|
UTI's
|
|
MDKD may present as a ____, ____ mass.
|
palpable, flank
|
|
What are the sonographic findings w/ MDKD?
|
multiple cysts or varying sizes & parenchymal thinning
|
|
In the late stage of MDKD there is a ____ in kidney size w/ an ____ in cortical echogenicity.
|
decrease, increase
|
|
There is ____ ____ in the opposite kidney w/ MDKD.
|
compensatory hypertrophy
|
|
MDKD is potter type ____ & IPKD is potter type ____.
|
2, 1
|
|
T or F. IPKD is less common than adult polycystic disease.
|
TRUE
|
|
A rare, autosomal recessive inherited disorder characterized by abnormal proliferation & dilatation of renal tubules:
|
IPKD
|
|
IPKD results in multiple ____ ____.
|
microscopic/tiny cysts
|
|
IPKD affects ____ more & may be seen during a prenatal US.
|
females
|
|
The most severe forms of IPKD are those found ____.
|
prenatally (enlarged echogenic kidneys, small/absent bladder, oligohydramnios)
|
|
IPKD is commonly found in association w/ ____ cysts.
|
liver
|
|
What else can IPKD be associated with?
|
hepatic fibrosis, biliary ectasia, & splenomegaly
|
|
What are the 4 forms of IPKD?
|
perinatal, neonatal, infantile & juvenile
|
|
IPKD may be incompatible with life & may cause ____ ____ & ____ ____.
|
renal failure, portal hypertension
|
|
Bilaterally enlarged, very echogenic kidneys w/ multiple tiny cysts is the sono appearance of:
|
IPKD
|
|
The ____ & ____ are not clearly differentiated w/ IPKD.
|
medulla & cortex
|
|
In neonates, ____ ____ is a component of potter syndrome & occurs secondary to oligo & renal enlargement.
|
pulmonary hypoplasia
|
|
IPKD is typically fatal due to ____ ____ & ____ ____.
|
renal failure & pulmonary hypoplasia
|
|
An autosomal dominant inherited disorder w/ bilateral development of parenchymal cysts is:
|
APKD
|
|
APKD is potter type ____.
|
3
|
|
T or F. APKD is found equally in both male & females.
|
TRUE
|
|
APKD is usually ____ and accounts for ____% of all PKD cases.
|
bilateral, 90%
|
|
By the age of 60, ____% of pts w/ APKD will have end-stage renal disease.
|
50%
|
|
What is the 3rd most common cause of chronic renal failure?
|
APKD
|
|
APKD is a progressive disease that leads to ____.
|
hypertension
|
|
Early on, APKD is ____ and eventually causes ____, ____ & ____.
|
asymptomatic; pain, hypertension & hematuria
|
|
There is an increased incidence of ____ ____ & ____ w/ APKD.
|
renal infection & calculi
|
|
With APKD there is ____ ____ ____.
|
bilateral renal enlargement
|
|
There are ____ cysts in approx 80% of APKD patients.
|
liver
|
|
APKD is associated w/ ____ ____ of the ____ arteries.
|
berry's aneurysm, cerebral
|
|
What is medullary cystic disease?
|
an autosomal dominant or recessive inherited disorder
|
|
What is dominant medullary cystic disease characterized by?
|
adult onset, rapid progression, uremia and death w/in 2 yrs
|
|
What are the signs & symptoms of medullary cystic disease?
|
failure to thrive, renal failure, polyuria, hypertension
|
|
What lab findings are associated w/ medullary cystic disease?
|
anemia, sodium loss, azotemia, & increased BUN/creatinine
|
|
What is the sono appearance of medullary cystic disease?
|
bilateral, normal size or small kidneys, thin cortex, smooth contour
|
|
There is increased echogenicity of the ____ ____ w/ medullary cystic disease.
|
medullary pyramids
|
|
W/ medullary cystic disease there is a loss of ____ definition.
|
parenchymal (b/t cortex/medulla or medullary/sinus junction)
|
|
Bilateral, dysplastic cystic dilatation of the medullary & papillary portions of the collecting tubules is:
|
medullary sponge kidney (MSK)
|
|
T or F. MSK is found in young to middle-aged adults.
|
TRUE
|
|
MSK is usually ____ & usually has normal ____ function.
|
bilateral, kidney
|
|
What is MSK associated with?
|
Caroli's disease, parathyroid adenomas, and Ehlers-Danlos syndrome
|
|
MSK is usually ____ but may be characterized by what findings?
|
asymptomatic; repeated renal colics, calculus disease, hematuria, or repeated UTI
|
|
MSK is also characterized by ____ ____ of the ____ ____.
|
cystic dilatation, collecting tubules
|
|
The pyramids have a ____ appearance w/ MSK.
|
echogenic
|
|
MSK is more common in ____.
|
males
|
|
Medullary nephrocalcinosis is often present in ____% of MSK cases.
|
80%
|
|
Patients w/ chronic renal failure undergoing dialysis develop multiple cysts in native or transplant kidneys known as:
|
acquired cystic kidney disease
|
|
What are 4 types of benign solid renal neoplasms?
|
adenoma, oncocytoma, angiomyolipoma, mesoblastic nephroma
|
|
A benign counterpart of renal cell carcinoma derived from glandular epithelium is an ____.
|
adenoma
|
|
What is the most common cortical renal mass?
|
adenoma
|
|
Adenomas are more common in ____.
|
males
|
|
Adenomas are usually an incidental finding because they are usually ____.
|
asymptomatic
|
|
Adenomas mimic a ____ on US.
|
RCC
|
|
What is the typical sono appearance of an adenoma?
|
well-defined, small (<3cm), iso or hypoechoic
|
|
A rare, benign, epithelial tumor consisting mainly of oncocytes is an ____.
|
oncocytoma
|
|
Oncocytomas are well ____ & are usually ____.
|
encapsulated, solitary
|
|
Oncocytomas are usually ____ and can be ____ in size.
|
asymptomatic, variable
|
|
What is the typical sono appearance of a oncocytoma?
|
well defined, homogenous, hypoechoic mass that is sperical & large (7cm)
|
|
Oncocytoma's mimic ____ on US.
|
RCC
|
|
Some oncocytoma's may appear ____ to the normal renal parenchyma.
|
isoechoic
|
|
A benign tumor composed of fat, vessels & smooth muscle is an _____.
|
angiomyolipoma (renal hamartoma)
|
|
Angiomyolipoma's are more common in ____.
|
females
|
|
Angiomyolipoma's are more common in the ____ kidney.
|
right
|
|
Angiomyolipoma's have variable echogenicity but are typically ____ lesions in the ____ ____.
|
hyperechoic, renal parenchyma
|
|
What is the sono appearance of an angiomyolipoma?
|
hyperechoic, variable size, round, well defined, low velocity bld flow
|
|
Presence of ____ in a renal lesion is typical of an angiomyolipoma.
|
fat
|
|
Angiomyolipoma's may ____ secondary to the vascular elements.
|
bleed
|
|
A mesoblastic nephroma is AKA ____ ____ ____.
|
fetal renal hamartoma
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A pediatric benign tumor composed of mesoderm tissue is a:
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mesoblastic nephroma
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The benign counterpart of a Wilm's tumor is a ____ ____.
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mesoblastic nephroma
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What is the most common solid renal mass in neonates?
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mesoblastic nephroma (fetal renal hamartoma)
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Mesoblastic nephromas are more common in ____.
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males
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Mesoblastic nephromas may appear as a ____ ____ mass causing ____.
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palpable flank, hypertension
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A solid renal mass w/ possible areas of cystic degeneration and varying echogenicity is the sono appearance of:
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mesoblastic nephroma
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What are the 4 types of malignant renal neoplasms?
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renal cell carcinoma, Wilm's tumor, transitional cell carcinoma, kidney metastasis
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Renal cell carcinoma is AKA ____.
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hypernephroma
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What makes up 90% of renal cell carcinoma?
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renal adenocarcinoma
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What are the symptoms of RCC?
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pain, hematuria, palpable mass, anemia, weight loss, fatigue
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RCC appears as a ____ mass w/ variable ____.
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solid, echogenicity
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What is commonly seen in RCC masses?
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calcifications
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The majority of RCC masses are ____.
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echogenic
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What else should be scanned when RCC is questioned?
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the IVC for tumor invasion
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RCC has increased ____ w/ high ____ & ____ flow.
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vascularity, systolic & diastolic (arterial)
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A Wilm's tumor is known as AKA ____.
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nephroblastoma
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A pediatric malignant mixed tumor composed of embryonal elements is a ____ ____.
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Wilm's tumor
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What is the 2nd most common solid tumor in children?
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Wilm's tumor
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A ____ ____ is the most common renal tumor in children 1-8 yrs old.
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wilm's tumor
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Wilm's tumors usually affect ____ & are usually ____.
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males, bilateral
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Wilm's tumors may also be associated w/ ____ ____ syndrome.
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Beckwith-Weidemann
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The main symptoms of a wilm's tumor are:
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palpable flank mass, hypertension, hematuria, & fever
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Wilm's tumors are generally ____ & ____.
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homogenous & echogenic
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What might Wilm's tumors include?
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may have hypoechoic or cystic areas of necrosis
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Wilm's tumors are usually ____ in size and can contain ____.
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large, calcifications
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It is possible to confuse wilm's tumors w/ a _____ due to the close relation to the adrenal gland.
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neuroblastoma
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Neuroblastoma's usually appear _____.
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heterogeneous
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A primary malignant epithelial tumor originating in urinary collecting system is:
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transitional cell carcinoma
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About ____% of all kidney tumors are TCC.
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5 - 10%
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T or F. TCC is not usually detected by US.
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TRUE
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TCC causes ____ ____ & ____.
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painless hematuria & hydronephrosis
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TCC appears as an ____/____ mass w/in the ____ ____.
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isoechoic/hypoechoic, collecting system
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Dilatation of the renal pelvis is called ____.
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pelvicalyectasis
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T or F. RCC may metastasis to the contralateral kidney.
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TRUE
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Lymphomatous involvement causes bilateral renal ____.
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enlargement
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With metastasis to the kidney, the kidneys may be diffusely ____ w/ increased ____ ____.
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hypoechoic, sound transmission
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Focal concentrations of calcium, uric acid, or crystine in the collecting system or renal parenchyma is known as:
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renal calculi
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Kidney stones affect ____% of the population.
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12%
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Renal calculi are more common in ____ & ____.
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men & caucasians
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What 3 things make up kidney stones?
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calcium, uric acid, crystine
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Renal calculi can cause ____ ____ & ____.
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acute pain & hematuria
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Renal calculi have strong ____ ____ posteriorly.
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acoustic shadowing
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Why are renal calculi hard to image in the ureter?
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size, bowel gas, depth in body, lack of fluid
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What would you do to detect calculi in the kidneys?
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use the highest frequency transducer & proper focal zone placement
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What can cause staghorn calculi?
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UTI, low fluid intake, high protein diet, high uric acid, abnormal calcium metabolism
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What do staghorn calculi cause?
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causes painful spasms, hematuria, flank pain
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T or F. With staghorn calculi, there is hydronephrosis in the kidney.
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TRUE
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What is ESWL?
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extracorporeal shock wave lithotripsy
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What is the most frequently used procedure for the treatment of kidney stones?
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ESWL
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What does ESWL do?
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breaks down stones into small particles so they can pass thru
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A procedure used to remove large stones that involves a surgeon cutting into the kidney is:
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percutaneous nephrolithotomy
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A procedure used for mid or low ureter stones using an instrument thru the urethra is:
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ureteroscopy
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Formation of aggregates of calcium in renal tubules (medullary pyramids) is ____ ____.
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medullary nephrocalcinosis
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Medullary nephrocalcinosis is usually asymptomatic but causes ____ ____ & ____.
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renal failure & hyperparathyroidism
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Increased echogenicity of the pyramids w/ normal cortical echogenicity is the sono appearance of ____ ____.
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medullary nephrocalcinosis
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What is medullary nephrocalcinosis associated with?
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cushing syndrome, medullary sponge kidney, hyperparathyroidism, distal tubular acidosis, sarcoidosis
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Diffuse or focal calcium deposition in the renal cortex is known as ____ ____.
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cortical nephrocalcinosis
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Cortical nephrocalcinosis causes focal or diffuse increase in ____ ____ & a ____ in size.
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cortical echogenicity, decrease
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Dilatation of the renal pelvis & calyces due to obstruction of outflow of urine is:
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hydronephrosis
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What are the types of causes for hydronephrosis?
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congenital, intrinsic, extrinsic
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Hydronephrosis may produce ____ ____.
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renal atrophy
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Dilatation of the ureter is known as ____.
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hydroureter
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There is an increased ____ w/ hydronephrosis.
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RI
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What are the 3 classifications of hydronephrosis?
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mild-grade1, moderate-grade2, severe-grade3
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Slight separation of the collecting system is consider grade ____ hydro.
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1
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A five-ring pattern of hydro is considered grade ____.
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2
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When the collecting system appears as a huge, anechoic cystic sac it is considered grade ___ hydro.
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3
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A non-obstructive kidney should have a doppler RI of less than ____.
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< .7
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A ____ ____ should be identified on the side of the non-obstructive kidney.
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uretal jet
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What are the congenital causes of hydro?
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urethral stricture, posterior urethral valve, bladder neck obstruction, ectopic ureterocele, retrocaval ureter
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Intrinsic causes of hydro include:
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calculus, stricture, tumor, ureterocele, clot, TB, pyelonephrosis
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What are some extrinsic causes of hydro?
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fibroids, pregnancy, lymphadenopathy, trauma, urethritis
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The presence of pus in the urinary collecting system is ____.
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pyonephrosis
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Pyonephrosis causes ____ & ____ ____.
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fever & flank pain
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Trauma to the kidneys causes ____ ____ & ____.
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decreased hematocrit & oliguria
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An acute infarction (first 24 hrs) has a ____ pattern on US.
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hypoechoic
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Over time a chronic infarction will cause the kidney to become ____ & ____.
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small & echogenic
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A collection of urine encapsulated by fibrous tissue resulting from leakage of urine from a tear in the ureter, renal pelvis or calices is:
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urinoma (pseudocyst)
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What are the different names for a urinoma?
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paranephric, pararenal, or uriniferous pseudocyst
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RAS (renal artery stenosis) causes ____ and causes the kidney to become ____.
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hypertension, smaller
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What are the doppler findings of a direct RAS?
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increased renal artery ratio, increased peak systolic velocity, spectral broadening, tradus parvus waveform
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An indirect RAS has a ____ diastolic systolic ratio and delayed ____ ____.
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decreased, acceleration time
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Renal artery occulusion causes absence of flow ____ to the occulusion.
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distal
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With a renal vein thrombosis there is an ____ in renal size in the acute phase & a ____ in size in the late/chronic phase.
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increase, decrease
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What are the doppler findings of a renal vein thrombosis?
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absence of flow in the renal vein w/ increased arterial resistance
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