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28 Cards in this Set

  • Front
  • Back
Uretropelvic Junction Obstruction (UPJ)
Common, 2:1 men
10-30% bilateral
L affected twice more
Marked-ballooning of the renal pelvis
Chronic-renal parenchymal atrophy
Uretropelvic Junction Obstruction (UPJ) (causes)
Obstructions usually functional
Intrinsic pressure
Excessive collagen
Stuck Valves
Luminal Stenosis
Congenital Megacalyces
Usually unilateral
Very large calyces
Normal renal function
Assoc. with megaureter
Absent papillary impressions
Congenital Megaureter
Functional ureteric obstruction-very large ureter
Distal ureter is aperistaltic
Prevalent in men, L side
8-50% bilateral
Dilation of distal 3rd w/ peristalsis in proximal 2/3
Aberrant Vessels
Unusually courses of vessels that obstruct the ureter.
Retrocaval Ureter
IVC develops from the subcardinal vein instead of the supracardinal
Ureter passes behind IVC
Men 20-40 yrs old
Acute Pyelonephritis
Acute kidney infection
85% from ascending route (bladder)
15% are hematogeneous seeding
Diagnosis made clincally
Renal enlargement, hypoechoic parenchyma, anechoic sinus
Renal Abscess (where can it come from?)
Bacteria spread from the kidney from:
bladder, hematogeneous routes, ruptured pyonephrosis, retroperitoneal infections, invasive procedures
Renal Abscess (sonographically)
Round, thick walled, hypoechoic, complex mass w/ good transmission
Internal mobile debris
CT is more accurate
Purulent material in the collecting system
Assoc. w/ renal obstruction
Bacteremia and septic shock-fatal
Young-UPJ, stones
Old-malignant ureteral obstruction
Emphysematous Pyelonephritis
Rare, 2:1 women
Life threatening bacterial infection of the renal parenchyma
Gas formation, renal ischemia
90% have diabetes
Diff. to see w/ bowel gas
Xanthogranulomatous Pyelonephritis
Chronic renal infection causing destruction of parenchyma and replacement of it by lipid laden macrophages
Macrophages calcify=staghorn calculus=obstruction
Middle aged
Papillary Necrosis (causes)
Ischemia leads to papillary death or necrosis. Caused by:
Analgesic Abuse
Sickle Cell Anemia
Urinary Tract Tuberculosis
Hematogeneous seeding of the kidney by myobacterium tuberculosis from the lung
Forms 5-10 years after pulmonary infection
Urinary Tract Tuberculosis (acute)
Thick bladder wall
UPJ obstruction by intrinsic pressure
Urinary Tract Tuberculosis (chronic)
Results in:
caviatation, calcification, mass lesion, abscess, fistula
Simple Cortical Cyst
Asymptomatic, idiopathic
May be from focal inflammation or second to occlusion
50% adults over 50
Round/oval, smooth walls, enhancement, common in cortex
Parapelvic Cyst
Renal sinus cyst, looks like a simple cyst
Pain, htn, obstruction
Cyst doesn't interfere w/ collecting system
Renal pelvis is dilated but the sinus isn't
Von-Hipple Lindau
Mult. body systems disease
Diffuse, can affect the kidneys w/ bilateral cysts and adenomas
30-50 yrs old
Risk of renal cancer
Tuberous Sclerosis
Genetically transmitted disease w/ mental retardation and seizures
If cysts, it can look like autosomal dominant polycystic disease
If cysts and angiomyolipomas, AML is found
Tuberous Sclerosis (assoc. renal lesions)
Renal cell carcinoma
Acquired Cystic Disease
Dialysis pts
Renal cysts may be from spontaneous bleeding and hemorrhage
Infantile Autosomal-Recessive Polycystic Disease
Bilateral enlarged echogenic kidneys, loss of distinction between corticomedullary region
Lung hypoplasia and renal insufficiency
Not compatible w/ life
Late stages: echogenic liver from hepatic fibrosis
Adult Autosomal-Dominant Polycystic Disease
Bilateral enlarged kidneys w/ large complex cysts from infection or hemorrhage.
Renal failure, pain, fever, uremia, hematuria, palpable mass
Cysts can spread to liver, spleen, testes, and pancreas
Multicystic Dysplastic Kidney
Most common palpable abdominal mass in newborns
Nonhereditary renal dysplasia
Uretral atresia, non functioning kidney, 30% UPJ
Multicystic Dysplastic Kidney (sonographically)
Infants/Children: enlarged kidney
Adults: small and calcified kidney
Loss of parenchyma, mult cysts of diff. sizes
Medullary Sponge Kidney
Rare, nonhereditary
Benign renal disease in children
Medullary Sponge Kidney (sonographically)
Tubular dilation
40-80% calcium stones
Large non-communicating cysts