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57 Cards in this Set
- Front
- Back
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Bun (blood urea nitrogen) |
lab test will rise from acute or chronic disease also in other. not renal disease |
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Creatinine (more sensitive) |
lab test measures kidneys ability to get rid of waste increase in renal disease and function. |
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Urinalysis |
comprises of a battery of chemical and microscopic tests that help to screen for UTI, renal disease, and diseases of other organs that result in abnormal metabolites (break-down products) appearing in the urine. |
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Hematuria |
blood in urine |
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Protein in urine |
= kidney damage |
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Simple Renal Cysts criteria |
-Incidence increase with age. -usually asymptomatic-unless large -location usually cortical, most common - |
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Hemorrhagic renal cyst |
sono-appear: internal echoes/ fluid filled level -may be complex from clot formation - increase risk in Polycystic disease patients - May calcify |
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Infected cyst |
Sono-appear: internal echoes, thick walled, complex renal mass, may calcify -Pt usually symptomatic -pain - increased WBC
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Parapelvis cyst |
Aka: renal sinus cyst, pelvic cyst -usually seen in pt's around 50-60 yrs or older. -almost always asymptomatic -rare instances of obstruction of the collecting system -rarely they can lead to hypertension, hematuria, hydronephrosis, or may get infected.
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Parapelvis cyst Sono-appear: |
-multi echo-free areas in the region of the renal sinus. -differ from hyrdo may be difficult -one of the most common causes of a false pos diagnosis of hydro on U/S. |
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Hydronephrosis appearance |
established w/o question when dilated calyces are seen to communicate w/ a dilated renal pelvis. |
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Von Hippel-Lindau |
"Renal cysts associated w/ mult renal neoplasms" -a rare, genetic multi-system disorder characterized by the abnormal growth of tumors in certain parts of the body. -pt w/ VHL at higher risk than normal for certain types of Ca, specially kidney CA. -may result in blindness and/or permanent brain damage. -Clear Cell Carcinoma- brain tumors or kidney Ca complications that usually contribute to death. |
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Von Hippel-Lindau Sono-Appear: |
-multi cyst or masses -masses may develop w/in cyst -look in Pancreas |
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Tuberous sclerosis |
"Renal cysts associated w/ mult renal neoplasms" - rare genetic, NEUROLOGICAL disorder primarily characterized by seizures, mental retardation, and skin and eye lesions. -renal prob's such as cysts & angiomyolipomas occur in an est. 40-80% of pt w/ TSC. -usually between ages 20-30 -Cysts are usually small, in limited #'s, and cause no serious prob's. -Approx. 2% of pt w/ TSC develop large #'s of cysts in a pattern similiar to polycystic during childhood, kid function comprimised, and kid failure occur. - rare- cysts may bleed, leading to blood loss and anemia. |
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Angiomyolipomas |
BENIGN growths consisting of fatty tissue and muscle cells. -most common kid lesion in TSC - usually found in both kids (w/ TSC) -usually asymptomatic, unless large -if large, may cause pain or kid failure. bleeding can cause pain and weakness. -found in 1-300 pt W/OUT TSC |
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Angiomyolipomas Sono Appear: |
-multiple cysts -multi small anechoic and hyperechoic lesions bilaterally Multiple: -rare, no true capsule, commonly bleed -tumor composed of fat smooth muscle, aggregates of thick wall blood vessels -appears highly echogenic due to high fat content -less echogenic areas due to hemorrhage, necrosis |
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Angiomyolipomas: associated w/ TSC |
-20% -occurs in 80% of pt w/ TSC -may be only evidence of TSC -average of teens - equal in males/females -commonly large -usually bilateral -usually multiple |
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Polycystic kidney disease (PKD) |
-genetic disorder -characterized by the growth of numerous cysts in kids. -cysts are fluid filled -cysts can slowly replace much of the mass of the kid, reducing function, and kid failure |
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Types of PKD: |
-Autosomal dominant PKD (ADPKD) --Adult PKD (APKD) -Autosomal recessive PKD --Infantile PKD -Acquired cystic kid diseases (ACKD) -Acquired cystic disease of Dialysis
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Autosomal Dominant PKD (ADPKD) OR Adult PKD (APKD) |
-about 90% of PKD cases. -typical in 30-40 yr olds, but can occur in childhood. -can live for decades w/out symptoms, reasoning for label "Adult PKD" -equal in M/F, some studies more often in females. -equal in races, some studies more often in whites than blacks. HIGH BLOOD PRESSURE EARLY SIGN
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Autosomal Recessive PKD (ARPKD) |
-symptoms start immediately in babies. -Infantile PKD -Autosomal Recessive Diseases- inherited from both parents who are unknowingly genetic carriers. Autosomes- non-sex chromosomes 1..22, both males and females normally have pairs of each -relatively rare, because it involves rec'ing a bad gene from both parents. |
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Acquired cystic Kidney disease (ACKD) |
-non-genetic form -occurs in people on dialysis -persons w/ renal failure who are on long term dialysis may develop cystic changes in the kids. -Sono: cysts may be numerous, but never as large as w/ DPKD, & the kids are still gen. small, because most disease leading to renal failure produce small, shrunken kids w/ end-stage renal disease. |
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Infantile Polycystic Kidney Disease (IPKD) |
Autosomal Recessive Diseases- inherited from both parents who are unknowingly genetic carriers. Autosomes- non-sex chromosomes 1..22, both males and females normally have pairs of each |
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Autosomal Dominant PKD (ADPKD) OR Adult PKD (APKD) |
- usally bilateral -associated w/ liver, pancreatic and splenic cyst - associated w/ Berry's aneurysms - increased renal calculi and infection - |
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Autosomal Dominant PKD (ADPKD) OR Adult PKD (APKD) Sono: |
-Enlarged kids w/ numerous variable-sized cyst. - cysts can hemorrhage or calcify |
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Autosomal Recessive PKD (ARPKD) or Infantile PKD (IPKD) |
-seen in utero - the kids are affected BILATERALLY, so in utero, there is typically OLIGOHYDRAMNIOS or deficiency of amniotic fluid because of poor renal function and failer to form significant amounts of fetal urine. -most significant result from Oligohydramnios is pulmonary hypoplasia or incomplete development of lungs. so the newborns do not have sufficient lung capacity to survive. |
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OLIGOHYDRAMNIOS |
is a condition in pregnancy characterized by a deficiency of amniotic fluid. - most significant result: pulmonary hypoplasia or incomplete development of lungs. So the newborn do not have sufficient lung capacity to survive. |
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Multicystic Dysplastic Kidney (MCDK) |
-most common palpable mass in neonates. - NOT HEREDITARY. - condition is usually unilateral -other kid may be enlarged |
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Multicystic Dysplastic Kidney (MCDK) Sono appearance: |
-cyst of varying size - absence of renal parenchyma - U/s over palpable mass reveals mult. noncommunicating cyts that occupy the entire renal fossa w/ no evidence of RENAL PARENCHYMA. |
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Medullary Cystic disease |
-disorder involving the formation of cysts in the medulla -inheredited in most cases -causes an inability to concentrate the urine, which results in excessive fluid loss followed by sodium loss. |
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Medullary Sponge disease |
-usually bilateral - Sono- pyramids appear echogenic due to microscopic cyst. Shows a hyperechoic medulla associated w/ echogenic foci, sometimes casting shadows. - Medullary Nephrocalcinosis
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Medullary Nephrocalcinosis |
a condition realted to Medullary Sponge disease which causes deposition of calcium salts in the renal parenchyma |
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Solid Renal Masses |
- benign -Angiomyolipoma- Renal Hamartoma- benign tumor composed of fat, blood vessels and smooth muscle tissue. - solitary, small cortical lesions - increased in R Kid -increased in females 40-60 |
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Solid Renal Masses Sono appearance: |
more echogenic than renal sinus or mixed hyperechoic lesion. - may see low velocity blood flow - can be large |
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Adenoma: |
MOST COMMON CORTICAL RENAL MASS -benign counterpart of Renal Cell CA -males 3:1 - > 30 years of age - increase w/ smoking, long term dialysis -asymptomatic or painless hematuria - incidentally findings -Sono- well-defined, isoechoic or hypoechoic mass, commonly in the cortex close to the renal capsule. - may have calcifications -usually 3 cm or less (over 3 SHOULD BE CONSIDERED MALIGNANT) |
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Oncocytoma |
type of solid renal mass -rare type of adenoma. ** presence of a stellate scar composed of fibrous tissue which is often detectable on ct, mri, U/s. -more in males -6th & 7th decades |
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Mesoblastic nephroma |
MOST COMMON NEONATAL SOLID RENAL TUMOR. -benign w/ malignant potential -cannot be distinguished from a congenital Wilm's tumor -presents as a abd mass, more commonly in males the first year of life, mean age 3 months
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Renal Cell Carcinoma (RCC) |
-most common rnal cA -usuallu unilateral -males more than feamles -6th & 7th generations -pain, hematuria, palpable mass, weight loss, hypertension. Mets sites: liver, opp kid, adrenal and IVC variable: soild to multiocular -most are echogenic -calcififications are common renal vein or IVC thrombus hypervascular w/ high systolic and diastolic flow |
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Transitional Cell Carcinoma |
-tumor that rises from the uroepithelium anywhere in the renal collecting system. -accounts for 5-10% of all renal neoplasms. -most common in bladder. -kid found in pelvis -painless hematuria, weight loss, flank pain sono: isoechoic or hypoechoic mass w/in collecting sysytem with dilation of the renal pelvis. |
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Renal Lymphoma |
At the time of autopsy in patients who have died from lymphoma, the kids are found to be invloved 1/3-1/2 the cases. -may present mult bilateral, intrarenal masses or as a solitary intrarenal mass (difficult to differentiate. - |
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Wilm's Tumor (Nephroblastoma) |
-most common tumor IN CHILDREN 1-8 YRS. -childhood equivalent to RCC -usually unilateral -fever, hematuria, palpable mass -sono: homogeneous and echogenic -may have areas of necrosis that will be systic -large -calcifications -may extend into preirenal area, renal vein, ivc. -mets: liver, lung, nodes, brain, and bone -due to close relation to adrenal gland may be confused w/ Neuroblastoma |
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Mets to kidneys |
from: lung, breast, contralateral kid. sono: vaiable from hypo to hyperechoic -may be multiple |
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Acute Pyelonephritis |
inflammation of the renal parenchyma - usually secondary to lower UTI -females more than males -15-30 yrs -unilateral or bilateral -flank pain, fever -labs: increase WBC, bacteremia, micro hematuria -sono: normal or enlarged kids, compression of renal sinus. |
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Emphysematous Pyelonephritis- |
life threatening infection, pus and gas formation in tissue or collecting system. -females to males, avg 54 yrs, - fever, flank pain, lethargy, confusion, dehydration, acidosis -labs: urine & serum bacteria cultures -Sono: gas w/in parenchyma and/or collecting system/ comet tail reverb -CT test of choice |
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Chronic Pyelonephritis- |
interstitial nephritis resulting from ongoing or recurring UTI's -clinical- asymptomatic/renal failure Sono: decreased renal size/ focal areas of coritical thinning and increased echogenicity |
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Acute Tubular Necrosis (ATN) |
caused by ischemia of the kids (lack of oxygen), or by exposure to materials that are poisonous to kidneys -most common: acute allergic reaction to meds -usually reversible -Sono: mostly normal (89%) or increased echogenicity (11%) -RI greater than .7 |
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Glomerulonephritis |
-caused by prob's w/ the immune system, not always known -blood in urine, dark, rust colored urine, foamy urine, fever -sono: increase in cortical echoes |
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Candidiasis |
system fungal infection in immunocompromised pt -sono: mult focal abscesses - |
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Pyonephrosis |
pus in obstructive collecting system -secondary to obstruction of the ureter -sono: hydro, low level mobile echoes within dilated calyces |
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Schistosomiasis |
parasitic infection of schistosome organism, affect 8% of world pop, Africa, Egypt, Puerto Rico, Nigeri, infected water -urinary freq., urgency, flank pain -sono: norm kids, bladder wall thickness, filling defect and irregularities |
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Urinary Tuberculosis |
infestation to the kids of tuberculosis from extraurinary source, usually lung. -males less than 50 years -asymp, frequency -labs- gross hematuria Sono: ACUTE: usually unilateral, enlarged kid, mult focal lesions of varying echogen. CHRONIC: decrased renal size, eventually shrunken and calcified |
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Abscesses |
focal collection of inflammatort & necrotic debris -usually a complication -lab- hematuria, bacteremia, pyuria Sono: |
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AIDS |
Sono: increased cortical echoes, normal or enlarged kidneys |
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Acute Interstitial nephritis |
interstitium is the tissue that surrounds and imbeds the glomeruli (filtering screens) and tubules (tubes that channel urine) |
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ACUTE RENAL FAILURE |
Prerenal acute RF- dimished renal blood flow (60-70% of cases) MOST COMMON Intrinsic acute RF- damage to the renal parenchyma (25-40% of cases) (acute tubular necrosis, MOST COMMON) Post renal acute RF- urinary tract obstruction (5-10% cases) |
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Pre-renal Causes |
-loss of perfusion caused by renal vascular thrombosis, renal artery stenosis, sepsis, heart failure. |
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intrarenal causes: |
chronic infections such as glomerulonephritis, chronic pyelonephritis -Aids -acute tubular necrosis and exposure to toxins |
