Urinary System - Part 7

Question 1

What is the cause of a renal abscess?

Answer 1

Infection

Question 2

What are the clinical findings of a renal abscess? (3)

Answer 2

1. Flank pain
2. Fever or chills
3. Leukocytosis

Question 3

What is the US appearance of a renal abscess? (3)

Answer 3

1. Hypo echoic or complex mass
2. Thick irregular wall margins
3. Shadowing associated with gas
   formation

Question 4

What are 4 differential diagnosis for renal abscess?

Answer 4

1. Neoplasm
2. Focal pyelonephritis 3. Complicated cyst
3. Resolving hematoma

Question 5

ATN

Answer 5

Acute tubular necrosis

Question 6

What is ATN caused by? (5)

Answer 6

1. Toxic drug exposure 2. Hypotension
2. Trauma
3. Surgery of the heart or aorta
4. Sepsis

Question 7

What are the clinical findings for ATN? (3)

Answer 7

1. Asymptomatic
2. Renal failure
3. Oliguria
   - small amounts of urine

Question 8

What is the US appearance for ATN? (3)

Answer 8

1. Bilateral enlarged kidneys
2. Hyper echoic renal pyramids
3. Normal renal cortex

Question 9

What are 4 differential diagnosis ATN?

Answer 9

1. Renal sinus lipomatosis
2. Chronic pyelonephritis
3. Renal failure
4. Nephrocalcinosis

Question 10

What is the cause of chronic renal failure? (5)

Answer 10

1. Glomerulonephritis
2. Hypertension
3. Vascular disease
4. Diabetes mellitus
5. Chronic hydronephrosis

Question 11

What are the clinical findings for chronic renal failure? (7)

Answer 11

1. Elevated BUN and creatinine
2. Proteinuria
3. Polyuria
4. Headaches
5. Fatigue
6. Weakness
7. Anemia

Question 12

What is the US appearance for chronic renal failure? (4)

Answer 12

1. Renal atrophy
2. Hyper echoic parenchyma
3. Thin renal cortex
4. Difficult to distinguish the kidney
   from surrounding structures

Question 13

What are 2 differential diagnosis for chronic renal failure?

Answer 13

1. Renal sinus lipomatosis

2. Hypoplastic kidney

Question 14

What causes glomerulonephritis? (6)

Answer 14

1. Immune diseases 2. Infection
2. Strep throat
3. Lupus
4. Chronic hepatitis C
5. Vasculitis

Question 15

What are the clinical findings of glomerulonephritis? (7)

Answer 15

1. Asymptomatic
2. Proteinuria
3. Oliguria
4. Hypertension
5. Hematuria
6. Fatigue
7. Edema

Question 16

What is the US appearance of glomerulonephritis? (2)

Answer 16

1. Hyper echoic renal cortex

2. Enlarged kidney(s)

Question 17

What is a differential diagnosis for glomerulonephritis?

Answer 17

Renal sinus lipomatosis

Question 18

What causes pyelonephritis?

Answer 18

Bacteria ascends from the bladder

Question 19

What are clinical findings for pyelonephritis? (5)

Answer 19

1. Flank pain
2. Fever or chills
3. Dysuria
4. Pyuria
5. Leukocytosis

Question 20

What is the US appearance for pyelonephritis? (3)

Answer 20

1. Generalized or focal swelling of the kidney(s)
2. Well-defined renal pyramids
3. Loss of corticomedullary
   definition

Question 21

What are 2 differential diagnosis for pyelonephritis?

Answer 21

1. Renal abscess

2. Neoplasm

Question 22

What causes hydronephrosis?

Answer 22

Obstruction of the urinary tract

Question 23

What are the clinical findings of hydronephrosis? (4)

Answer 23

1. Flank pain
2. Hematuria
3. Fever
4. Leukocytosis

Question 24

What is grade 1 hydronephrosis?

Answer 24

Small fluid-filled separation of the renal pelvis

Question 25

What is grade 2 hydronephrosis?

Answer 25

Dilation of some but not all calyces

Question 26

What is grade 3 hydronephrosis? (2)

Answer 26

1. Marked dilation of renal pelvis and all calyces | 2. Echogenic line separating the collecting system from the parenchyma can be demonstrated

Question 27

What is grade 4 hydronephrosis? (4)

Answer 27

1. Prominent dilatation of collecting system 2. Cortical thinning 3. Unable to separate collecting system and renal parenchyma 4. Regardless of the grade evaluate bladder for ureteral jets using colour Doppler

Question 28

What are 5 differential diagnosis for hydronephrosis?

Answer 28

1. Extrarenal pelvis 2. Parapelvic cyst 3. Polycystic disease 4. Reflux 5. Over-distended urinary bladder

Question 29

What are the causes of hydroureter?

Answer 29

Obstruction of the UPJ, UVJ, or region where the ureter crosses the pelvic brim

Question 30

What are the clinical findings of hydroureter? (2)

Answer 30

1. Asymptomatic | 2. Flank pain

Question 31

What is the US appearance of hydroureter? (2)

Answer 31

1. Anechoic tubular structure connecting the renal pelvis to the urinary bladder 2. No internal blood flow

Question 32

What is a differential diagnosis of hydroureter?

Answer 32

Fluid filled bowel

Question 33

Nephrolithiasis

Answer 33

Kidney stones

Question 34

What is a cause of nephrolithiasis?

Answer 34

Urinary stasis

Question 35

What are the clinical findings of nephrolithiasis? (4)

Answer 35

1. Asymptomatic 2. Renal colic 3. Flank pain 4. Hematuria

Question 36

What is the US appearance of nephrolithiasis? (4)

Answer 36

1. Hyper echoic focus within the kidney 2. Occurs in the corticomedullary junction 3. Posterior acoustic shadowing 4. Colour Doppler twinkle artifact

Question 37

What are 2 differential diagnosis of nephrolithiasis?

Answer 37

1. Calcified vessel | 2. Angiomyolipoma