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Flashcards in Ch 14 test urinary system Deck (49)
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1
Q

A congenital obstruction found in utero and in infants is called a(n):

a. Ureteropelvic junction (UPJ) obstruction
b. Ureterocele
c. Bladder diverticulum
d. Posterior urethral valves

A

A

A congenital obstruction of the ureteropelvic junction can be seen in utero and in infants.

2
Q

Parapelvic cysts are located in the:

a. Renal hilum
b. Renal cortex
c. Lower pole

A

A
A parapelvic cyst (renal sinus cyst) is found in the renal hilum but does not communicate with the renal collecting system.

3
Q

The most common solid renal mass found in childhood is:

a. Renal cell carcinoma
b. Angiomyolipoma
c. Wilms tumor
d. Von Hippel-Lindau tumor

A

C
The nephroblastoma or Wilms tumor is the most common solid renal mass of childhood, peaking at 2 years of age. Wilms tumor can reoccur

4
Q

The sonographic appearance of tuberous sclerosis may be difficult to differentiate from:

a. Medullary sponge kidney
b. Nephrocalcinosis
c. Hydronephrosis
d. Adult polycystic kidney disease

A

D

The sonographic appearance of tuberous sclerosis may be difficult to differentiate from adult polycystic kidney disease

5
Q

In cases of nephrocalcinosis, calcium deposits are usually located in the:

a. Cortex
b. Renal sinus
c. Medulla
d. Renal hilum

A

C medulla Pg 403

6
Q

Fusion of the lower pole of the kidneys is called a:

a. Cross-renal ectopia
b. Pelvic kidney
c. Supernumerary kidney
d. Horseshoe kidney

A

D
A horseshoe kidney typically demonstrates fusion of the lower poles. It is commonly associated with improper ascent and malrotation. Inferior poles lie more medial, with the isthmus crossing anterior to the aorta.

7
Q

The most echogenic portion of the kidney is(are) the:

a. Cortex
b. Sinus
c. Medullary pyramids
d. Parenchyma

A

B
The renal sinus is the most echogenic portion of the normal kidney. It includes the calyces, renal pelvis, renal vessels, fat, nerves, and lymphatic channels.

8
Q

A cystlike enlargement of the distal end of the ureter is called:

a. Ureterocele
b. Diverticulum
c. Urachal cyst
d. Cystitis

A

A
A ureterocele is a cystlike enlargement of the lower end of the ureter. It can be congenital or acquired and may cause obstruction or infection.

9
Q

Which one of the following describes the sonographic appearance of chronic pyelonephritis?

a. Echogenic cortex
b. Hypoechoic enlarged kidney
c. Inability to distinguish the cortex from the medullary regions
d. Echogenic foci in the medullary regions

A

C
In chronic renal disease, including chronic pyelonephritis, the kidneys appear diffusely enlarged with a loss of normal anatomy.

10
Q

A cortical bulge in the lateral border of the kidney is called a(n):

a. Junctional parenchymal defect
b. Dromedary hump
c. Extrarenal pelvis
d. Column of Bertin

A

B

A dromedary hump is a cortical bulge in the lateral border of the kidney and is more common in the left kidney.

11
Q

A dilated renal pelvis without ureteral dilation is observed in patients with:

a. Hydronephrosis
b. Posterior urethral valve obstruction
c. Ureteropelvic junction obstruction
d. Ureterocele

A

C

Dilation of the kidney or ureter or both occurs superior to the obstruction.

12
Q

Which one of the following clinical findings is the most likely reason for a renal artery duplex examination?

a. Hypertension
b. Oliguria
c. Hematuria
d. Severe flank pain

A

A Hypertension

13
Q

A posttransplant perinephric fluid collection can exhibit all of the following except a:

a. Ureterocele
b. Hematoma
c. Urinoma
d. Lymphocele

A

A

Perinephric fluid collections include hematoma, abscess, lymphocele, or urinoma.

14
Q

A renal sonogram is performed. The finding of hypoechoic areas adjacent to the renal sinus is most consistent with:

a. Bifid renal pelvis
b. Renal pyramid
c. Column of Bertin
d. Junctional parenchymal defect

A

B
The renal medulla consists of hypoechoic pyramids disbursed in uniform distribution and separated by bands of intervening parenchyma that extend toward the renal sinus.

15
Q

A baseline renal transplant sonographic examination is performed within _____ hours after surgery.

a. 4 to 8
b. 12 to 18
c. 24 to 36
d. 48 to 72

A

D
A baseline sonographic evaluation is performed as early as 48 hours after surgery to determine renal size, calyceal pattern, and extrarenal fluid collections.

16
Q

A common finding in people over 50 years of age is:

a. Renal calculi
b. Renal cysts
c. Multicystic disease
d. Hypernephroma

A

B

Approximately 50% of patients over the age of 50 years have a simple renal cyst.

17
Q

Dilation of the renal pelvis with a thinning of the renal cortex is characteristic of which one of the following?

a. Duplex collection system
b. Column of Bertin
c. Hydronephrosis
d. Extrarenal pelvis

A

C
Grade 4 hydronephrosis is characterized by prominent dilation of the collecting system, thinning of the renal parenchyma, and a lack of differentiation between the collecting system and the renal parenchyma.

18
Q

Renal vein thrombosis may be visualized in patients with:

a. Pyelonephritis
b. Renal calculi
c. Renal cell carcinoma
d. Angiomyolipoma

A

C
Renal cell carcinoma may demonstrate renal vein thrombosis or tumor extension into the renal vein and inferior vena cava (IVC).

19
Q

Ureteral jets are not visualized in patients with:

a. Renal cell carcinoma
b. Obstruction
c. Duplex collecting system
d. Acute focal bacterial nephritis

A

B
Complete obstruction demonstrates an absence of the respective ureteral jet; partial obstruction may show a low-level jet on the side of the obstruction or an asymmetry of the ureteral jets or both.

20
Q

The process of disposing metabolic wastes is called:

a. Urea
b. Excretion
c. Deamination
d. Urination

A

B
Metabolic wastes must be excreted quickly to prevent toxic concentrations of homeostasis (maintenance of normal body physiologic stability).

21
Q

Which one of the following is present in urine whenever extensive damage or destruction of the functioning erythrocytes occurs?

a. Protein
b. Creatinine
c. Hemoglobin
d. Albumin

A

C
Hemoglobin is present in urine whenever extensive damage or destruction of the functioning erythrocytes occurs. This condition injures the kidney and can cause acute renal failure.

22
Q

The kidneys are located in the:

a. Peritoneal cavity
b. Retroperitoneal cavity
c. Perirenal cavity
d. Perirenal space

A

B

The urinary system is located in the retroperitoneal cavity.

23
Q

The left kidney is in contact with the:

a. Spleen, pancreas, and gallbladder
b. Spleen, gallbladder, and duodenum
c. Pancreas, colon, and porta hepatis
d. Spleen, pancreas, colon, and jejunum

A

D
The left adrenal gland, spleen, stomach, and pancreas lie anterior to the left kidney. The diaphragm, psoas muscle, and quadratus lumborum muscle lie posterior to the left kidney.

24
Q

The right kidney is in contact with the:

a. Spleen, colon, and adrenal gland
b. Liver, colon, and adrenal gland
c. Liver, pancreas, and gallbladder
d. Liver, gallbladder, and splenic flexure

A

B
The right adrenal gland and second part of the duodenum lie anterior to the right kidney. The diaphragm, psoas muscle, and quadratus lumborum muscle lie posterior to the right kidney.

25
Q

Outside the renal capsule is the:

a. Perinephric fat
b. Paranephric space
c. Renal fascia
d. Renal medulla

A

A

Outside of the fibrous capsule is a covering of perinephric fat.

26
Q

A triangular-shaped lesion on the peripheral border of the kidney most likely represents a(n):

a. Renal tumor
b. Artifact from rib
c. IVC compression
d. Junctional parenchymal defect

A

D

A junctional parenchymal defect is a triangular-shaped echogenic area in the upper pole of the renal parenchyma.

27
Q

The left renal vein courses:

a. Posterior to the IVC
b. Anterior to the IVC
c. Anterior to the aorta
d. Anterior to the superior mesenteric artery

A

C
The left renal vein flows from the renal sinus, anterior to the aorta, and posterior to the superior mesenteric artery to join the IVC.

28
Q

The vessel seen posterior to the IVC on the sagittal scan represents the:

a. Right adrenal artery
b. Right renal artery
c. Left renal artery
d. Left renal vein

A

B

The right renal artery is seen as a circular structure coursing posterior to the IVC in the sagittal plane.

29
Q

Renal sonography is not helpful in evaluating:

a. Obstructive uropathy
b. Cyst formation
c. Renal function
d. Angiomyolipoma

A

C

Sonography is not helpful in evaluating organ function.

30
Q

A potential space located between the liver edge and right kidney is:

a. Morison’s pouch
b. Douglas’ pouch
c. Cul-de-sac
d. Winhauer space

A

A
Morison’s pouch is located in the right posterior subhepatic space anterior to the right kidney and posterior to the right lobe of the liver.

31
Q

Renal cell carcinoma commonly invades the IVC via the:

a. Renal vein
b. Renal artery
c. Portal vein
d. Splenic vein

A

A

Renal cell carcinoma may invade the renal vein and IVC with a tumor or thrombosis.

32
Q

Pyonephrosis refers to the presence of:

a. Blood in a dilated collecting system
b. Pus in a dilated collected system
c. Urine in a dilated collecting system
d. A perinephric abscess

A

B

Pyonephrosis occurs when pus is found in the obstructed renal system.

33
Q

An extremely large echogenic renal sinus that appears to engulf the entire renal parenchymal outline suggests:

a. Hydronephrosis
b. Lipomatosis
c. Hypernephroma
d. Nephrocalcinosis

A

B
In sinus lipomatosis, the abundant fibrous tissue may cause enlargement of the sinus region with an increase in echogenicity.

34
Q

Dilation of the renal pelvis may be caused by all of the following except:

a. Oliguria
b. Reflux
c. Pregnancy
d. Distended urinary bladder

A

A
Dilation of the renal pelvis may be caused by polyuria, distended bladder, reflux, pregnancy, and atrophy after obstruction.

35
Q

A benign vascular fatty tumor of the kidney is called:

a. Angiomyolipoma
b. Hypernephroma
c. Neuroblastoma
d. Lymphoma

A

A

An angiomyolipoma is the most common benign renal tumor. It is composed of fat, muscle, and blood vessels.

36
Q

All of the following statements about the kidneys are true except:

a. The kidneys are intraperitoneal in location.
b. The average adult kidneys measure approximately 9 to 12 cm in length.
c. The kidneys may move with respiration.
d. The anteroposterior thickness of the normal adult kidneys is approximately 4 to 5 cm.

A

A

The kidneys are located in the retroperitoneal cavity.

37
Q

Hydronephrosis may be best demonstrated sonographically by which one of the following patterns?

a. Distorted shape of the kidney outline
b. Multiple cystic masses throughout the renal parenchyma
c. Fluid-filled pelvocaliceal collecting system
d. Hyperechoic pelvocaliceal collecting system

A

C

Hydronephrosis demonstrates a fluid-filled renal collecting system.

38
Q

Autosomal dominant polycystic kidney disease may be characterized by all of the following statements except:

a. The disease is latent until the fourth or fifth decade of life.
b. The severity of the disease varies, depending on the genotype.
c. The disease may be associated with cysts in the liver, pancreas, and spleen.
d. The involved kidneys are small and extremely echogenic.

A

D

The kidneys become enlarged with multiple cysts.

39
Q

Which one of the following statements about the kidneys is false?

a. The kidneys are rigidly fixed on the abdominal wall.
b. The kidneys consist of an internal medullary and external cortical substance.
c. The kidneys rest on the psoas and quadratus lumborum muscles.
d. Renal pyramids are found within the medullary region.

A

A

The kidneys are located in the retroperitoneum, not on the abdominal wall.

40
Q

The most common location of renal ectopia is in the:

a. Pelvis
b. Intrathoracic
c. Epigastric region
d. Retroperitoneum

A

A
The pelvic kidney, also called the sacral kidney, is the most common renal ectopia and should not be misdiagnosed as a pelvic tumor.

41
Q

Which one of the following disorders does not produce a complex sonographic pattern?

a. Infected cyst
b. Hemorrhagic cyst
c. Hematomas
d. Congenital simple cyst

A

D
The sonographic criteria of a simple cyst include anechoic properties (without internal echoes), thin smooth walls, and posterior acoustic enhancement.

42
Q

The normal bladder wall should be smooth and thin and measure ____________ millimeters (mm).

a. 2 to 4
b. 3 to 6
c. 5 to 7
d. 5 to 10

A

B

Depending on the level of bladder distention, the normal bladder wall may measure 3 to 6 mm.

43
Q

Which one of the following describes a bladder diverticulum?

a. Cystic enlargement of the bladder orifice
b. Echogenic mass of the bladder wall
c. Herniation of the bladder wall
d. Focal thickening of the bladder wall

A

C

A bladder diverticulum is defined as a herniation of the bladder wall.

44
Q

In the adult, a postvoid residual of less than _____ cc of urine is considered normal.

a. 35
b. 50
c. 20
d. 25

A

C

A postvoid residual of less than 20 cc of urine is considered normal in the adult.

45
Q

A central cystic region that extends beyond the medial renal border is called:

a. Hydronephrosis
b. Parapelvic cyst
c. Peripelvic cyst
d. Extrarenal pelvis

A

D
An extrarenal pelvis appears as a central cystic region that may partially or entirely extend beyond the confines of the bulk of the renal sinus.

46
Q

The most common neonatal renal mass and abd mass is :
a auto dominant polycystic disease
b. Neuroblastoma
c. multi-cystic dysplasia kidney
d. autosomal recessive polycystic kidney disease

A

C multi-cystic dyplasia kidney

47
Q

Most common childhood/infant disease?

A

Neuroblastoma

48
Q

Most common neonatal adrenal mass?

A

Adrenal hemorrage

49
Q

Most common child hood tumor

A

Wilms Tumor