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Urogenital Tract
Martin's Notes
| Question | Answer |
|---|---|
| Metanephros | Term for permanent kidney |
| ureteric bud | The _______________ gives rise to the ureter, renal pelvis, calyces, and collecting tubules. |
| Metanephric diverticulum or ureteric bud, Metanephric mesoderm | Permanent kidneys develop from two different sources: |
| 11 | Kidneys complete migration occurs by the ____ wk of gestation. |
| 2-4 | 25% of adult kidneys contain _____ renal arteries. |
| 12-13 | 99% of kidneys are visible by _____ wk |
| 1-2 | Normal ureteral size: ____ mm |
| 12-13 | Bladder visible transvaginally by ____ wk |
| Pyelectasis | Dilation of only the renal pelvis |
| 4, 5 | Dilation of the renal pelvis is considered abnormal if equal to or greater than ____ or ____ mm in 2nd trimester. |
| 7-10 | Dilation of the renal pelvis is considered abnormal if equal to or greater than ______ mm in 3rd trimester. |
| Hydroureters | Abnormal ureters |
| Vertebral Anomalies | V in VATER |
| Anal Atresia | A in VATER |
| Trachoesophageal fistula | T in VATER |
| Radial defects & renal anomalies | R in VATER |
| 30, 3 | If renal abnormality exists with additional malformations, the increased risk for chromosomal abnormalities is times ____ for multiple and ____ for isolated. |
| 1:4000 | Bilateral Renal Agenesis (BRA) occurs in _____ births. |
| 2.5:1 | BRA has a M to F ratio of ______ |
| Polyhydramnios (correct would be oligo) | Which is NOT associated with BRA? Pulmonary hypoplasia, polyhydramnios, facial abnormalities, limb deformities? |
| Lying-down adrenal | This appearance of the adrenal glands is seen in BRA. |
| 1:1000 | Unilateral Renal Agenesis occurs in ______ births. |
| Unilateral Renal Agenesis | Sono findings of a normal AFV, normal bladder, and compensatory hypertrophy occur in which congenital malformation? |
| Unilateral Renal Agenesis | This congenital malformation may be associated with SUA, genital, cardiac, skeletal, and GI abnormalities. |
| Bilateral Renal Agenesis | This congenital malformation displays severe oligo, facial anomalies, and absent renal arteries sonographically. |
| Renal Ectopia | Pelvic kidney |
| Crossed Renal Ectopia | Enlarged, bilobed kidney |
| Horseshoe kidney | Most common fusion anomaly of the kidney |
| 1:400-500 | Horseshoe kidney occurs in ________ births. |
| Horseshoe kidney | This congenital malformation is associated with urogenital & CNS anomalies, Turner's, and T18 |
| 2 | MCDK: Potter Type ____ |
| Multicystic Renal Dysplasia | MCDK aka Potter Type 2 aka ________________ |
| MCDK | Most common form of renal cystic disease in childhood |
| MCDK | ONE of the most common abdominal masses in the neonate |
| 13-26 | Unilateral MCDK is associated with contralateral renal abnormalities in _________% |
| 19-24 | Bilateral MCDK has a lethal rate of ________% |
| Bilateral | US findings of MCDK: severe oligo if unilateral or bilateral? |
| 1 | ARPKD aka Potter Type ____ |
| liver | ARPKD involves both the kidneys and the _______ |
| Perinatal, Juvenile | Two types of ARPKD are ________ and _________ |
| Pulmonary hypoplasia | Perinatal ARPKD results in early death due to what? |
| 1-5 | Juvenile ARPKD appears @ _______ yrs of age |
| Numerous tiny cysts | Sono appearance of ARPKD has increased renal echogenicity due to what? |
| Oligo | ARPKD: Polyhydramnios or Oligo? |
| Infantile | ARPKD aka Potter Type 1 aka _________ |
| 3 | ADPKD aka Potter Type ___ |
| Adult | ADPKD aka Potter Type 3 aka _________ |
| ADPKD | Most common hereditary renal cystic disease |
| ADPKD | This renal cystic disease has a sonographically "normal" kidney appearance. |
| Family history | What is critical in the diagnosis of ADPKD? |
| Meckel-Gruber Syndrome | Lethal autosomal recessive disorder usually detected by sonography at 11-14 weeks. |
| Cystic dysplastic kidneys, Occipital encephalocele, Polydactyly | Meckel-Gruber syndrome classic triad? |
| 13, 18 | Meckel-Gruber associated with Trisomy ____ and Trisomy ____ |
| Mesoblastic nephroma | Most common renal tumor in a newborn |
| Leiomyomatous hamartoma, hamartoma | Mesoblastic nephroma is also known as "_________ _________" or "fetal renal _________" |
| Benign | Mesoblastic nephroma is benign or malignant? |
| Pyramid | Adrenals are ______ shaped early |
| hemorrhage | Abnormalities of the adrenals include _______, cyst, hypertrophy, and tumor (neuroblastoma). |
| Adrenal Neuroblastoma | Most common abdominal malignancy in neonates |
| Hydronephrosis | Dilation of renal pelvis and calyces |
| Hydronephrosis | This occurs in response to a blockage of urine at some junction in the urinary system |
| aneuploidy & postnatal uropathy | Detection of fetal pyelectasis is important in consideration of __________ & __________ |
| 4 or 5 | Renal pelvis diameter (RPD) is considered dilated when =/> ______ mm in 2nd trimester |
| 7-10 | Renal pelvis diameter (RPD) is considered dilated when ______ mm in 3rd trimester |
| Grade 0 | Which grade of Hydronephrosis? Intact central renal complex |
| Grade 1 | Which grade of Hydronephrosis? Only dilated renal pelvis; there is some fluid in the renal pelvis. |
| Grade 2 | Which grade of Hydronephrosis? Dilated renal pelvis and a few calices are visible. |
| Grade 3 | Which grade of Hydronephrosis? All calices are dilated. |
| Grade 4 | Which grade of Hydronephrosis? Further dilation of renal pelvis and calices, with thin renal parenchyma. |
| Ureteropelvic Junction Obstruction (UPJ) | Results from an obstruction at the junction of the renal pelvis and the ureter |
| Ureteropelvic Junction Obstruction (UPJ) | Most common location for renal obstruction |
| Ureteropelvic Junction Obstruction (UPJ) | Most common cause of fetal hydro |
| Ureteropelvic Junction Obstruction (UPJ) | More common in males and often unilateral |
| Ureteropelvic Junction Obstruction (UPJ) | Most cases of ________ are FUNCTIONAL (caused by muscular abnormality) |
| adhesions | Other causes of UPJ are abnormal bends/kinks in ureter, abnormal valves in the ureter, and __________. |
| oligohydramnios | If UPJ or UVJ are bilateral, possible ________ results |
| Vesicoureteral Junction Obstruction (UVJ) | Results from an obstruction of ureter at level of bladder |
| Vesicoureteral Junction Obstruction (UVJ) | This condition results from duplication of ureters, UVJ stenosis, or congenital megaloureter. |
| Vesicoureteral Junction Obstruction (UVJ) | Sonographic findings of this can include a tortuous ureter and if unilateral, normal fluid and bladder. |
| Posterior Uretheral Valves (PUV) | Congenital folds of the urethra act as valves and obstruct urinary outflow |
| Posterior Uretheral Valves (PUV) | Results in hydronephrosis, hydroureters, or dilation of the bladder and prox urethra. |
| Posterior Uretheral Valves (PUV) | This occurs in Males ONLY |
| Posterior Uretheral Valves (PUV) | Keyhole appearance is associated with: |
| Keyhold appearance | Dilated bladder & proximal urethra in PUV has this appearance |
| Urethral Atresia | Most severe form of obstructive uropathy |
| Urethral Atresia | Sonographic findings of this after 1st trimester include a markedly distended bladder and anhydramnios. |
| Cloaca | Cavity lined with endoderm at the posterior end of the body serving as a common passageway for urinary, digestive, and reproductive ducts. |
| Cloacal Malformation | Failure of urorectal septum to reach perineum |
| Cloacal Malformation | Affects females 1:50,000 |
| Cloacal Malformation | Sonographic findings of this include: normal or decreased fluid, normal, distended, or non-visualized bladder, ascites, hydronephrosis, ambiguous genitalia, and vertebral anomalies. |
| Ambiguous genitalia (this is cloacal malformation) | Which is not included in the Prune belly syndrome triad: Absent abdominal musculature, Ambiguous genitalia, Undescended testes, Urinary tract anomalies |
| Prune Belly Syndrome | At birth, decompression of hydronephrosis causes wrinkling of anterior abdominal wall skin. What condition? |
| prostatic, tortuous | Songraphic findings of Prune belly syndrome are: Oligohydramnios, Hydronephrosis, Massively distended bladder, Undescended testes, dilated _______ urethra, ________ dilated ureters, normal/hydro/dysplastic kidneys. |
| Vesicoamniotic shunting | This is the shunt placement to relieve severe lower urinary tract obstruction and improving chance of survival |
| lungs | Vesicoamniotic shunting drains urine into amniotic fluid, allowing the _______ to develop & prevent/stablize renal dysplastic change. |
| Bladder Exstrophy | Caused by an incomplete median closure of the inferior portion of the anterior abdominal wall and anterior wall of the urinary bladder |
| Bladder Exstrophy | Predominantly in males; exposure & protrusion of posterior wall of bladder |
| Bladder Exstrophy | Associated with separation of pubic bones |
| Bladder Exstrophy | Rarely, this occurs with OEIS complex. |
| Imperforate anus | OEIS complex: Omphalocele, Exstrophy of bladder, _____________ & Spinal defects |
| Bladder Exstrophy | Sonographic findings of this include a low umbilical cord insertion site and small penis. |
| 12th | By the ____ week of gestation the external genital organs are fully differentiated. |
| History of trisomal disorders (correct is x-linked disorders) | All are medical implications for documentation of gender EXCEPT: History of trisomal disorders, Assignment of dizygosity in twins pregnancy, to diagnose structural abnormalities, familial syndrome |
| Hypospadias | Defined as: Incomplete fusion of the urogenital folds may cause abnormal openings of the urethra |
| Hydrocele | Defined as: Accumulation of serous fluid surrounding the testicle |
| Micropenis | Small penis |
| Cryptorchidism | Undescended Testes aka: |
| 32 | Undescended testes: after _____ weeks, both are descended in 97% |
| clitoris | Abnormal genitalia in females: enlarged ________ |
| Hydrometrocolpos | Defined as: Collection of fluid in the vagina and uterus |
| Hydrometrocolpos | Appears as ovoid, cystic or complex mass posterior to the bladder. May cause hydronephrosis or hydroureter. |
| Ovarian cyst | Results from maternal stimulation and is usually benign. |
| adjacent | Ovarian cysts are __________ to bladder |
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