ABD I - Urinary Part 2

Renal cell carcinoma

The most common of all renal tumors (85-90% of all tumors)

hypernephroma, adenocarcinoma, von Grawitz tumor

Other names for renal cell carcinoma

Renal cell carcinoma

Patient comes in with hematuria, erythrocytosis, and increased lactic acid dehydrogenase. Sono is complex heterogeneous mass with irregular borders

Stage 1 renal cell carcinoma

Confined to kidneys

Stage 2 renal cell carcinoma

Spread to perinephric fat but within Gerota’s Fascia

Stage 3 renal cell carcinoma

Spread to renal vein, inferior vena cava, rt atrium or regional lymph nodes

Stage 4 of renal cell carcinoma

Invasion of neighboring structures; distant metastases

Treatment

radial / partial nephrectomy depending on location

Transitional cell carcinoma

Most common tumor of the renal collecting system that can be anywhere in collecting system

Transitional cell carcinoma

Patient has hematuria, wt loss, flank pain. Sono is solid hypoechoic mass with ill-defined within the renal ainua

Wilms tumor (nephroblastoma)

most common solid renal mass of childhood

Wilms tumor

Palpable abdominal mass often spreads outside the renal capsule and spreads to the venous system - heart – lung

Beckwith-Widemann syndrome

WIlms tumor is associated with

Lymphoma

Occur in the presence of lymphoma disease from invasion from neighboring lymph nodes.

Lymphoma

Patient’s sono is markedly hypoechoic nodules with no through transmission

Nephritis

inflammation of the kidney, a focal or diffuse proliferative or destructive dz that involves the glomerulus, tubule, or interstitial renal tissue

Nephrosis

excess accumulation of fluid in the body causing kidney to pass too much protein into urine causing swollen body

Nephrotic Syndrome

Damage to glomeruli. A condition marked by massive edema, heavy proteinuria, hypoalbuminemia decreased

Acute glomerulonephritis

Is necrosis or proliferation of cellular elements which occur in the glomeruli

Acute glomerulonephritis

Pt has HTN, anemia, peripheral edema and nephrotic syndrome. Sono is enlarged kidneys with echogenic cortex due to change

Acute glomerulonephritis

Is the most common cause of chronic renal failure

Acute interstitial nephritis

Is associated with infectious processes (scarlet fever) or an allergic reaction to certain drugs

Acute interstitial nephritis

Pt has Urea, proteinuria, hematuria, rash, fever and eosinophilia. sono is enlarged, echogenic cortex

Nephropathy

the deterioration of kidney function

Sickle cell nephropathy

Renal involvement in pts with sickle cell disease

Sickle cell nephropathy

Pt has hematuria. Sono is enlarged kidneys with decreased echogenicity secondary to edema

Hypertensive nephropathy

Uncontrolled hypertension can lead to progressive renal damage and azotemia

small bilateral kidneys

occur secondary to end-stage disease as a result of hypertension, inflammation, or ischemia

Papillary necrosis

Occurs when cells at the apex of the renal pyramids are destroyed

Papillary necrosis

Pt sono is one or more fluid spaces at the corticomedullary junction that are round or triangular with arcuate vessels

Lupus nephritis

is a connective tissue disorder believed to result from an abnormal immune system where kidneys are involved

Lupus nephritis

Pt has hematuria, proteinuria, hypertension and renal insufficiency. Sono is increased cortical echogenicity and renal atrophy

Causes of AIDs

Acute tubular necrosis, nephrocalcinosis, interstitial nephritis, and focal segmental glomerulosclerosis

Acute pyelonephritis

Femal pt has dysuria, urine frequency, fever, bacteruria, leukocytosis. Sono is enlarged kidneys with mild hydro and hypoechoic areas

Chronic pyelonephritis

Pt has reccurent UTIs. Sono is Normal to small kidneys, parenchymal thinning, increased echogenicity

Pyonephrosis

Pus in the dilated collecting system, complication of hydronephrosis that occurs secondary to urinary stasis and infection

drainage

Pyonephrosis requires emergent percutaneous

Pyonephrosis

Pt has urosepsis and dilated pelvocaliceal cyst filled with internal echoes

Acute tubular necrosis

Most common medical renal disease to produce acute renal failure

Acute tubular necrosis

interruption or impairment in the blood flow in and out of the kidney due to trauma and is reversible

Emphysematous pyelonephritis

gas forming organism from parenchymal infection requiring emergency nephrectomg

Xanthogranulomatous pyelonephritis

Causes destruction of parenchyma and replaces it with cystic spaces

Renal failure

Occurs when the kidneys are unable to remove waste products from the bloodstream

Prerenal failure

renal failure secondary to hypoperfusion caused by hypotension and CHF

Renal failure

parenchymal disease caused by infection, nephrotoxicity and renal mass

Postrenal failure

outflow obstruction in lower urinary tract caused by retroperitoneal fibrosis

Chronic renal failure

Loss of renal function as a result of disease

nephron, vascular, interstitial

3 types of chronic renal failure

small markedly hyperechoic kidneys

Sonography of renal failure

Renal atrophy

Loss of renal tissue as a result of diseases

Bladder exstrophy

anterior wall of the bladder does not form, the posterior wall communicates with the skin

duplication

two separate bladders, two urethras, and two external openings

Urachal cyst

echo free tubular structure in the lower abdominal wall that may extend from umbilicus to bladder

Posterior urethral valves

Valves situated in the posterior urethra cause obstruction of the bladder, ureters, and kidneys occurring only in males

Ureterocele

a cyst like enlargement of the lower end of the ureter caused by stenosis of distal ureter

Ectopic ureterocele

usually found with complete ureteral duplication, inserts low in the bladder neck, urethra or lower genital tract

3-6mm

Normal bladder wall should be

<20ccs

Normal bladder volume after post void should be

Bladder cystitis

Inflammation of the bladder that is usually caused by infection

Bladder tumors

malignant tumors in bladder causing painless hematuria from invasion from cervix, uterus, prostate or upper urinary system

Neurogenic bladder

Dysfunctional urinary bladder that results from any lack of coordination between the central nervous system and the somatic nervous system