Renal

The kidney is responsible for approximately __ of all abdominal masses in neonates?
1. 10%
2. 33%
3. 66%
4. 90%
Which is NOT a common cystic renal mass in infancy?
1. Autosomal recessive polycystic disease
2. Multicystic dysplastic kidney
3. Cystic WilmsÂ’ tumor
4. Hydronephrosis
T or F: In neonates, congenital mesoblastic nephroma is the most common solid renal mass.
1. True
2. False
Adenoma sebaceum occurring with tuberous sclerosis is associated with what type of renal tumor?
1. WilmsÂ’ tumor
2. Clear cell carcinoma
3. Angiomyolipoma
4. Rhabdoid tumor
A patient is now 6 hours old has not voided. How would you proceed?
1. VCUG
2. Renal scintigraphy
3. Abdominal CT
4. Catheterize the bladder
5. Review fluid balance and observe
Which entity is more common?
1. Autosomal recessive polycystic kidney disease
2. Autosomal dominant polycystic kidney disease
3. Equivalent
T or F: Multicystic dysplastic kidneys are rarely associated with ipsilateral ureteral atresia?
1. True
2. False
What is the inheritance pattern of infantile polycystic kidney disease?
1. X - linked recessive
2. Autosomal recessive
3. Autosomal dominant
Which is NOT an associated finding with Â‘infantileÂ’ autosomal recessive polycystic kidney disease?
1. Pulmonary hypoplasia
2. Hepatic fibrosis
3. Hepatic cysts
4. Peliosis
Adult polycystic kidney disease follows what inheritance pattern?
1. X - linked recessive
2. Autosomal recessive
3. Autosomal dominant
Which abnormality is NOT associated with abnormalities of renal position, fusion, number, and size?
1. RokitanskyÂ’s syndrome
2. VATER association
3. Trisomy 18
4. KlinefelterÂ’s syndrome
What percent of ectopic kidneys are located in the pelvis?
1. 10%
2. 30%
3. 60%
4. 80%
Which abnormality is most commonly associated with pelvic kidney?
1. Skeletal
2. Cardiovascular
3. Neurological
4. Gastrointestinal
Which one of the following is true?
1. Lower kidneys have a dorsal renal pelvis.
2. Approximately 10% of undescended kidneys are solitary.
3. 10% of patients with pelvic kidneys have GI abnormalities.
4. The higher the kidney, the nearer it lies to the midline and the more ventral the renal pelvis is located.
T or F: The diagnosis of renal agenesis is confirmed by the presence of a hemitrigone with no ipsilateral ureteral orifice.
1. True
2. False
What is the incidence of unilateral renal agenesis?
1. 1 in 100
2. 1 in 500
3. 1 in 1,000
4. 1 in 5,000
T or F: Urinary dysplasia is correlated with vesicoureteral reflux and urinary tract obstruction.
1. True
2. False
Which is correct regarding the etiology of neonatal renal vein thrombosis?
1. Hypercoaguable state is present in 75%
2. Transposition of the great vessels is the most common congenital heart disease associated with RV thrombosis
3. Hemoconcentration and dehydration are usually causative
4. Hypotension is a sine qua non
Which statement is true regarding renal vein thrombosis?
1. Thrombocytopenia is seen in nearly 90%
2. A palpable mass is found in 1/3rd of patients
3. Hematuria is uncommon
4. Hypotension may result
T or F: Most infants with unilateral renal vein thrombosis should receive heparin.
1. True
2. False
What is the prognosis for unilateral renal vein thrombosis?
1. Most kidneys will recover more than 50% of function
2. Most kidneys become fibrotic and nonfunctional
3. Most kidneys will eventually require nephrectomy
What is the most common cause of hydronephrosis in the fetal kidney?
1. VUR (Reflux)
2. UPJ obstruction
3. Dysplasia
4. Multicystic kidney
Which is more common: extrinsic or idiopathic UPJ obstruction?
1. Extrinsic
2. Idiopathic
3. Equivalent
T or F: Bilateral hydronephrosis on prenatal ultrasound is commonly caused by transient bilateral UPJ obstruction.
1. True
2. False
T or F: Glomerular hypertrophy and vascular development continue until 2 years of age.
1. True
2. False
All the following except one occurs during transition physiology from fetal to neonatal.
1. Decrease in renal vascular resistance
2. Decrease in renal vascular resistance
3. Decreased excretion pressure
4. Decreased tubular:calyceal gradient
How long does it take for the increasing glomerular filtration rate to level out after birth?
1. 1 week
2. 2 - 3 months
3. 6 months
4. 4 years
Fetal urine output dramatically increases up until birth - what happens thereafter?
1. After 2 days, UO returns to 40% of fetal peak
2. Returns to fetal levels by 1 week
3. Returns to fetal levels by 1 month
T or F: Primary UPJ obstruction does not generally place the infant at risk for rapid renal deterioration.
1. True
2. False
At what age does the Lasix washout renogram become accurate?
1. 2nd day of life
2. 3 - 4 weeks of life
3. 3 months of life
4. 6 months of life
On a Whitaker test, bladder:kidney pressure gradients of ___ cm H2O indicate no obstruction.
1. Less than 5 cm water
2. Less than 12 cm water
3. Less than 22 cm water
4. Less than 50 cm water
What follow-up is appropriate for antenatal hydronephrosis resolved by ultrasound on the 1st day of life?
1. No further follow - up needed
2. US in 6 months
3. US in 3 months, and in 1 year
4. VCUG with a Renogram if no reflux
What is the success rate after surgical repair of UPJ obstruction.
1. 75%
2. 85%
3. 95%
Which is an indication for stenting a dismembered pyeloplasty?
1. Solitary kidney
2. Significant inflammatory change
3. Long narrowing
4. Transperitoneal approach
5. All of the above
A patient has Grade 4 vesicoureteral reflux and UPJ obstruction. The treatment is?
1. Repair both simultaneously
2. Repair the obstruction first
3. Repair the reflux first
4. Order of repair is unimportant
The ureteral bud develops from the __________ .
1. Metanephros
2. Mesonephros
3. Mullerian system
When does the ureteral bud develop from the mesonephric duct?
1. 2nd week of gestation
2. 4th week of gestation
3. 6th week of gestation
4. 8th week of gestation
The ureter is given off by the mesonephric duct to ______?
1. It joins the bladder at the trigone
2. It joins the cloaca
3. Terminate in the prostatic urethra
What structure does NOT arise from the Wolffian duct?
1. Vas deferens
2. Prostatic urethra
3. Ejaculatory ducts
4. Epididymis
5. All arise from the Wolffian duct
What is the embryologic derivation of the ectopic ureter?
1. Ureteral bud develops too distally on the mesonephric duct
2. Ureteral bud develops too proximally on the mesonephric duct
3. Ureteral bud develops too distally on the metanephric duct
4. Ureteral bud develops too proximally on the metanephric duct
T or F: In kids with secondary VUR, the chance of resolution is independent of grade of reflux.
1. True
2. False
What is the incidence of reflux in children with UTIs?
1. 5%
2. 10%
3. 20 - 30%
4. 50 - 60%
Which of the following with asymptomatic bacteriuria should undergo treatment?
1. 12 y o female with normal anatomy and no VUR
2. 6 y o male on CIC for spina bifida and no VUR
3. 2 y o male with normal anatomy and no VUR
T or F: Radiographic evaluation is necessary for all children after the initial diagnosis of UTI.
1. True
2. False
True or false: Normal uroepithelial cells from healthy children have antimicrobial activity.
1. True
2. False
T or F: Bacteria in asymptomatic children on intermittent catheterization is significant, and should be treated.
1. True
2. False
Which of the following is associated with protection against UTI?
1. Periurethral colonization
2. K Antigen
3. Chemical irritants
4. Unidirectional urine flow
All the following except ____ are UTI virulence factors.
1. P - fimbrae
2. K and O antigens
3. Urease
4. Hemolysins
5. All are virulence factors
10 - 15% of children who experience clinically significant UTIs will develop renal scarring,
1. True
2. False
What is the embryologic cause of duplicated ureter and kidney?
1. 2 ureteral buds develop from 1 metanephric duct
2. 2 ureteral buds develop from 1 mesonephric duct
3. 2 ureteral buds develop from 1 wolffian duct
4. Duplication of the nephrogenic ridge
In duplicated systems, the proximal ureteral insertion usually drains which renal pole?
1. Upper
2. Lower
3. Varies
Chwalla's membrane may be associated with ___ ?
1. Persistent cloaca
2. Ectopic kidney
3. Septate vagina
4. Ureterocele
T or F: When the ureteral bud fails to develop, renal ectopia occurs?
1. True
2. False
What is the incidence of ureteral duplication?
1. 1 in 5,000
2. 1 in 1,000
3. 1 in 100
4. 1 in 50
What is the incidence of ectopic ureter?
1. 1 in 10,000
2. 1 in 5,000
3. 1 in 2,000
4. 1 in 1,000
Continuous wetness despite a normal voiding pattern with no other symptoms suggests ____?
1. HinmanÂ’s syndrome
2. Tethered spinal cord
3. Ectopic ureter
4. Ureterocele
T or F: The vast majority of ureteral duplications and ectopic ureters occur in females.
1. True
2. False
Which is not a common presentation of ectopic ureter?
1. UTI
2. Hydronephrosis
3. Vesicoureteral reflux
4. Incontinence
What is suggested by the 'drooping lily sign' on IVP?
1. Ectopic ureter
2. Calyceal stone
3. Renal dysplasia
4. Calyceal diverticulum
At what locations are ectopic ureters usually identified in males?
1. Proximal urethra
2. Bladder neck
3. Trigone
4. All of the above
Which is true regarding the management of bilateral ectopic ureters?
1. Bladder augmentation often required
2. Usually only 1 ureter reimplanted at a time
3. Bilateral nephrectomy often necessary
4. TUU and unilateral reimplantation is often required
T or F: Approximately 80 percent of ureteroceles occur in males.
1. True
2. False
After excision of nonfunctional upper pole with ureterocele, and what is done for the ureterocele itself?
1. Primary excision and ureteral reimplantation
2. Deflux injection
3. Drainage in the absence of reflux
T or F: primary excision of ureteroceles is appropriate for nonrefluxing obstructed systems?
1. True
2. False
Which is the most common grade of ectopic ureterocele via a functional classification?
1. Grade 1
2. Grade 2
3. Grade 3
Which are typical symptoms of megaureter?
1. UTI
2. Nausea and vomiting
3. Hypertension
4. Pain
5. All of the above
Which is not a cause of secondary obstructed megaureter?
1. Tumor
2. Neurogenic bladder
3. Posterior urethral valves
4. Prune belly syndrome
What is the minimum ratio of ureteral length to diameter for megaureter reimplantation?
1. 1:1
2. 3:1
3. 5:1
4. 8:1
Which is the least common complication following megaureter reimplantation?
1. Leak
2. Obstruction from excessive tapering
3. Stricture
4. Persistent reflux
What is the cause of a retrocaval ureter?
1. Persistence of subcardinal vein
2. Persistence of retrocardinal vein
3. Ectopic ureteral bud location
4. Mesonephric bud malposition
Which is NOT one of the common causes of urolithiasis in newborns?
1. Furosemide therapy
2. Renal tubular acidosis
3. Familial hypercalcuria
T or F: Urolithiasis in older children is commonly the result of metabolic abnormalities?
1. True
2. False
Which of these stones is not radiopaque?
1. Calcium oxalate
2. Uric acid
3. Struvite
4. Calcium phosphate
Which is NOT a cause of nephrocalcinosis?
1. Medullary sponge kidney
2. Xanthogranulomatous pyelonephritis
3. Tuberculosis
4. Hyperuricemia
T or F: Hypocitraturia is caused by chronic diarrhea or renal tubular acidosis produces calcium phosphate stones.
1. True
2. False
________ stones are found in association with infections.
1. Oxalate
2. Struvite
3. Uric acid
4. Ca++ Phosphate
What is the accuracy of a clean catch specimen with more than 100,000 CFU/ml in a child less than 18 months?
1. 25%
2. 50%
3. 75%
4. 90%
What does the presence of white cell casts on microscopic evaluation of the urine suggest?
1. UTI
2. Tuberculosis
3. Pyelonephritis
4. Vesicoureteral reflux
Which is more common with dipstick for nitrites: false positivity or false negativity?
1. False Positive
2. False Negative
The most common reason for recurrent UTI is relapsed infection from the same bacterial strain.
1. True
2. False

Renal

Quiz