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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}
|QuestionAuthor={{Rim}}, {{AJL}} {{Alison}}
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Embryology
|MainCategory=Embryology
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|MainCategory=Embryology
|MainCategory=Embryology
|SubCategory=Renal
|SubCategory=Renal
|Prompt=A 19 year old male patient presents to the emergency department with abdominal pain. Appropriate history and physical examination are conducted.  Abdominal and pelvic computed tomography (CT) scans are ordered to investigate the cause of the patient’s complaint.  Based on the CT scan, no etiology of the abdominal pain is determined.  However, an incidental finding is documented as seen in the CT scan image shown below.  Which artery is involved in this patient’s incidental finding?
|Prompt=A 19-year-old male presents to the ER with complaints of abdominal pain. You order abdominal and pelvic CT scans and no etiology of the abdominal pain is determined.  However, an incidental finding is documented in the CT scan image illustrated below.  Which of the following arteries is involved in this patient’s incidental finding?


[[Image:WBR CT Scan Horseshoe Kidney.png|400px]]
[[Image:WBR CT Scan Horseshoe Kidney.png|400px]]
|Explanation=[[Horseshoe kidney]] is a congenital disorder caused by renal fusion of the central portion.  As the fused kidney ascends during embryological development, the [[inferior mesenteric artery]] (IMA) stops its ascend and the kidney remains low in the abdomen.  Horseshoe kidney is commonly an incidental finding. The kidney function is generally not impaired.
|Explanation=[[Horseshoe kidney]] is a congenital disorder caused by renal fusion of the central portion.  As the fused kidney ascends during embryological development, the [[inferior mesenteric artery]] (IMA) hinders its ascent and the kidney remains low in the abdomen.  Horseshoe kidneys are frequently incidental findings because kidney function is generally not impaired.
 
EducationalObjectives= [[Horseshoe kidney]] is a congenital disorder caused by fusion of the two kidneys.  Patients with horseshoe kidney often have normal renal function.  During development, the fused kidney fails to ascend to its normal location in the abdomen due to obstruction by the IMA.  As a result, [[horseshoe kidney]] lies low in the abdomen.
|References= First Aid 2014 page 523
 


Educational Objective:
Horseshoe kidney is a congenital disorder caused by fusion of the two kidneys.  Patients with horseshoe kidney often have normal renal function.  During development, the fused kidney fails to ascend to its normal location in the abdomen due to obstruction by the IMA.  As a result, horseshoe kidney lies lows in the abdomen.
|AnswerA=Umbilical artery
|AnswerA=Umbilical artery
|AnswerAExp=Umbilical artery is not involved in horseshoe kidney.
|AnswerAExp=Umbilical artery is not involved in [[horseshoe kidney]].
|AnswerB=Superior mesenteric artery (SMA)
|AnswerB=Superior mesenteric artery (SMA)
|AnswerBExp=The superior mesenteric artery (SMA) is not involved in horseshoe kidney.
|AnswerBExp=The superior mesenteric artery (SMA) is not involved in [[horseshoe kidney]].
|AnswerC=Inferior mesenteric artery (IMA)
|AnswerC=Inferior mesenteric artery (IMA)
|AnswerCExp=The inferior mesenteric artery (IMA) stops the ascend of the horseshoe kidney and the latter remains low in the abdomen.
|AnswerCExp=The inferior mesenteric artery (IMA) stops the ascend of the [[horseshoe kidney]] and the latter remains low in the abdomen.
|AnswerD=Descending aorta
|AnswerD=Descending aorta
|AnswerDExp=Descending aorta is not involved in horseshoe kidney.
|AnswerDExp=Descending aorta is not involved in [[horseshoe kidney]].
|AnswerE=Renal artery
|AnswerE=Renal artery
|AnswerEExp=Renal artery is not involved in horseshoe kidney.
|AnswerEExp=Renal artery is not involved in [[horseshoe kidney]].
|RightAnswer=C
|RightAnswer=C
|Approved=No
|WBRKeyword= horseshoe kidney, kidney, excretory system, arteries, cardiovascular system, IMA, abnormal, incidental finding
|Approved=Yes
}}
}}

Revision as of 19:09, 18 July 2014

 
Author [[PageAuthor::Rim Halaby, M.D. [1], Alison Leibowitz [2] (Reviewed by Alison Leibowitz)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Embryology
Sub Category SubCategory::Renal
Prompt [[Prompt::A 19-year-old male presents to the ER with complaints of abdominal pain. You order abdominal and pelvic CT scans and no etiology of the abdominal pain is determined. However, an incidental finding is documented in the CT scan image illustrated below. Which of the following arteries is involved in this patient’s incidental finding?

]]

Answer A AnswerA::Umbilical artery
Answer A Explanation [[AnswerAExp::Umbilical artery is not involved in horseshoe kidney.]]
Answer B AnswerB::Superior mesenteric artery (SMA)
Answer B Explanation [[AnswerBExp::The superior mesenteric artery (SMA) is not involved in horseshoe kidney.]]
Answer C AnswerC::Inferior mesenteric artery (IMA)
Answer C Explanation [[AnswerCExp::The inferior mesenteric artery (IMA) stops the ascend of the horseshoe kidney and the latter remains low in the abdomen.]]
Answer D AnswerD::Descending aorta
Answer D Explanation [[AnswerDExp::Descending aorta is not involved in horseshoe kidney.]]
Answer E AnswerE::Renal artery
Answer E Explanation [[AnswerEExp::Renal artery is not involved in horseshoe kidney.]]
Right Answer RightAnswer::C
Explanation [[Explanation::Horseshoe kidney is a congenital disorder caused by renal fusion of the central portion. As the fused kidney ascends during embryological development, the inferior mesenteric artery (IMA) hinders its ascent and the kidney remains low in the abdomen. Horseshoe kidneys are frequently incidental findings because kidney function is generally not impaired.

EducationalObjectives= Horseshoe kidney is a congenital disorder caused by fusion of the two kidneys. Patients with horseshoe kidney often have normal renal function. During development, the fused kidney fails to ascend to its normal location in the abdomen due to obstruction by the IMA. As a result, horseshoe kidney lies low in the abdomen.
Educational Objective:
References: First Aid 2014 page 523]]

Approved Approved::Yes
Keyword WBRKeyword::horseshoe kidney, WBRKeyword::kidney, WBRKeyword::excretory system, WBRKeyword::arteries, WBRKeyword::cardiovascular system, WBRKeyword::IMA, WBRKeyword::abnormal, WBRKeyword::incidental finding
Linked Question Linked::
Order in Linked Questions LinkedOrder::