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Applied Anatomic Pathology > Autopsy 4: Pediatric > Flashcards

Autopsy 4: Pediatric Flashcards

1
Q

which week differentiates a fetus from a surgical vs autopsy specimen

A

20 weeks

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2
Q

define premature

A

birth before 37 weeks

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3
Q

define stillbirth

A

fetus born with no signs of life after 28 weeks

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4
Q

define full term

A

child born between 37 and 42 weeks

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5
Q

what is IUFD

A

intrauterine fetal demise

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6
Q

what are some cases in which the medical examiner will take a fetal case

A

SIDS, neglect, poisoning, homicide

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7
Q

what is a gravida para (GXPX)

A

pregnancies and live births
g refers to how many times a female has been pregnant
P refers to how many times a female has delivered a live baby

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8
Q

what are the two most common birth injury of the skeletal system in a fetus

A

clavicular and humeral fractures

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9
Q

what are the best sources of cytogenetics cultures for a fetus

A

fascia
lung
Achilles tendon
chorionic villi
cartilage

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10
Q

what solution should fetal cytogenetic samples be sent in

A

Hank Solution

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11
Q

what causes 64% of intrauterine fetal deaths

A

abnormalities within the placenta

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12
Q

what are the grades of maceration

A

grading scale of fetuses who died while still in their mother
scale is from 0-5
fetus has progressively more skin slippage and erythema (congestion)

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13
Q

how long does mummification take of a fetus who dies while still inside the uterus

A

2 weeks

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14
Q

what is the crown-rump length

A

length of a fetus from anterior fontanel to base of coccyx

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15
Q

what is the crown-heel length

A

length of a fetus from anterior fontanel to tip of heel

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16
Q

where should one take an abdominal circumference of a fetus

A

at the level of the umbilicus

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17
Q

where should one take an chest circumference of a fetus

A

at the level of the nipple

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18
Q

what crown length is usually ___ that of the crown-heel length

A

2/3rds

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19
Q

what are the four facial measurements one should take of a fetus

A

outer and inner canthus
inter pupillary distance
philtrum

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20
Q

what is the correct position of the ears on a fetus

A

lateral canthus should be line with the upper portion of the helix

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21
Q

what is the term used for a enlarged tongue

A

macroglossia

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22
Q

what is the term used for a recessed mandible

A

micrognathia

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23
Q

what is the term for severe malnutrition

A

marasmus

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24
Q

what is the term for extreme wasting usually due to systemic disease like cancer

A

cachexia

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25
Q

what is the term for gray-blue spots on the sacrum of children

A

Mongolian spots

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26
Q

what is the word for a missing anus

A

imperforate anus

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27
Q

when is the differentiation of male and female external genitalia complete

A

12 weeks

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28
Q

what is the term for a congenital abnormality in the male urethra

A

hypospadias

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29
Q

what is the term for a bald spot at the top of the head in a fetus

A

cutis aplasia

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30
Q

what is the term for a bulging of the abdominal cavity, typically due to an issue with the linea alba

A

diastases recti

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31
Q

a single palmar crease can be associated with which genetic condition

A

trisomy 21 - downs syndrome

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32
Q

how do you check for a pneumothorax in an infant

A

open the chest cavity under water and look for bubbling

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33
Q

where do you pull a blood sample from in a fetus

A

right atrium

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34
Q

what is the best autopsy technique to use on a fetus

A

the en masse method - aka removing the entire block

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35
Q

what is the single largest cause of neonatal deaths globally

A

infections - they usually arise from the placenta

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36
Q

what is necrotizing enterocolitis

A

inflammation of the intestines cause a distended and thinning appearance - can eventually lead to a perforation

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37
Q

what are some consequences of rubella in a child

A

deafness
heart issues (patent ductus ateriosus)
hepatosplenomegaly
microcephaly (small head)

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38
Q

what is pneumatosis intestinalis

A

gas bubbles seen in the colon

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39
Q

what three things can cytomegalovirus cause in a child

A

myocarditis
intestinal pneumonia
sialadenitis

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40
Q

what does the ADAM complex stand for

A

amniotic deformities, adhesions, mutilations

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41
Q

what is the term for lack of amniotic fluid

A

oligohydraminos

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42
Q

what is Potter sequence

A

group of abnormalities that can be seen in babies that experience oligohydraminos
1.) pulmonary hypoplasia
2.) arthrogryposis (joint contractures)
3.) limb deformities
4.) limb edema/congestion
5.) brain defects

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43
Q

what are three facial features associated with oligohydraminos

A

slanting forehead
blunt-tipped nose
recessed chin

44
Q

what is nuchal umbilical cord

A

umbilical cord with knots and/or strictures in it

45
Q

what is the most common cause of neonatal respiratory distress syndrome (RDS)

A

hyaline membrane disease (lack of pulmonary surfactant)

46
Q

how can you test a fetus’s lungs for ventilation complications

A

put them in a container of water - if they sink, they were poorly aerated

47
Q

what is it important to note when evaluating the small and large intestines in situ

A

whether or not they’re in their normal anatomy location

48
Q

what is caput succedaneum

A

accumulation of interstitial fluid in the soft tissues of the scalp - head becomes edematous and swells

49
Q

what is the most frequent cranial birth injury

A

cephalohematoma

50
Q

what is a cephalohematoma

A

hemorrhage occurring in the scalp between the bone and periosteum
hemorrhage does not cross suture lines

51
Q

what is the most common, important pathologic finding associated with birth head injuries

A

intracranial hemorrhage

52
Q

how are eyes removed in a pediatric case

A

from above through the base of the skull

53
Q

what is the most serious threat in fetal hydrops

A

CNS damage, specifically kernicterus (too much billirubin)

54
Q

what is fetal hydrops

A

excessive extravascular fluid

55
Q

what is a malformation

A

error in morphogenesis (single gene or chromosomal)

56
Q

what is a disruption

A

issue with something that was previously normal
ex. amniotic band syndrome

57
Q

what is a deformation

A

abnormal biomechanical force
ex. uterine constraint

58
Q

what is the most common lethal genetic disease that affects the white population

A

cystic fibrosis (mucoviscidosis)

59
Q

what is meconium ileus

A

intestinal obstruction caused by thick meconium in cystic fibrosis cases

60
Q

what type of chromosomal abnormality is most common in spontaneous abortion cases

A

autosomal trisomies

61
Q

what is the ratio of chromosomal defects at birth

A

1:200

62
Q

what is a common, mild malformation in chromosome defects

A

single umbilical artery

63
Q

what are some common findings in those with trisomy 21 (Downs Syndrome)

A

upward slanting eyes
smooth philtrum
protruding tongue
gap between first and second toes
single palmar crease
cardiac defects

64
Q

what are some brain features of someone with trisomy 21 (Downs Syndrome)

A

short A-P diameter
open operculum
hypoplastic superior temporal gyrus

65
Q

what are some common findings in those with trisomy 13 (Patau Syndrome)

A

midline facial defect (cleft lips and palates)
rocker bottom feet
cardiac defects
polydactyly

66
Q

what are some common findings in those with trisomy 18 (Edwards Syndrome)

A

micrognathia
overlapping fingers
rocker bottom feet
renal malformations
low set ears

67
Q

what causes Cri Du Chat Syndrome (cat cry syndrome)

A

partial deletion of short arm of chromosome 5

68
Q

what are some common findings in those with Cri Du Chat Syndrome (cat cry syndrome)

A

round, oval face
catlike cry
growth and mental retardations
excess nuchal skin

69
Q

how many chromosomes does a fetus with triploidy have

A

69

70
Q

what are some common findings in those with triploidy

A

hydrocephalus
low-set, deformed ears
micrognathia
syndactyly

71
Q

what are some common findings of those with monosomy X (Turner Syndrome)

A

short stature
small for gestational age
lymphedema of extremities
excess skin at nape of neck
broad chest

72
Q

what are some common findings of those with Klinefelter syndrome (male with XXY)

A

gynecomastia
small testes and penis
hypogonadism

73
Q

what is the most frequent mental retardation syndrome

A

fragile X syndrome - most common in males

74
Q

what are some common findings of those with fragile X syndrome

A

large ears
hyper extensible joints
pectus excavatum (depressed chest)
seizures

75
Q

what is a meningoencephalocele

A

neural tube defect which causes a large portion of the occipitoparietal brain tissue to protrude through a posterior fontanel

76
Q

what is Meckel-Gruber syndrome

A

a fetus with a meningoencephalocele

77
Q

what is iniencephaly

A

neural tube defect where there is a deficiency of the occipital bone and cervicothoracic spinal fusion

78
Q

what is anencephaly

A

neural tube defect that causes absence of scalp, cranium, and most of brain

79
Q

what is craniorachischisis

A

neural tube defect that causes both anencephaly and bony defect of the spine

80
Q

what should you do if there is a suspected cardiovascular malformation in a fetal case

A

perfuse cavities with fixative overnight

81
Q

what is the most common congenital abnormality of the heart

A

ventricular septal defect

82
Q

what are the three most common congenital abnormalities of the heart

A

septal defects (holes)
stenotic lesions
outflow tract abnormalities

83
Q

what are the two types of ventricular septal defects

A

perimembranous (membranous portion of interventricular septum) and muscular (entirely within muscular portion)

84
Q

what is the most common type of atrial septal defect

A

atrial secundum (does not involve the fossa ovalis)

85
Q

what is the ductus arteriosus

A

connection between the pulmonary artery and aorta to prevent blood from going to the lungs in a fetus
can stay open after birth (patent ductus arteriosus)

86
Q

what are the four conditions that make up the tetralogy of fallot

A

1.) ventricular septal defects
2.) pulmonary valve stenosis
3.) misplaced aorta
4.) right ventricular hypertrophy

87
Q

coarctation of aorta is associated with which syndrome

A

turner syndrome

88
Q

what heart defect is most common in Downs Syndrome

A

atrioventricular septal defect

89
Q

what are the three main causes of aortic stenosis

A

congenital
rheumatic fever
calcium build up

90
Q

what is transposition of the great arteries

A

aorta is connected to the right ventricle while the pulmonary artery is connected to the left ventricle

91
Q

what is truncus arteriosus

A

condition where there is only one great artery arising from the heart

92
Q

what is cardiac ventricular non-compaction

A

trabeculae in the ventricles of a fetus do not compact against the myocardium over time
mostly affects the left ventricle

93
Q

what is the most common tumor of infancy

A

hemangioma

94
Q

what is the most common cardiac tumor in infants and children

A

rhabdomyoma

95
Q

what are the three most common locations for a cardiac rhabdomyoma

A

right ventricle
left ventricle
septum

96
Q

what are the most common teratomas of childhood

A

sacrococcygeal teratomas

97
Q

what is the most common primary renal tumor of childhood

A

wilms tumor (nephroblastoma)

98
Q

what are three of the most common causes for SIDS

A

maternal cigarette smoking
material anemia
prone sleeping

99
Q

what are the 2 most common SIDS findings at autopsy

A

thymus, pleural, and epicardial petechiae
hyperated lungs with congestion

100
Q

what is Münchausen syndrome by proxy

A

adult career causes or falsifies illness to a child to gain medical attention and to initiate extensive investigation

101
Q

what are two common fetal findings in fetal alcohol syndrome cases

A

deceased brain weight
agenesis of the corpus callousum

102
Q

what is an omphalocele

A

defect of the anterior abdominal wall (fails to develop)
abdominal contents are contained within the peritoneal membrane

103
Q

what is gastroschisis

A

loops of bowel come through an opening in the abdominal wall

104
Q

what is the rule of 2’s for meckel diverticulum

A

2% of the population
2 feet from the IVC (in adults)
2 in long (in adults)

105
Q

what is fetus papyraceus

A

compressed, macerated remains of a fetus that demises early in a multiple gestation (usually IVF)

Applied Anatomic Pathology (17 decks)

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