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Pediatric Sonography > Ch 11- Pediatric Spleen > Flashcards

Ch 11- Pediatric Spleen Flashcards

1
Q

The Spleen is an ______ located in the _______.

A

1) intraperitoneal organ

2) LUQ

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2
Q

The spleen is part of the _______ system ( responsible for ____)

A

1) Reticuloendothelial system

2) Phagocytosis

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3
Q

Phagocytosis is the engulfing & destroying of ________ & their _____, _____ & _____, & taking them out of the circulating blood

A

1) damaged/old cells

2)debris

3) foreign materail

4) Pathogens

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4
Q

The spleen is the _______ organ composed primarily of the _____ & it is a component of the _______. It is ______ for life.

A

1) largest lymphoid

2) lymph tissue

3) body’s defense system

4) not essential

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5
Q

The sonographic appearance of the spleen in the neonate is ____ or ____ relative to the kidneys. By the end of the first years of life, it becomes ____ relative to the kidneys.

A

1) Iso or

2)Hypoechoic

3)hyperechoic

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6
Q

The accessory spleen arises from failure of the ______ of ______ to fuse during development of the spleen, which results in _____ of splenic tissue

A

1) individual clumps

2) mesenchyme

3) small nodules

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7
Q

Accessory spleen is usually ____ & found at the ______.

A

1) single

2) splenic hilum

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8
Q

Accessory spleens are usually single, but they may also be ______ & located anywhere, especially along the____ or _____

A

1) Multiple

2) splenic vessels

3) omental layers

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9
Q

Splenic tissue may be found attached to the left ovary or scrotum due to the relationship of _____, _____ & _______

A

1) splenic

2) mesonephric

3) left gonadal development

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10
Q

Accessory spleen may atrophy if the _________

A

Spleen is removed

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11
Q

The spleen is highly mobile & on a long/absent pedicle. This may result in a _______

A

Wandering spleen

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12
Q

wandering spleen is common in _________ syndrome.

A

Prune- belly syndrome

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13
Q

In acute torsion, a large, hypoechoic spleen will be seen due to _____ & ______. In chronic torsion the spleen will be _____ & ______ to image

A

1) Infarction

2) congestion

3) small

4) difficult to image

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14
Q

Polysplenia, a heterotaxy syndrome with multiple splenules, is more common in ______

A

Females

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15
Q

Asplenia , or ______, absence of the spleen, is more common in ________ & diagnosed in _____

A

1) right isomerism

2) Males

3) neonates

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15
Q

With polysplenia, patient’s present with a ______ Liver, _____ bowel, _____ agenisis, ______atresia, _____ agenisis, bilat _____ & a interupted ______ with _______ or _________, ______ & a ________ pancreas

A

1) Midline liver
2) malrotated bowel
3) GB agenesis
4) Biliary atreasia
5) Renal agenesis
6) bilobed lungs
7) intrahepatic IVC
8) azygos or hemiazygos continuation
9) non-cyanotic heart disease
10) semi-annular panc ( AKA Left Isomerism)

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16
Q

Asplenia is associated with complex _______, _____ of the great vessels, ______ agenesis, Bilat ______, _____ , ______ kidney & ______ liver.

A

1) cyanotic congenital heart disease

2) transposition

3) GB

4) trilobed lungs

5)imperforate anus

6) horseshoe kidney

7) transverse liver

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17
Q

List the causes of Splenomegaly (11)

A

1) Hepatomegaly
2) leukemia
3) ECMO
4) infiltrative storage disorder
5) Mononucleosis
6) infection
7) focal lesions
8) portal HTN
9) heart failure
10) Lymphoma
11) hemolytic anemias

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18
Q

A small spleen may be due to ….

A

1) infarction due to wandering spleen or sickle cell
2) congenital absence or hypoplasia
3) partial splenectomy
4) Celiac disease
5) Fanconi anemia
(a rare inherited disorder, common in persons of Jewish decent & south Africans, that lead to bone marrow failure)

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19
Q

Splenic cyst may be congenital (__________) or acquired (_________). They may rupture & become _______.

A

1) true epithelial or epidermoid

2) false or pseudocyst ( poet-traumatic)

3) Infected

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20
Q

it is _______ to differentiate between congenital cyst & acquired cyst Sonographically.

A

not possible

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21
Q

Congenital cysts have an _____ lining & _____ walls.

A

1) epithelial lining

2) imperceptible walls

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22
Q

Cyst secondary to a hematoma or infective process will ________

A

have no epithelial lining

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23
Q

Post-traumatic cysts have _____ walls that may be ____

A

1) thicker walls

2) calcified

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24
Q

Epidermoid cysts are primary _____ cyst which may have ______ present in the cyst or wall. They may be septated & have internal echos due to ____

A

1) congenital cyst

2) calcifications

3) hemorrhage

25
Q

Hydatid cysts result from ______ or ______(due to___). They are _____, may be ____ or ____ & have _____.

A

1) ruptured liver cyst

2)systemic infection

3) due to parasites

4) well defined

5) single or multiple

6) wall calcifications

26
Q

Lymphangiomas of the spleen are ____, ____, ____ of _____, filled with _____, which have ______.

A

1) rare

2) multiple

3) cystic spaces

4) variable thickness

5) lymph

6) have vascular septations

27
Q

Hemangiomas are ______ of the spleen, they are ____ in appearance to those in the liver of adults.

A

1) common benign neoplasms

2) similar

28
Q

Hemangiomas of the spleen are associated with ____, ______, ______ & ______

Their apparence varies due to _________

A

1) Beckwith-Wiedeman Syndrome

2) Klippel-Trenunay-Weber syndrome

3) Turner syndrome

4) Kasabach- Merrit syndrome (a large hemangioma which causes platelet trapping & damage resulting in disseminated intravascular coagulation which may be fatal)

5) The size of the vessels

29
Q

Abscesses in the spleen have ___ walls & _______ & are usually _____ in size

A

1) Thick walls

2) internal echoes

3) > 1.5 cm

30
Q

Abscesses form due to the ______ through the _____

A

1) spread of infection

2) bloodstream

31
Q

A abscess is a collection of ____ within the splenic parenchyma..

A

Pus

32
Q

Children who develop splenic abscesses are usually _______

A

Immunocompromised

33
Q

These abscesses can be spread due to _____, an _____, ____ or ____. They may also be associated with _____.

A

1) appendicitis

2)empyema

3)osteomyelitis

4) ear infections

5) bacterial endocarditis

34
Q

Fungal abscesses are seen in cases of ____, ____ & ____.

A

1) candida

2) aspergillus

3) cryptococcus

35
Q

Fungal abscesses have a ____ appearance & are _____

A

1) bulls eye or target apperance

2) very small

36
Q

Candida abscesses occur in _______ children

A

immunocompromised

37
Q

Cat-scratch disease can cause ________.

A

Multiple splenic abscesses

38
Q

Splenic Calcifications may be due to ______ or ____.

A

1) Histoplasmosis

2) TB

39
Q

Neoplastic Conditions of the spleen include ____ & _____, which are most common. The spleen be involved in a ____ or ___ manner

A

1) Lymphoma

2) Leukemia

3) focal

4) diffuse

40
Q

Lymphoma may cause _____ of the spleen, & focal ___ lesions within th3e parenchyma will be seen which have a ___ or ___ appearance .

A

1) enlargement

2) hypoechoic

3) hypo- or hyperechoic

41
Q

In Leukemia, a ___ or ____ parenchyma will be seen with ____ of the spleen. _____ are sometimes seen.

A

1) hypo- or hyperechoic

2) enlargement

3) small focal lesions

42
Q

Langerhans Cell histiocytosis is proliferation of the histocytes involving the ____, ____, _____ & _____

A

1) skin

2) bone marrow

3) reticuloendothelial system

4) lungs

43
Q

Langerhans Cell histiocytosis an _____ spleen with multiple focal _____ nodules is encountered.

A

1_ enlarged

2) hypoechoic

44
Q

Gaucher disease is a _______ disorder where the _____ is lacking.

A

1) congenital storage disorder

2) enzyme glucocerebrosidase

45
Q

Gaucher disease this enzyme _______

A

Breaks down a fatty substance

46
Q

Without the enzyme, glucocerebroside ________ & accumulates in the ___ & ___. It causes ___ or ____ nodules in the spleen

A

1) builds up to toxic levels

2) liver

3) Spleen

4) hyper or hypoechoic

47
Q

Extramedullary hemopoiesis (failure of RBC development in the bone marrow), ______ & _____ of the spleen occur.

A

1) infarction

2) fibrosis

48
Q

The spleen is very vulnerable to ______

A

infection

49
Q

Sonographically, infarcts appear ______

A

Wedge- shaped

50
Q

List the conditions causing splenic infarction. (5)

A

1) Sickle cell
2) splenic torsion
3) cardiac emboli
4) vascular disease
5) portal HTN (rarely)

51
Q

Following a splenic infarction, ____ formation, or _________ with _______ may occur.

A

1) pseudocyst

2) rupture of the infection

3) abscess formation

52
Q

Splenic Peliosis is a rare condition associated with ___, ____ & ______. It is also associated with a rare tropical parasitic infection, _____ which occurs in the _____.

A

1) TB

2) Steroid therapy

3) hematologic malignancies

4) Leishmaniasis

5) Middle Eaet

53
Q

_____ spaces are seen in the spleen with Splenic Peliosis

A

Blood-filled spaces

54
Q

Trauma in the spleen is usually due to ________

A

Abdominal trauma

55
Q

The spleen is the _________ in children. ___ is the preferred imaging modality.

A

1) most commonly injured solid organ

2) CT

56
Q

With splenic trauma abn include ____, a _____, ____, ____ or ____ of the spleen.

A

1) laceration

2) a subscasular hematoma

3) a hematoma

4) fracture

5) rupture

57
Q

Splenic bleeding is acutely ____ sonographically & may be ________from normal splenic tissue.

A

1) hyperechoic

2) may be difficult to distinguish

58
Q

Subscapular fluid will present as a ___________ seen __________.

A

1) Crescent-shaped

2) just beneath the capsule

59
Q

If a splenic rupture occurred, _____ in the _____ or rest of the abdomen will be found.

A

1) fluid

2) flank

60
Q

When the spleen is injured, splenic tissue __________. This is called ______.

A

1) scatters throughout the peritoneal cavity

2) Splenosis

Pediatric Sonography (5 decks)

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