Differentials Flashcards
Hypoechoic Liver Masses
Lymphoma (#1), mets (melanoma, Pancreas Adeno, Cervical, Lung, ?melanoma, GI sometimes)
Echogenic Liver Masses
Hemangioma, Mets (esp mucinous, Colon #1, Ovary, Stomach, RCC, Islet Cell), Focal Fat Infiltration, HCC, adenoma
Shadowing Liver Foci
Ca+ (Mets), Air (PV Gas), Stones, Fat Containing Lesion
Target Lesion in Liver
Mets, HCC, Lymphoma, Abscess
Hypervascular Liver Masses
Renal, Islet Cell, Carcinoid, Melanoma, Breast, Thyroid, Sarcoma, Pheo, Choriocarcinoma, Colon
Calcified Liver Mass
Mets: Mucinous, Breast, RCC, Lung, NB, OSA
Echinococcus, TB/Histo, Old Abscess, Fibrolamellar HCC, Hepatoblastoma
Mucinous Tumors
COBS = Colon, Ovary, Breast, Stomach
GB Comet Tails (552D)
Adenomyomatosis, Cholesterolosis, Emphysematous Cholecystitis
GB Wall Thickening
Cirrhosis, CHF, Hypoproteinemia, GB Cancer, Adenomyomatosis, Hepatitis Cholecystitis, AIDS, ?hemorrhage
GB Sludge (576D)
Fasting, TPN, Hemolysis, Cystic Duct Obstruction, Acute & Chronic Chole
GB Hydrops (551D, 573D)
Obstructed: Stone, Tumor
Nonobstructed: Kawasaki’s, Diabetes, Hyperalimentation, EtOH, Acromegaly, Narcotics, AIDS, Anticholinergics
Echogenic GB (WES Sign)
Stones (Can’t See Back Wall), Emphysematous Cholecystitis (Dirty Shadows, Ring Down Comets), Porcelain GB (Sometimes see back wall)
GB Polypoid Lesion
Polyp (Cholesterol, Adenoma), Cancer, Tumefactive Sludge, Blood Clot, Adenomyomatosis (Adenomyoma)
+Doppler = Cancer, Adenomatous Polyp
Bile Duct Wall Thickening
AIDS, Cholangiocarcinoma, Bacterial & Oriental Cholangitis, PSC
Biliary Duct Filling Defect
Stone & Gas (Shadows), Blood Clot, Tumor, Infectious Debris
Intrahepatic Stones
Recurrent Pyogenic Cholangitis, Sclerosing Cholangitis, Caroli’s Dz
Intrapancreatic Biliary Obstruction
Stone (#1), Pancreatic Adeno, Stricture (Pancreatitis, AIDS)
Suprapancreatic Obstruction
Tumor (Cholangio, Portal LAD), Mirizzi
Hypoechoic Pancreatic Lesion
Adenocarcinoma, Islet Cell, Cystic Neoplasm, Mets, Lymphoma, Focal Pancreatitis, Pseudocyst/aneurysm
Hypoecohic Spleen Lesions
SNAIL = Sarcoid, Neoplasm (Mets), Abscess, Infarct, Lymphoma
Multiple Echogenic Splenic Foci
PCP, Candida (Treated?), TB
Echogenic Renal Cortex (727D)
Glomerulonephritis, Xplant Rejection, SLE, Cortical Necrosis, ATN, ESRD, Diabetes, AIDS
Medullary Nephrocalcinosis (736D)
FHAM HOP = Furosemide, HPT, Acidosis (RTA I distal), MSK, Hypercalcemia (Sarcoid, Milk Alkali, Hypervitaminosis D), Oxalosis, Papillary Necrosis
Cortical Nephrocalcinosis (737D)
COAG = Cortical Necrosis, Oxalosis, Alports, Glomerulonephritis (chronic)
Intratesticular Lesion
Tumor/Mets, Infarct, Abscess, Focal Orchitis, Hematoma, Sarcoid, Simple Cyst, Epidermoid Cyst
Prostate Cyst
Utricle (Midline), Mullerian (Larger), EJ Duct (Paramedian), Seminal Vesicle Cyst
Falsely High Carotid Velocity
HTN, Bradycardia, Obstructed Contralateral ICA
False Low Carotid Velocity
Tandem Lesion, Proximal CCA Lesion, Low Cardiac Output
Oligohydramnios
DRIPP C = Demise, Renal Anomaly (Usually bilateral), IUGR (80%), PROM, Post Dates, Chromosomal Anomaly
Polyhydramnios
Idiopathic, Maternal (Diabetes, HTN, Rh, Chorioangioma)
Fetal (CHANT): NTD/CNS, Proximal GI obstruction, Chest Mass (CCAM, CDH), Hydrops, TTTS
Non-Immune Hydrops
CHITOS = Chromosomal, CHD, Hygroma, Infection/TORCH, TTTS, Other (CDH, VOGA, Chorioangioma), Sacrococcygeal Teratoma
Elevated AFP (824D)
GEM MINER CO = Gastroschisis, Esophageal Atresia, Multiple Gestation, Mole, Incorrect Dates, NTD, Error (lab), Renal Anomaly, Chorioangioma, Ompahlocele
Basically anything but closed NTD
Low AFP
Trisomy 13/18/21, Fetal Death, Mole, Wrong Dates
Fetal Hand Problems
Polydactyly = Meckel Gruber, Ellis Van Creveldt, Trisomy 13
Clinodactyly = Trisomy 21
Overlapping = Trisomy 18
Hitch Hiker Thumb = Diastrophic dysplasia
Fetal Skull Problems
Lemon = Chiari II, Cephalocele, Normal
Strawberry = Trisomy 18
Cloverleaf = Thanatophoric
Spalding’s Sign = Demise
Demineralized Fetal Skull
OI 2, Hypophosphatasia Congenita, Achondrogensis
2 Vessel Cord (735P)
Trisomy 13/18, LBWC, Normal Variant
Fluid in Fetal Chest
Effusion, Hydrops
Fetal Chest Mass
CDH, CCAM, Seqestration, Broncho-genic Cyst, Bronchial Atresia
Cystic = CCAM 1&2, CDH, BC, CLE
Pericardial Effusion
Viral (CMV, HIV), CHD/Arrhythmia, Hydrops
Fetal Kidney Cysts / Cystic Mass
MCDK, Hydro/Obstruction, Meckel Gruber
Fetal Abdominal Mass
Cystic = Duplication Cyst, Ovarian Cyst, Meconium Pseudocyst, Teratoma, PUV & Bladder Obstruction, Mesenteric & Omental Cyst, Choledochal, Renal Cysts & Hydro, Dilated Bowel/SBO, Umbilical Vein Varix, Hydrometrocolpos, Mesoblastic Nephroma (MN) Solid = Meconium Pseudocyst, Sacro-coccygeal Teratoma, NB, MN
Peri-Ass Mass
Sacrococcygeal Teratoma, Myelo-meningoceal
Double Bubble
Duodenal Atresia/Stenosis & Web, Preduodenal PV, Ladds Bands, Malrotation, Annular Pancreas
No Stomach (Similar to Poly)
Oligo, EA, CDH & Chest Mass, CNS & Swallow Problem, Situs
Fetal Liver Calcifications
Idiopathic, TORCH, Ischemia, Neoplasm (Hepatoblastoma, NB Mets, Hemangio-endothelioma?), Meconium Peritonitis (Perihepatic)
Fetal Abdominal Calcifications
Meconium Peritonitis & Pseudocyst, Intraluminal Meconium (Anorectal Malformation & Meconium Ileus), CMV, Toxo, NB, Teratoma, Hepatoblastoma
Echogenic Bowel
Normal Variant, Downs, CF
Fetal Ascites
Pseudoascites (muscle), Urinary, Meconium Peritonitis, Ruptured Ovarian Cyst, Infection, Hydrops
Hydronephrosis
UPJ/UVJ, Reflux, Prune Belly, PUVs, Megacystis, Compressing Pelvic Mass
Nonvisualized Fetal Bladder
Bilateral Renal Agenesis, Bilateral UPJ, Bilateral MCDK, ARPKD, Exstrophy, Severe IUGR
Absent Fetal Kidney
Shadowing from Spine, Pelvic Kidney, Crossed Ectopia, Unilateral Agenesis
Choroid Plexus Cyst
Normal (2%), Trisomy 18/21
Fetal Neck Mass
Posterior = Hygroma ( Hydrops), Cephalocele, Cervical Myelomeningocele Anterior = Teratoma, Fetal Goiter, Thyroglossal Cyst, Branchial Cleft (usually lateral)
Fetal Intracranial Mass
Hemorrhage, Lipoma, Teratoma
Ventriculomegaly
Hydrocephalus, Holoprosencephaly (NO cavum/falx), Hydranencephaly (+Falx)
Hydrocephalus
Aqueductal Stenosis (Normal 4 th), Chiari II (Lemon, Banana), DW, Communicating Hydro (TORCH, Downs) Mild Ventriculomegaly (11-15mm) = CCA, Downs, TORCH, Normal Variant
Brain Cyst (NOT Hydro)
Arachnoid Cyst, Porencephalic Cyst, Schizencephaly, Holoprosencephaly (Dorsal Cyst), CCA (IH Cyst), VOGA, Teratoma
Enlarged Cisterna Magna
DW, Trisomy 13/18, Arachnoid Cyst, Normal Variant (Mega Cisterna Magna)
Absent CSP
CCA, Holoprosencephaly
Adnexal Mass in Pregnancy
Corpus Luteum, Hemorrhagic Cyst, Endometrioma, Teratoma, Neoplasm
Tamoxifen Effects (313P)
Increased Endometrial Hyperplasia, Polyps & Cancer
Antiestrogen drug w/ weak estrogenic activity
Cystic Changes in Uterus
Adenomyosis, Tamoxifen, EM Polyp or Hyperplasia, GTD (actually in placenta), Arcuate Veins
Simple Adnexal Cyst
Functional Cyst, Paraovarian Cyst, Peritoneal Inclusion Cyst, Hydrosalpinx, Cystic Neoplasm (Cystadenoma)
Complex Adnexal Mass
Ecoptic Pregnancy, TOA, Hemorrhagic Cyst, Endometrioma, Dermoid, Ovarian Neoplasm or Mets
Thick EMS
Hyperplasia, EM Cancer, Polyps
If Pregnant = EP, RPOCs, GTD