ERU-28&29 The Fetal GI and GU Systems

Question 1

When does the fetal gut develop?

Answer 1

End of the 5th week

Question 2

What anomalies are often associated with esophageal atresia

Answer 2

duodenal atresia, VACTERL association, Down syndrome, IUGR, tris 18

Question 3

What does “double bubble” sign indicate?

Answer 3

Duodenal atresia

Question 4

Duodenal atresia is associated with what diagnosis?

Answer 4

Tris 21, esophageal atresia, VACTERL association

Question 5

With what diagnoses is hepatomegaly associated?

Answer 5

Beckwith-Wiedemann, Rh incompatability, intrauterine infection

Question 6

hirschprung disease

Answer 6

Absence of innervation in the bowel wall resulting in bowel obstruction
Dilated fetal rectum noted on US

Question 7

Gastroschisis vs Omphalocele

Answer 7

G: Herniation of abd contents through a right-sided, periumbilical abd wall defect. Better prognosis. Less association with chromosomal abn.

O: An midline abd wall defect where there is herniation of the fetal bowel and other abdominal organs into the base of the umbilical cord. Cord inserts into midline of mass

Question 8

By what week of gestation should physiologic herniation resolve?

Answer 8

12

Question 9

What is the most common type of colonic atresia?

Answer 9

anorectal atresia

Question 10

When should the fetal stomach be visible on US?

Answer 10

14 weeks

Question 11

When do fetal kidneys form?

Answer 11

9 weeks formed

10 weeks functional

Question 12

What is the urachus and where is it located?

Answer 12

A canal connecting the fetal bladder with the allantois (membrane that contributes to bladder development)

Located between the apex of the bladder and the umbilicus

Question 13

When should the fetal bladder be visible on US?

Answer 13

By 15 weeks

Question 14

VACTERL

Answer 14

Vrtebral anomalies
Anal atresia
Cardiac anomalies
TracheoEsophageal fistula
Renal anomalies
Limb anomalies

Question 15

What does “lying down” adrenal sign indicate?

Answer 15

Renal ageneisi

Question 16

Meckel-Gruber syndroms

Answer 16

A fetal disorder that includes renal cystic disease, occipital encephalocele and polydactyly

Question 17

Multicystic Dysplastic Renal Disease

Answer 17

Findings include multiple, smooth walled, noncommunicating cysts of varying sizes in the renal fossa
Usually unilateral. Fatal if bilateral
Caused by early obstruction of the ureter

Question 18

Obstructive Cystic Dysplasia

Answer 18

Caused by early obstruction

Associated with peripheral renal cysts, ureterocele, thick walled bladder and hydronephrosis

Question 19

What is a normal renal pelvic diameter?

Answer 19

<20w : 7mm (AP plane). Borderline 4-6mm

>20w: 10mm. Borderline 5-9mm

Question 20

What does “keyhole sign” indicate on US?

Answer 20

Bladder outlet obstruction

Question 21

Prune Belly Syndrome

Answer 21

Caused by megacystis and a massively dilated urinary bladder. Usually seen in males 2/2 urethral abnormality.
Absent abd muscles, undescended testis, and urinary tract abn

Question 22

OEIS

Answer 22

Omphalocele, exstrophy of the bladder, imperforate anus, and spina bifida.

Question 23

Most common cause of solid fetal renal mass

Answer 23

Mesoblastic nephroma

Question 24

What is the most common malignant abd mass in neonates?

Answer 24

Neuroblastoma, usually located in the adrenal gland