Exam 3 Flashcards
Know the techniques helpful in ensuring the cooperation of a pediatric patient during examination
-Speak softly
-make steady eye contact
-allow child to become familiar w/ room
-feed infant during exam
-parent hold child’s hand
-use warm gel
distract child
-scan between screaming child’s breaths
Know wilson’s disease
- Rare
- Faulty copper metabolism
- eventually results in severe damage to liver & brain
- Diagnosis: Blood & urine test + liver biopsy
- Treatment: penicillamine
- Signs: eyes may have a green ring around them
Hemangioendothelioma in the pediatric patient is considered dangerous in relation to risk of?
Hemmorage
Know most common primary malignant liver neoplasm
Hematoblastoma
Congenital anomaly that is discovered in a pediatric patient is a choledochal cyst this anomaly is associated with?
- Congenital cyst-like dilation of CBD
- Different types
- Most common is a cyst like mass in the porta-hepatis region
- Diagnosed in patients w/ intermittent RUQ pain, Jaundice, palpable RUQ mass
Know biliary atresia in pediatric patient
- Ducts from liver to duodenum are obliterated
- Prognosis depends on duration of condition
- Important to differentiate from neonatal hepatitis
- US Appearance: Non visualization of GB, GB is less than 1.5cm
Location of neuroblastoma
Adrenals
Hemorrhage of adrenal glands most seen in patents?
2-7 days old
Sonographic appearance of thyroid adenoma
- US appearance varies
- Majority solid & hypoechoic (98%)
- May be isoechoic or hypoechoic
- Peripheral echolucent halo (doesn’t rule out thyroid carcinoma)
- degenerating adenomas may be complex in appearance (containing solid components)
US appearance/ characteristics of Hashimoto’s Thyroiditis
- Enlarged
- Heterogeneous
- Coarse
- Hypervascularity
- May have discreet nodules
- Calcifications
Signs and symptoms of Grave’s disease
- Anxiety
- Irretability
- Tremor in hands & fingers
- Heat sensitive
- Bulging eyes
- Goiter (Enlarged thyroid glands)
- Thick red skin
Parathyroid adenoma produces an excess of?
parathyroid hormone
Location of thyroglossal duct?
- ML anterior to trachea
- anterior to thyroid
- superior to thyroid
Most likely to be mistakenly interpreted as a mass of thyroid or parathyroid gland?
Longus Colli
Most common type of thyroid carcinoma?
Papillary 60-70%
US features of thyroid carcinoma
- Irregular borders
- Tiny calcifications
- Cystic & Solid components
- Thick incomplete halos
- many times hypoechoic
Tissue that connects both thyroid lobes?
Isthamus
Signs and Symptoms of hypothyroidism
- Fatigue
- Flakey dry skin
- Weight gain
- Heavy menses
- Intolerance to cold
Location of ____________ lateral to carotid arteries.
cyst
Parathyroid adenoma lab values
increased/elevated calcium or hypercalcemia
Location of Mcburney’s Point
RLQ
Symptoms & signs of appendicitis
- Pain @ preumbilical region and localizing to RLQ (Mcburney’s)
- Rebound tenderness
- Anorexia, Nausea, vomiting, Diarrhea
- Fever
- Leukocytosis
Risk of developing appendicitis in ___________ population.
young adults
Size of normal Appendix
less than 6mm
Appearance of appendicitis in TRV and SAG planes
Bull’s eye - TRV
Finger like - SAG
Normal size of lymph nodes in the pelvis and abdomen
<1cm
Location of lymph nodes
- Neck
- Armpits
- Collarbones
- Armpits
Which type of lymphoma has less cure rate/ or higher cure rate - hodgkins or non hodgkins?
Hodgkins - high cure rate
Non-Hodgkins - low cure rate
US characteristics of normal and enlarged lymph nodes
?
Bladder outlet obstruction in newborns is caused by _____________?
Posterior urethral Valves
Review mesenchymal hamartoma
- Rare
- Occurs in infants and children under 2
- Derived from embryonal tissue
- US: variable, well circumscribed, may have stellate appearance may have trabecular appearance
Know US appearance of infant kidneys
- central portion less echogenic
- Echogenicity of cortex isoechoic to liver or hypoechoic to liver if premature
- Pyramids larger & more prominent
- Contour may be lobulated due to residual fetal lobulation
Causes of hydronephrosis in neonates, which one is most common
-Most common cause is ureteropelvic junction obstruction (UPJ)
Know appendicitis care fully + types
acute chromatic gangrenous
?
US appearance of appendicolith
May be present w/ distal shadowing
US appearance of bowel wall
Hypoechoic with echogenic rim
Large popcorn type calcifications seen on mammography are associated with________?
?
Best transducer for US imaging of the breast?
7 - 12.0 MHZ linear transducer
Snowstorm sign - review it carefully
appear as dirty shadowing or noise representing a silicone granuloma
Complications of breast implants
- Hematoma
- Abscess
- Silicone or saline bleed
- Capsular contracture
- Implant rupture
Review phyllodes tumor
- Rare
- Solid tumor
- Benign or Malignant
- Arises from stromal tissue of breast
- More common in women 30-50
- Usually solitary
- Large & palpable
Intracapsular rupture of silicone breast implant appear like ladder sign on US, on MRI it would appear like ______________?
Linguine Sign
Know the names of all benign breast lesions
- Fibroadenoma (most common)
- simple cyst
- fibrocystic change FCC
- Complicated versus complex cyst
- Galactocele
- Sebaceous cyst
- Mastitis
- Abscess
- Mondor Disease
- Phyllodes Tumor
- Lipoma
- Hematoma
- Seroma
- Fat Necrosis
- Adenoma + secretory ad
- hamartoma
- intraductal papilloma
- papillomatosis
Do you think simple breast cysts need treatments?
Need treatment based on BIRADS designation if they meet criteria for simple cyst they can be set BIRADS 2 - benign = no treatment
Know BIRADS categories.
Cat 0 - inconclusibe findings; need additional imaging Cat 1 - normal Cat 2 - Benign Cat 3 - Probably Benign Cat 4 - Suspicious Cat 5 - Malignant
US characteristics of malignant breast lesions.
- Round, oval, or elipsed shape
- Wider than tall: horizontal orientation, do not cross tissue planes
- Smooth Well defined borders
- Microlobulation
Know increased risk factors for development of breast cancer
Gender
- Age
- family history
- Menstrual history
- child bearing history
- Hormonal factors
- atypical hyperplasia
- Radiation therapy
- Obesity
Cranio - caudal view in Mammography is useful in ________________ mass localization
Medial or Lateral?
Which quadrant in breast is most common to find cancer?
Upper outer quadrant
Location of tail of the breast?
Tail of spence is located superio-lateral to breast almost axilla region
