Imaging SBAs Unit 5

Question 1

Round pneumonia may not feature

Answer 1

Air bronchograms

Question 2

Prenatal US, large cystic area with normal cerebellum but no cortical mantle

Answer 2

Hydrancephaly

Question 3

VACTERL

Answer 3

Vertebral defects (hemivertebrae, segmentation faults, bony bars, scoliosis)
Anorectal anomalies (anal atresia)
Cardiac anomalies and Cleft palate
TracheoEsophageal fistula/oesophageal atresia
Radial ray (thumb) and Renal abnormalities
Limb abnormalities

Question 4

Abnormality on pelvic US in female (child), next step

Answer 4

MRI (TV US generally avoided in kids)

Question 5

Cystic nephroma features

Answer 5

Surrounding claw of normally enhancing renal parenchyma,
Septal enhancement
Corresponding photopaenic area on DMSA,
Herniation of cysts into renal pelvis and proximal ureter

Question 6

Normal prepubertal uterus size

Answer 6

Fundal AP <1cm,
CC length 2.5-4cm

Question 7

Neuroblastoma staging imaging

Answer 7

CT chest,
MRI head, neck, abdomen, pelvis,
MIBG scintigraphy,
sometimes also 99mTC skeletal scintigraphy

Question 8

Urachus anatomy

Answer 8

Anteriosuperior dome of bladder to umbilicus

Question 9

2 uterine horns with no communication between them

Answer 9

Uterine didelphys

Question 10

Uterine congenital anomalies

Answer 10

Didelphis: Complete uterine duplication/
2 cervices, 2 uteri, 2 upper 1/3 vagina
Bicornate: Can be unicollis (1 cervix) or bicolllis (2 cervices)
Uterus separated by deep myometrial cleft. Fundal contour less than 5mm above ostia (often below)
Septate uterus:
Most common, causes fertility issues.
Fundal contour is normal (>5mm above ostia)
Arcuate: Milk smooth concavity of fundus, considered normal variant

Question 11

Billiary atresia can have

Answer 11

Normal gallbladder

Question 12

Meds used for Meckels scan

Answer 12

Pentagastrin, Glucagon, Cimetidine

Question 13

Annular pancreas causes (kids)

Answer 13

Duodenal stenosis (not necessarily complete obstruction)

Question 14

Child UTI Imaging guidance

Answer 14

Under 6 months:
Responds well to treatment: US within 6 weeks
Atypical or recurrent: US acutely, MCUG and DMSA within 4-6 months.
6mo-3yrs:
Atypical: US acutely and DMSA 4-6 months.
Recurrent: US 6 weeks and DMSA 4-6 months.
3yrs+:
Atypical: US acutely
Recurrent: US 6 weeks and DMSA 4-6 months

Question 15

Hypoplastic left heart syndrome associated with

Answer 15

Coarctation in 80% of cases

Question 16

Aneurysmal bone cyst Rx

Answer 16

Pre-op selective arterial embolisation and complete resection

Question 17

Normal angles of mature hip on US

Answer 17

alpha >60 (angle between straight lateral edge of ileum and bony acetabular margin)
Beta <77 (angle between straight lateral edge of ilium and fibrocartilaginous margin)

Question 18

Abnormal hip angles comparison

Answer 18

Alpha <60, beta >77: Dysplastic hips
Alpha >60 (normal), Beta >77: Decentered, subluxed hip
Alpha <60, Beta <77 (normal): deficient bony acetabulum

Question 19

First line Ix for intussusception

Answer 19

Abdo USS

Question 20

Commonest congenital diaphragmatic hernia

Answer 20

Bochladek (can occur on right too)

Question 21

Bilious vomiting, redcurrant jelly stools, 2YO

Answer 21

Midgut volvulus with subsequent vascular compromise, needs urgent upper GI

Question 22

Pulmonary oligaemia, elevated apex.
Right atrial enlargement and tricuspid regurg

Answer 22

Ebstein anomaly

Question 23

Aggressive, permeative metaphyseal lesion with fluid-fluid levels

Answer 23

Telangectatic osteosarcoma

Question 24

Horizontal bronchi and wide carina

Answer 24

Polysplenia/left heterotaxia

Question 25

Irregular sella mass with high T1, High T2, enhancement and T2* drop out

Answer 25

Craniopharyngioma (adamantinomatous (kid) type with calcifications)

Question 26

Anterior neck lump near thyroid cartilage, not moving on tongue protrusion

Answer 26

(atypical) thyroglossal cyst

Question 27

Dandy walker malformation vs variant

Answer 27

Variant: Only partial vermian hypoplasia, non-enlarged posterior fossa and non-displaced tentorium

Question 28

Cyanosis at birth, flattened pulmonary arteries

Answer 28

Tricuspid atresia

Question 29

Commonest type of tracheo-oesophageal fistula

Answer 29

Type C (Proximal atresia, distal fistula)

Question 30

Soft tissue density mass in mediastinum, compressing major airway

Answer 30

Bronchogenic cyst