Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EDIR Notebook > Pediatric > Flashcards

Pediatric Flashcards

1
Q
  1. Regarding hypertrophic pyloric stenosis, which of the following are correct:
    (a) It is frequently diagnosed in premature infants.
    (b) Males and females are equally affected.
    (c) The peak incidence is between 2 and 6 months of age.
    (d) It is associated with gastric pneumatosis.
    (e) An elongated pyloric canal measuring 14 mm on ultrasound supports the diagnosis.
A

Answers:
(a) Not correct
(b) Not correct
(c) Not correct
(d) Correct
(e) Not correct
Explanation:
Hypertrophic pyloric stenosis is typically seen in first born males with peak incidence between 2 and 6 weeks of age.
It is rarely seen in premature infants.
To make a diagnosis on ultrasound the pyloric canal length should be 17mm, pyloric wall thickness atleast 3 mm and
transverse diameter of pylorus atleast 13 mm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  1. Regarding infantile polycystic kidney disease, which of the following are correct?
    (a) The most common age of presentation is between 2 and 5 years of age.
    (b) It is inherited as an autosomal dominant condition.
    (c) Severe infantile polycystic disease is associated with severe hepatic fibrosis.
    (d) Is typically reveals a striated nephrogram on the delayed excretory urogram.
    (e) Infantile polycystic kidneys are echopoor on ultrasound
A

Answers:
(a) Not correct
(b) Not correct
(c) Not correct
(d) Correct
(e) Not correct
Explanation:
Infantile polycystic kidney disease is inherited in an autosomal recessive pattern with antenatal form being the most
common type. This type presents in utero and progresses to renal failure and pulmonary hypoplasia (Potter sequence)
with majority of patients dying within 24 hrs of life.
The milder forms are neonatal, infantile and juvenile presenting in the first few years of life. They are associated with
more severe hepatic fibrosis and less severity of renal disease.
The affected kidneys are replaced my multiple small elongated cysts representing dilated tubules and collecting ducts.
The cysts are too small to be delineated on ultrasound, thus producing an echogenic pattern due to multiple interfaces.
There is poor corticomedullary differentiation.
Adult type polycystic disease shows autosomal dominant inheritance with defects on chromosome 16 and 4.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  1. In childhood which of the following are correct regarding non-Hodgkin’s lymphoma?
    (a) Non-Hodgkin’s lymphoma is more common than Hodgkin’s disease in young children.
    (b) Splenic involvement occurs in more than 70 % of cases atpresentation.
    (c) Pulmonary involvement is more common in Hodgkin’s disease.
    (d) Central nervous system disease at presentation indicates a poor prognosis.
    (e) There is a higher incidence of extra-nodal disease in childhood non-Hodgkin’s lymphoma than when it occurs
    in adults.
A

Answers:
(a) Correct
(b) Not correct
(c) Correct
(d) Correct
(e) Correct
Explanation:
Abdominal involvement in non-Hodgkin’s usually presents with a mass typically at ileocaecal region or
intussusception causing obstruction.
Splenic involvement is seen in less than 40% of cases at presentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  1. Which of the following statements are correct?
    (a) The normal thymus in a child is hypoechoic relative to the liver.
    (b) The thymus is highly vascular on color Doppler ultrasound.
    (c) The thymus arises from the third and fourth branchial pouches.
    (d) Teratomas comprise the most common anterior mediastinal mass in childhood.
    (e) Thymolipomas are common causes of thymic enlargement in childhood.
A

Answers:
(a) Correct
(b) Not correct
(c) Correct
(d) Not correct
(e) Not correct
Explanation:
Normal thymus is hypovascular on color Doppler.
Thymic hyperplasia is the most common anterior mediastinal mass in childhood. It may be secondary to
hyperthyroidism, myasthenia gravis and rebound growth following illness or stress.
Thymomas and Thymolipomas are extremely rare in childhood. Neoplastic involvement is usually secondary to
infiltration by leukemia or lymphoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  1. Which of the following statements are correct?
    (a) The ‘H’ type traheo-oesophageal fistula is the most common.
    (b) Duodenal atresia usually presents with bilious vomiting.
    (c) Duplication cysts of the gastrointestinal tract are most common in the ileal region.
    (d) Duodenal duplication cysts are located on the convex border of the duodenum.
    (e) Duodenal atresia is associated with malrotation of the small bowel.
A

Answers:
(a) Not correct
(b) Correct
(c) Correct
(d) Not correct
(e) Correct
Explanation:
The H type trachea-esophageal fistula is seen only in 10% cases. Upper esophageal atresia with a fistula between
lower esophagus and trachea is the most common type (85%).
Duodenal duplication cysts are usually situated along the concave border where they may cause duodenal obstruction,
biliary obstruction or pancreatitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  1. Which of the following statements are correct?
    (a) Vesico-ureteric reflux usually occurs into the lower pole moiety of a complete ureteral duplication
    (b) Ectopic ureterocoeles in duplex kidneys are more common in boy than girls.
    (c) An ectopic ureteral insertion may present with daytime incontinence in a girl.
    (d) Horseshoe kidneys are associated with a higher incidence of duplicated kidneys.
    (e) Ectopic ureteral insertion in boys in always supra-sphincteric.
A

Answers:
(a) Correct
(b) Not correct
(c) Correct
(d) Correct
(e) Correct
Explanation:
Ureterocoeles which are related to the upper pole moiety of a duplex kidney occur 8 times more frequently in girls
than boys.
Ureterocoeles related to non-duplicated system show an equal gender incidence.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
  1. Which of the following statements are correct?
    (a) Ewing’s tumors rarely arise within flat bones.
    (b) Giant cell tumors of bone are most commonly seen in the 5-15 years age group.
    (c) Parosteal osteosarcomas have a peak in the 10-20 years age group.
    (d) Eosinophilic granuloma usually involves one bone only.
    (e) Ewing’s tumors often demonstrate calcification on CT.
A

Answers:
(a) Not correct
(b) Not correct
(c) Not correct
(d) Correct
(e) Not correct
Explanation:
About 60% of Ewing tumors arise in long bones, most common site is metadiaphysis of femur. About 40% arise in flat
bones especially in pelvis, particularly in patients over 20 years age. Calcification is rare in Ewing’s tumor of bone.
It typically presents with an onion skin periosteal reaction on radiograph.
Majority of giant cell tumors occur in patients following fusion of the epiphysis. Thus usually occur after 18-20 years
of age. They have a narrow zone of transition and usually abut the articular margin.
Parosteal osteosarcomas occur in an older age group than the periosteal type with 50% occurring after 30 years of
age.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  1. Regarding hepatoblastomas, which of the following are correct?
    (a) Alpha-fetoprotein levels are not elevated.
    (b) Presentation is usually after 4 years of age.
    (c) Following intravenous contrast enhanced CT, hepatoblastomas are hypodense relative to the surrounding liver.
    (d) Calcification is rarely seen.
    (e) MRI characteristics of hepatocellular carcinomas and hepatoblastomas are similar.
A

Answers:
(a) Not correct
(b) Not correct
(c) Correct
(d) Not correct
(e) Correct
Explanation:
Hepatoblastomas typically present as an abdominal mass in an asymptomatic child under 2 yrs of age. Hepatocellular
carcinoma presents over 4 yrs of age.
Both hepatoblastomas and hepatocellular carcinoma cause elevated alpha-fetoprotein levels. Hepatoblastomas are
associated with hemihypertrophy and Beckwith-Wiedemann syndrome.
Calcification is present in 50% cases of hepatoblastomas.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
  1. Regarding Eosinophilic granuloma, which of the following are correct?
    (a) Bone lesions are usually solitary
    (b) The mandible is rarely involved
    (c) Vertebral pedicels are typically affected
    (d) The cranial vault is rarely involved
    (e) A periosteal reaction is not seen on plain film.
A

Answers:
(a) Correct
(b) Not correct
(c) Not correct
(d) Not correct
(e) Not correct
Explanation:
EG typically involves the vertebral body, most commonly the thoracic spine, causing vertebra plana.
The skull is the most frequent site of involvement. Typically , there is round or oval lucency within the skull vault with
beveled edges.
It often involves the mandible causing ‘floating tooth ‘ appearance.
A periosteal reaction is not usually seen however it is not unusual in axial skeleton.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
  1. Regarding wormian bones, which of the following are correct?
    (a) They typically involve the coronal suture
    (b) They are a normal finding up to 18 months of age.
    (c) They are a feature of Down’s syndrome
    (d) They are seen in sickle cell anaemia
    (e) They are a feature of rickets
A

Answers:
(a) Not correct
(b) Not correct
(c) Correct
(d) Not correct
(e) Correct
Explanation:
Wormian bones are a normal finding upto 6-12 months of age.
They typically involve the lambdoid and posterior Sagittal sutures, extending around the posterior fontanelle.
Sickle cell and other types of anemia cause ‘hair on end’ appearance of cranial vault.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  1. Which of the following are correct of non-accidental injury (NAI):
  2. Cerebral injury from shaking is most common over 2 years of age
  3. Diaphyseal fracture are more common than metaphyseal fractures
  4. Multiple rib fracture are highly suspicious of NAI
  5. Spiral fracture of the tibia is highly suspicious
  6. Inter hemispheric subdural hematoma is an atypical finding
A

Answers:
1. Not correct
2. Correct
3. Correct
4. Not correct
5. Not correct
Explanation:
Cerebral injury from shaking is common below 2 years of age.
Spiral fractures of tibia occur usually secondary to trivial twisting injuries.
Inter hemispheric subdural hematoma is highly suspicious of NAI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
  1. Which of the following are correct regarding paediatric intussusception:
    (a) Accounts for over 75 % of paediatric intestinal obstruction
    (b) Plain films are typically abnormal
    (c) Typically occurs between 4-8 years of age
    (d) A lead point is identified in over 50 % of cases
    (e) Pneumoperitoneum is a contraindication to air reduction
A

Answers:
(a) Correct
(b) Not correct
(c) Not correct
(d) Not correct
(e) Correct
Explanation:
In intussusception plain films can be normal in 50% cases with highest incidence between 3 months and 4 years of
age. In children 95 % intussusception are idiopathic with no lead point.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. Which of the following are correct regarding radiological features of achondroplasia
    (a) Dilatation of the lateral cerebral ventricles
    (b) Decreased interpedicular distance caudally within the spine
    (c) Short fibs
    (d) Anterior vertebral scalloping
    (e) Relative shortening of fibula
A

Answers:
(a) Correct
(b) Correct
(c) Correct
(d) Not correct
(e) Not correct
Explanation:
Posterior vertebral scalloping and relative lengthening of fibula are seen in achondroplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  1. Which of the following are correct regarding slipped upper femoral epiphysis
    (a) Is seen typically between 4-8 years of age.
    (b) The line of Klein should intersect the normal femoral head.
    (c) Is bilateral in one third of cases.
    (d) The epiphysis slips postero-medially.
    (e) Subchondral lucency is an early sig
A

Answers:
(a) Not correct
(b) Correct
(c) Correct
(d) Correct
(e) Not correct
Explanation:
It is seen usually between 8-17 years of age.
Subchondral lucency is an early sign of Perthe’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  1. The following are CNS features of tuberous sclerosis.
    (a) Presentation is usually with seizures.
    (b) Subependymal nodules are most common in the occipital horn of the lateral ventricles.
    (c) Pilocytic astrocytoma is a complication.
    (d) Cortical tubers are most prominent on T1W MRI.
    (e) Calcification may be seen in upto 50 % on skull X-ray.
A

Answers:
(a) Correct
(b) Not correct
(c) Not correct
(d) Not correct
(e) Correct
Explanation:
In tuberous sclerosis subependymal nodules are most common along ventricular surface of caudate nucleus, with
cortical tubers which are most prominent on T2W and FLAIR.
Giant cell astrocytoma is a complication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  1. Which of the following are correct regarding retinoblastoma
    (a) Is the most common intra-ocular malignancy in childhood.
    (b) Ultrasound demonstrates a hypoechoic mass in the posterior globe.
    (c) Is associated with pineblastoma.
    (d) Is bilateral in 66 %.
    (e) CT shows calcification in 90 %.
A

Answers:
(a) Correct
(b) Not correct
(c) Correct
(d) Correct
(e) Correct
Explanation:
Retinoblastoma is the most common intraocular neoplasm of childhood.
It appears as hyperechoic mass on ultrasound with variable shadowing due to calcification and heterogeneity due to
necrosis and/or hemorrhage.

17
Q
  1. Which of the following are correct regarding congenital diaphragmatic hernias
    (a) Most congenital hernias are of the Morgagni type
    (b) Defective closure of the pleuroperitoneal membranes leads to a Bochdalek hernia
    (c) Right sided hernias may have a delayed presentation
    (d) Bochdalek hernias are usually left sided
    (e) Congenital cystic adenomatoid malformation is a differential diagnosis
A

Answers:
(a) Not correct
(b) Correct
(c) Correct
(d) Correct
(e) Correct
Explanation:
Bochdalek hernia is most common congenital hernia (85%-90%).
Morgagni type is seen in 10%-15% of the cases.

18
Q
  1. Which of the following are correct regarding congenital lobar emphysema
    (a) It commonly affects the lower lobes
    (b) Bilateral involvement is rare
    (c) It typically presents in the perinatal period.
    (d) Underlying vascular markings are present
    (e) The affected lobe is opaque after birth
A

Answers:
(a) Not correct
(b) Correct
(c) Not correct
(d) Correct
(e) Correct
Explanation:
Congenital lobar emphysema most commonly affects left upper lobe. Lower lobes involvement is seen in only 2 %. In
25% cases, presentation is not seen in perinatal period.

19
Q
  1. Which of the following are correct regarding duodenal atresia:
    (a) The double bubble sign may be seen on ultrasound examination
    (b) The double bubble sign is specific for duodenal atresia
    (c) Polyhydramnios gas is not seen distal to the atretic segment
    (d) Bowel gas is not seen distal to the atretic segment
    (e) Over 50 % are associated with down’s syndrome
A

Answers:
(a) Correct
(b) Not correct
(c) Correct
(d) Not correct
(e) Not correct
Explanation:
Double bubble sign is also seen in duodenal stenosis, annular pancreas and preduodenal portal vein.
In bifid CBD insertion bowel gas may not be seen distal to atretic segment.
1/3rd of cases are associated with Down’s syndrome.

20
Q
  1. Which of the following are correct regarding Sturge-Weber syndrome
    (a) Cortical gliosis is a feature.
    (b) It is accompanied by lepto-meningeal angiomas on the contralateral side.
    (c) Underlying cortical calcification is common.
    (d) Angiomas are more common over the frontotemporal regions.
    (e) It involves a port-wine stain affecting the trigeminal nerve distribution
A

Answers:
(a) Correct
(b) Not correct
(c) Correct
(d) Not correct
(e) Correct
Explanation:
In Sturge-Weber syndrome, lepto-meningeal angiomas are seen on ipsilateral side and angiomas are more common
over parieto-occipital region.

21
Q
  1. Which of the following are correct regarding imaging of the testis:
    (a) An appendix is present in over 90 % of males
    (b) Examination of the contralateral testis is mandatory in possible torsion
    (c) A hydrocele may cause false positive diagnosis of torsion on scintigraphic evaluation
    (d) Torsion is most common in the neonatal age group
    (e) A torted testis is usually of high echogenicity on ultrasound
A

Answers:
(a) Correct
(b) Correct
(c) Correct
(d) Not correct
(e) Not correct
Explanation:
Torsion of testis is rare in neonates.
A torted testis is usually hypoechoic on ultrasound due to congestion, infarction and edema.

22
Q
  1. The following are features of osteogenesis imperfecta:
    (a) Multiple wormian bones
    (b) Most cases involve an autosomal dominant mode of inheritance
    (c) Dense, sclerotic bones
    (d) Exuberant callus formation around features
    (e) Basilar invagination
A

Answers:
(a) Correct
(b) Correct
(c) Not correct
(d) Correct
(e) Correct
Explanation:
Osteogenesis imperfecta are heterogeneous group of congenital, non-sex-linked, genetic disorders of collagen type I
production, involving connective tissues and bones.
The hallmark feature of osteogenesis imperfecta is osteoporosis and fragile bones; hence bones show diffuse
demineralization and cortical thinning.

23
Q
  1. Radiological features of rickets include:
    (a) Widening of growth plate as a late sign
    (b) Radiological sign indicate the underlying etiology
    (c) Bulbous anterior rib ends
    (d) A sclerotic rim surrounding the epiphysis
    (e) Dense metaphyseal bands
A

Answers:
(a) Not correct
(b) Not correct
(c) Correct
(d) Not correct
(e) Correct
Explanation:
Rickets essentially refers to osteomalacia in the paediatric population that occurs prior to fusion of the growth
plate.The onset and presentation of rickets depends on the etiology and degree of deficiency. Typically in severe cases
rickets becomes apparent in the second year of life.
However radiological signs are the same and cannot indicate underlying etiology. Widening of growth plate is an
early sign.
Sclerotic rim surrounding the epiphysis is seen in scurvy.

24
Q
  1. Radiological features of absent corpus callosum include:
    (a) A high riding third ventricle
    (b) Enlargement of the occipital horns
    (c) Crescentic lateral ventricles
    (d) Hypoplasia of the optic nerves
    (e) Separation of pericallosal arteries on angiography
A

Answers:
(a) Correct
(b) Correct
(c) Correct
(d) Correct
(e) Correct
Explanation:
Dysgenesis of the corpus callosum may be complete (agenesis) or partial and represents an in utero developmental
anomaly. There appears to be a male predilection (M:F ~2:1).
Maternal alcohol consumption during pregnancy has been recognized as another risk factor

25
Q
  1. Radiological findings in sickle cell disease include:
    (a) ‘Hair-on-end’ skull appearance
    (b) Premature conversion of red to fatty bone marrow
    (c) Salmonella osteomyelitis
    (d) Subperiosteal new bone formation in the tubular bones of the hand and feet
    (e) Enlarged kidneys.
A

Answers:
(a) Correct
(b) Not correct
(c) Correct
(d) Correct
(e) Correct
Explanation:
Sickle cell disease is a hereditary condition caused by the formation of abnormal haemoglobin, which manifests as
multisystem ischemia and infarction, as well as hemolytic anemia. The disease carries an autosomal recessive
inheritance.
Conversion of red to fatty bone marrow is delayed. In late stages of disease kidneys can be small in size due to
infarcts.

26
Q
  1. Features of Swyer-James syndrome include:
    (a) Increased lucency of a hemithorax
    (b) Increased hilar markings, with peripheral pruning
    (c) Mild bronchiectasis
    (d) Air trapping during expiration
    (e) Typically a lobar or segmental distribution
A

Answers:
(a) Correct
(b) Not correct
(c) Correct
(d) Correct
(e) Not correct
Explanation:
Swyer-James syndrome is a rare lung condition that manifests as unilateral hemithorax lucency as a result of postinfectious
obliterative bronchiolitis.
It is generally characterized on radiographs by a unilateral small lung with hyperlucency and air trapping. Diminished
vascular markings are seen.

27
Q
  1. Regarding the Dandy-Walker malformation which of the following are correct:
    (a) There is inferior displacement of the vein of Galen
    (b) There is a high lying tentorium
    (c) The cerebellar vermis is normal
    (d) The corpus callosum is absent in up to 25 %
    (e) The posterior fossa is small
A

Answers:
(a) Not correct
(b) Correct
(c) Not correct
(d) Correct
(e) Not correct
Explanation:
Dandy Walker malformation is the most common posterior fossa malformation and consists of a triad of hypoplasia of
vermis with cephalad rotation of vermis remnant, cystic dilatation of fourth ventricle and enlarged posterior fossa.
There is superior displacement of vein of Galen.

28
Q
  1. Which of the following are correct regarding features of Ewing sarcoma:
    (a) Presentation with systemic sign and symptoms is recognized.
    (b) Is usually located in the epiphyses
    (c) Most commonly affects flat bones in children
    (d) Onion skin periosteal reaction is a rare radiological finding.
    (e) MRI demonstrates a soft tissue mass in 80-90% of patient
A

Answers:
(a) Correct
(b) Not correct
(c) Not correct
(d) Not correct
(e) Correct
Explanation:
Majority of Ewing sarcoma are located in diaphysis of the humerus, femur, tibia and fibula. Epiphysis is a rare
location. In the first two decades lesions are predominantly located in long bones. After that time lesions in flat bones
are more usual.
Ewing is an aggressive tumor with permeative or moth eaten appearance on radiograph with lamellated, onion skin or spiculated periosteal reaction.

29
Q
  1. Which of the following are correct regarding developmental dysplasia of the hip (DDH):
    (a) Ultrasound diagnosis is best done in the first week of life.
    (b) Is more common in boy.
    (c) The smaller the alpha angle, the greater the degree of acetabular dysplasia.
    (d) The triradiate cartilage is hyperechoic on ultrasound
    (e) Avascular necrosis of the femoral head is a recognized complication.
A

Answers:
(a) Not correct
(b) Not correct
(c) Correct
(d) Not correct
(e) Correct
Explanation:
DDH is more common in females with female to male ratio of 8:1. Most dislocations occur within first 2 weeks of
life. However examination should be done only after 1st weeks of life as instability is commonly seen within first few
days with as much as 6 mm motion of femoral head.
The triradiate cartilage is hypoechoic on ultrasound. The bony acetabulum, cartilaginous labrum and bony ilium are
hyperechoic on ultrasound.

30
Q
  1. Which of the following are correct regarding radiological feature of malrotation:
    (a) Duodenojejunal flexure to the left of the spine
    (b) Superior mesenteric artery to the right of the superior mesenteric vein.
    (c) Spiral / corkscrew appearance of proximal jejunum.
    (d) Proximal jejunum located in the right side of the abdomen
    (e) Normal position of caecum excludes malrotation
A

Answers:
(a) Not correct
(b) Correct
(c) Correct
(d) Correct
(e) Not correct
Explanation:
A normal DJ flexure lies to the left of spine at the same level as or more superior to the duodenal bulb. In malrotation
the DJ flexure (ligament of Treitz) is abnormally positioned.
In malrotation the caecum is generally malpositioned in the right upper quadrant or in the left side of abdomen. In 20%
of patients with malrotation caecum is normally positioned.

31
Q
  1. The following features favour a diagnosis of Wilm’s tumor rather than neuroblastoma:
    (a) Presentation before 1 year of age.
    (b) Calcification
    (c) Lung metastases
    (d) Claw sign
    (e) The tumor displaces rather than engulfs the major vessels
A

Answers:
(a) Not correct
(b) Not correct
(c) Correct
(d) Correct
(e) Correct
Explanation:
Peak age of Wilm’s tumor is 3 years and neuroblastoma is most common in children below 2 years.
Stippled type of calcification is seen in 85% of cases of neuroblastoma. Calcification is uncommon in Wilm’s and is
seen as curvilinear or amorphous type in 15% cases.

32
Q
  1. Which of the following are correct regarding pulmonary sequestration:
    (a) 70-80 % of cases area intra-lobar
    (b) Usually communicates with the tracheobronchial tree.
    (c) The majority present in the first 6 months of life.
    (d) Blood supply is from the pulmonary arteries
    (e) The posterior part of the left lower lobe is most frequently involved
A

Answers:
(a) Correct
(b) Not correct
(c) Not correct
(d) Not correct
(e) Correct
Explanation:
Pulmonary sequestration is a congenital abnormality consisting of non-functioning primitive lung tissue not
communicating with tracheobronchial tree.
Intralobular form is more common and presents in adulthood with recurrent chest infections and high output cardiac
failure.
The blood supply is systemic, mostly from descending thoracic aorta. Contrast enhancement at the same time as
thoracic aorta is characteristic on CT.

33
Q
  1. The following are correct regarding umbilical catheters in neonates:
    (a) Typically, there are two umbilical veins and one umbilical artery.
    (b) Arterial catheters initially go caudally and posteriorly before coursing cephalad.
    (c) Venous catheters follow an anterior and cephalad course
    (d) The tip of a venous catheter should be placed below the right atrium
    (e) Portal vein gas is a bad prognostic sign
A

Answers:
(a) Not correct
(b) Correct
(c) Correct
(d) Correct
(e) Not correct
Explanation:
Typically there are two umbilical arteries and one umbilical vein.
Air may be introduced inadvertently in intrahepatic portal venous system at time of umbilical venous catheter
insertion. This is usually transient.

34
Q
  1. Which of the following are correct regarding renal masses in neonates:
    (a) Wilm’s tumor is the most common cause of an abdominal mass in neonates.
    (b) Mesoblastic nephroma is the most common fetal renal reoplasm.
    (c) Mesoblastic nephroma is easily distinguished from Wilm’s tumor on cross-sectional imaging
    (d) Extension into the renal vein is a feature of mesoblastic nephroma.
    (e) Mesoblastic nephroma is associated with oligohydramnios.
A

Answers:
(a) Not correct
(b) Correct
(c) Not correct
(d) Not correct
(e) Not correct
Explanation:
Hydronephrotic kidney is the most common abdominal mass in neonates.
Mesoblastic nephroma is associated with polyhydramnios and thus premature labor. It cannot be distinguished from
Wilm’s tumor on cross-sectional imaging. It is benign and does not invade venous structures, hence differentiating it
from Wilm’s tumor.

35
Q
  1. Which of the following are correct regarding necrotizing enterocolitis (NEC):
    (a) Most cases occur in term neonates.
    (b) Polycythaemia is a risk factor in term neonates.
    (c) Onset is always in the first week of life.
    (d) Most commonly affects the jejunum.
    (e) Mortality rate is about 20-40%
A

Answers:
(a) Not correct
(b) Correct
(c) Not correct
(d) Not correct
(e) Correct
Explanation:
NEC is predominantly a disease of premature infants weighing less than 2 kgs. Very premature infants develop NEC
until 2nd or 3rd week of life or later. Most infants however develop NEC in first few days of life.
NEC is a serious neonatal disease of unknown etiology, involving predominantly the distal ileum and proximal colon
characterized by mucosal or transmucosal necrosis of part of the intestine which may progress to perforation.

36
Q
  1. Which of the following are correct regarding Hirschprung’s disease:
    (a) Failure to pass meconium in the first 24 h of life is typical.
    (b) Causes functional large bowel obstruction.
    (c) A transition zone from small caliber to dilated colon is a constant finding on enema.
    (d) The rectum has a larger caliber than the sigmoid colon.
    (e) Microcolon is a recognized feature on enema
A

Answers:
(a) Correct
(b) Correct
(c) Not correct
(d) Not correct
(e) Correct
Explanation:
The pathognomonic finding of Hirchsprung disease on contrast enema is a transition zone between normal and
aganglionic bowel i.e. abnormally small rectum and distal colon to a dilated normal proximal colon. However in
25% of patients transition zone is not seen which does not rule out Hirchsprung disease.
In a normal patient rectum has the largest luminal diameter of the left sided colon. When rectum alone is involved the
sigmoid colon has larger diameter than rectum.

37
Q
  1. Which of the following are correct regarding oesophageal atresia (OA) and trachea-oesophageal fistula
    (TOF):
    (a) There is an association with Hirschprung’s disease
    (b) Plain radiograph may show a gasless abdomen.
    (c) A gasless stomach is typical of H-type fistula.
    (d) Recurrent pneumonia is a feature.
    (e) H-type fistula is the most common variant
A

Answers:
(a) Not correct
(b) Correct
(c) Not correct
(d) Correct
(e) Not correct
Explanation:
OA and TOF are associated with anomalies in the VACTERL group. OA is also associated with other atresias like
duodenal atresia and imperforate anus.
OA and TOF include a spectrum of anomalies involving trachea and esophagus. The most common type is N type i.e.
proximal OA and distal TOF. H type is TOF without OA thus a gasless stomach is not possible.

EDIR Notebook (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions