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Small Parts/specialized > Pediatric Abdomen > Flashcards

Pediatric Abdomen Flashcards

1
Q

Transducer used for pediatric abdomen

A

Highest frequency (linear, curved array, or sector)

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2
Q

For better resolution, use ____ and ____ instead of decreasing depth

A

Sequential focusing and zoom

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3
Q

0-2 y/o: NPO for abdominal ultrasound ____

A

4 hours

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4
Q

3-5 y/o: NPO for abdominal ultrasound ____

A

5 hours

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5
Q

6+ y/o: NPO for abdominal ultrasound

A

6 hours

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6
Q

Right hepatic lobe should not extend more than ___ below costal margin in young infant without pulmonary hyperaeration

A

1cm

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7
Q

Normal echogenicity for neonatal/pediatric liver

A

Low to medium homogenicity w clear definition of portal venous vasculature

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8
Q

CBD in neonates/pediatrics:

A

Younger= smaller

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9
Q

CBD in neonates

A

<1mm

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10
Q

CBD in infants up to 1 y/o

A

<2mm

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11
Q

CBD in older children

A

<4mm

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12
Q

CBD in adolescents and adults

A

<6-7mm

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13
Q

Length of gallbladder should not exceed the length of the ____

A

Kidney

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14
Q

Infants <1 y/o: length of gallbladder is:

A

1.5-3cm

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15
Q

Length of gallbladder in older children:

A

3-7cm

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16
Q

Pancreatic duct should not exceed:

A

1-2mm

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17
Q

Pancreas texture is ___ compared to normal liver texture

A

Hypoechoic

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18
Q

Why is the pancreas hypoechoic compared to the normal liver?

A

There is little fatty tissue in Islets of Langerhans

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19
Q

Pancreatic head should measure :

A

1-2.2cm

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20
Q

Pancreas body measures:

A

.4-1cm

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21
Q

Pancreas tail measures:

A

.8-1.8cm

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22
Q

Spleen in infants less than 3 months old measures

A

6cm

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23
Q

> 12 y/o, spleen measures:

A

12cm

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24
Q

Portal vein measures _____ in children <10

A

8.5mm

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25
Q

Portal vein measurement for 10-20 y/o

A

10mm

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26
Q

Extrahepatic obstruction in neonate may be caused by:

A

Choledochal cyst, biliary atresia, or spontaneous perforation of bile ducts

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27
Q

Intrahepatic causes of neonatal jaundice:

A

Hepatitis and metabolic disease

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28
Q

Extrahepatic/intrahepatic obstruction to bile flow causes:

A

Jaundice

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29
Q

If neonate has jaundice that persists beyond ______, sonography may be ordered to differentiate causes

A

2-weeks after delivery

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30
Q

Inspissated means:

A

Thickened

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31
Q

Jaundice in infants and children may be due to

A

Cirrhosis, benign structures, neoplastic processes

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32
Q

3 most common causes of jaundice in neonates

A

BILIARY ATRESIA, Hepatitis, choledochal cyst

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33
Q

In neonatal hepatitis, the infection of the liver occurs within _____ of birth

A

First 3 months

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34
Q

Neonatal hepatitis: infection reaches liver through the _____

A

Placenta(from maternal secretions, catheters/blood transfusions)

35
Q

Most common agents of transplacental infection for neonatal hepatitis

A

Syphilis, toxoplasma, rubella, cytomegalovirus(CMV)

36
Q

Neonatal hepatitis sonographic findings:

A

Liver normal/enlarged

Echogenic parenchyma

Decreased visibility of peripheral portal venous structures

If dysfunction is severe, GB wall may be small

37
Q

Biliary atresia is _____ of biliary ductal system

A

Narrowing/underdevelopment

38
Q

Biliary atresia is more common in

39
Q

Clinical features in neonates for biliary atresia:

A

Persistent jaundice

Acholic(pale) stools

Dark urine

Hepatimegaly/distended abdomen

40
Q

Sonographic features biliary atresia

A

Liver is normal or enlarged

Normal or increased echogenic parenchyma with slight decrease in visualization of peripheral portal venous system

Intrahepatic ducts NOT dilated

Small triangular structure may be seen superior to porta hepatis

41
Q

Small triangular structure seeen superior to porta hepatis is:

A

Hypoplastic remnant of biliary structure

42
Q

Change in GB size after milk feeding suggests ____ of common hepatic/CBD(seen only in neonatal hepatitis)

43
Q

Presence of ______ should determine if biliary atresia is suspected

A

Polysplenia

44
Q

Abnormal cystic dilation of biliary tree that most frequently affects the CBD

A

Choledochal cyst

45
Q

Most common type of choledochal cyst

A

Fusiform dilation of CBD

46
Q

How many types of choledochal cysts are there

47
Q

Disease associated with choledochal cysts

A

Caroli’s disease

48
Q

Two most common neoplasms in pediatric population

A

Hemangioendothelioma(benign)

Hepatoblastoma(malignant)

49
Q

Most common benign liver tumor

A

Hemangioendothelioma

50
Q

Infantile hepatic vascular tumor:

A

Hemangioendothelioma

51
Q

Most common sonographic appearance of hemangioendothelioma is:

A

Hepatomegaly

52
Q

Most common malignant tumors in children

A

Hepatoblastoma and hepatocellular carcinoma

53
Q

Most common primary malignant disease of liver

A

Hepatoblastoma

54
Q

Most common abdominal malignancy in children

A

Neohroblastoma/Wilms tumor

55
Q

2nd most common abdominal malignancy in children

A

Neuroblastoma(adrenal gland)

56
Q

3rd most common abdominal malignancy in children

A

Hepatoblastoma

57
Q

Hepatoblastoma is associated with:

A

Beckwith-Weidmann syndrome, hemihypertrophy(excess growth of one side of body)

58
Q

Second most common malignant tumor in children

A

Hepatocellular carcinoma

59
Q

Hepatocellular carcinoma is also known as

60
Q

3 conditions indicating pediatric ultrasound for extreme abdominal pain

A

Hypertrophic pyloric stenosis

Appendicitis

Intussesception

61
Q

Located between stomach and duodenum

A

Pyloric canal

62
Q

Hypertrophy of circular muscle of pyloric causes

A

Narrowing of pyloric canal

63
Q

Hypertrophic pyloric stenosis(HPS) appears most commonly in

A

Male infants between 3-12 weeks pregnant old

64
Q

Most common clinical sign for HPS

A

Bile-free/ projectile vomiting

65
Q

Palpation of _____ shaped mass in RUQ is diagnostic and treated by surgical _______

A

Olive shaped

Pyloromyotomy

66
Q

Appearance of a hypertrophied pyloric muscle:

A

Bagel/donut appearance with echogenic central canal

67
Q

HPS: if muscle is thickened and elongated, the mucosa extends into the antrum— _____ sign

A

Cervix sign

68
Q

Pyoloric muscle wall normal measurements

A

<3mm in trans

<15-16mm in long

69
Q

Diagnosis of hypertrophic pyloric stenosis depends on

A

Pyloric muscle canal measures 15-16mm or greater

Pyloric wall muscle thickness of 3mm or more

Visualization of hypertrophied muscle

70
Q

Most common cause of emergent surgical abdominal pain in children

A

Appendicitis

71
Q

Appendicitis: transducer is moved slowly over abdomen using ____ technique

A

Graded compression

72
Q

Causes of appendices non visualization

A

Overlying bowel

Retrocecal positon of appendix

Over-distention or nondistention of bladder

73
Q

Sonographic features of appendicitis

A

Acutely inflamed

Noncompressible

Outer diameter measures >6-7mm

Hyperemia

Free peritoneal fluid

Apendicolith

Target sign

74
Q

Most common acute abdominal disorder in early childhood

A

Intussusception

75
Q

Occurs when bowel prolapses into more distal bowel and propelled in antegrade fashion

A

Intussusception

76
Q

Intussusception causes ______ of bowel which then causes obstruction

A

Telescoping

77
Q

Most common cause of intestinal obstruction in children under 3

A

Intussusception

78
Q

Clinical signs of intussusception

A

Colicky abdominal pain, vomiting, bloody(currant jelly) stools

79
Q

Intussusception sonographic features

A

Alternating hypo/hyperechoic rings surrounding an echogenic center—target sign, donut sign, cinnamon bun sign——transverse

Hypoechoic layers on each side of echogenic center——Pseudokidney or sandwich sign—longitudinal

80
Q

Hair balls in young women

A

Trichobezoar

81
Q

Vegetal matter

A

Phytobezoars

82
Q

Incompletely dissolved powdered formula

A

Lactobezoar

83
Q

Inorganic material(sand, asphalt, shellac, “concrete”)

A

Concretion

Small Parts/specialized (15 decks)

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