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CORE--Peds > Pediatric GU > Flashcards

Pediatric GU Flashcards

1
Q

Vesicoureteral reflux

A

abnormal retrograde reflux of urine into kidney; can cause pyelonephritis, renal scarring, loss of renal function; screen with siblings`

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2
Q

Primary vs secondary VUR

A

1: short intravesicular portion of ureter
2: obstruction (posterior urethral valve or neurogenic bladder)

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3
Q

Grading of VUR

A

I: reflux into ureter
II: reflux into nondilated renal calyces, normal ureteral/calyceal morphology
III: reflux into collecting system, blunting of calyx
IV: moderately dilated ureter
V: severely dilated and tortuous ureter

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4
Q

Imaging of VUR

A

renal US, VCUG, RNC, Tc 99m DMSA

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5
Q

Nuclear renal studies

A

radionuclide cystogram with Tc99m pertectnatate

Tc 99m DMSA renal scinitgraphy to evaluate cortical scarring

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6
Q

Weigert-Meyer rule

A

Upper pole inserts ectopically and inferomedially; obstructs; ureterocele
Lower pole refluxes, inserts orthotopically (normal)

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7
Q

Drooping lily sign

A

VCUG; invisible obstructed upper pole compresses the refluxed contrast in the lower moeity collection; ddx renal ptosis

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8
Q

Most common cause of unilateral hydronephrosis

A

UPJ obstruction

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9
Q

Causes of UPJ obstruction

A

aberrant renal artery/compression, aperistaltic segment of ureter, idopathic

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10
Q

Posterior urethral valves

A

Males; bladder outlet obstruction, web in urethra resulting in dilation of posterior/prostatic urethra, dilated/trabeculated bladder, hydronephrosis

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11
Q

Keyhole appearance (US)

A

dilated posterior urethra and bladder

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12
Q

Prune belly syndrome

A

loss of abdominal wall muscles and muscles of the urinary collecting system (hydronephrosis and dilation of bladders); associated with cryptorchidism

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13
Q

Differentiation between posterior urethral valves and prune belly syndrome

A

entire urethra dilated with prune belly syndrome, not just the prostatic ureter

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14
Q

Ureterocele (UVJ obstruction)

A

focal dilation of distal ureter in bladder wall; ectopic ureterocele (upper pole ureter); simple ureterocele

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15
Q

Most common neonatal cystic renal mass

A

Multicystic dysplastic kidney

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16
Q

How to differentiate from MCDK and hydronephrosis

A

noncommunicating cysts = MCDK

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17
Q

Associations with simple renal cysts in pediatrics

A

Tuberous sclerosis, VHL

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18
Q

VHL findings

A

renal cysts, renal AML, cardiac rhabdomyoma, CNS cortical hamartomas

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19
Q

VHL

A

renal cysts, RCC, adrenal pheochromocytoma, pancreatic cysts, CNS hemangioblastomas

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20
Q

Demographics for multilocular cystic nephroma

A

bimodal: young boys and middle aged women

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21
Q

Imaging findings for MLCN

A

multiseptated cystic neoplasm, benign; herniates into renal pelvis causing hydronephrosis

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22
Q

ADPKD imaging findings

A

manifests in adulthood; hepatic cysts, less commonly pancreatic cysts

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23
Q

ARPKD

A

tiny cysts; bilaterall enlarged kidneys; hepatic fibrosis (not cysts)

24
Q

Most common renal neoplasm in pediatrics

A

Wilms tumor; age 3-5yo

25
Tissue of origin for Wilms
metanephric blastema
26
Associations with Wilms
Beckwith Widemann syndrome, WAGR, horeshoe kidney, Trisomy 18; regular ultrasounds until school age to screen for Wilms
27
RCC occurs in what type of kids
VHL
28
Renal medullary carcinoma is common in what type of patients
Sicle cell trait
29
Rhabdoid tumor can also occur where
Brain; agressive ill defined renal mass
30
Clear cell carcinoma metastases occurs
bone
31
Most common pediatric malignancies that met to kidneys
lymphoma, leukemia, neuroblastoma
32
Mesoblastic nephroma age group
benign tumor in kids <1 yo; appears similar to Wilms
33
Tissue of origin for mesoblastic nephroma
metanephric blastema (same as Wilms)
34
Nephroblastomatosis or nephrogenic rest
persistence of metanephric blastema; becomes "rest" when it persist beeyond 36 weeks gestation, Wilms tumor precursor
35
Imaging findings of nephroblastomatosis
homogenous nonenhancing renal mass; multifocal, confluent and bilateral
36
Benign solid pediatric renal masses
mesoblastic nephroma, nephroblastomatosis, AML
37
Average age for neuroblastoma
2 yo
38
Cells of origin for neuroblastoma
primitive neural crest malignancy from sympathetic chain
39
Imaging findings of adrenal neuroblastoma
CXR: posterior mediastinal mass, bone mets CT: encases vessels (Wilms displaces); calcifies (Wilms rarely calcifies) MRI: invades neural foramina/spinal canal; diffusion restricts NM: I123 scinitgraphy positive (utilize bone scan for mets) Mets go to skin, liver, bone marrow
40
Staging system for neuroblastoma
INSS based on midline crossing (left neuroblastoma midline is right lateral edge of vertebral body)
41
Average age for ganglioneuroma
6yo; older than neuroblastoma and benign
42
Imaging features of ganglioneuroma
appears similar to neuroblastoma MRI: does not diffusion restrict (unlike neuroblastoma) NM: only half are positive on I-123
43
Imaging adrenal hemorrhage
may look like neuroblastoma but involutes; old hemorrhage may calcify; hypoechoic avascular suprarenal mass on US found after birth trauma, stress, associated with scrotal hemorrhage
44
Associations with adrenal cortical carcinoma
Beckwith Widemann, Li Fraumeni
45
Age distribution of adrenal cortical carcinoma
bimodal: kids <5, adults in 30-40s
46
Urachal anomalies, spectrum
patent urachus (most common), urachal cyst, urachal snius, vesicourachal diverticulum
47
Malignancy risk with urachal anomaly
adenocarcinoma
48
Retrorectal cyst?
rare; rectal duplication cyst; typically resected due to malignant potential
49
Hydrometrocolpos, hydrocolpos, hematometrocolpos
metrocolpos: vagina/uterus hydrocolpos: vagina Hematometrocolpos associated with congenital imperforate hymen
50
Ovarian dermoid cyst
mature cystic teratoma
51
Mullerian duct cyst
occurs exclusively in males; becomes fallopian tubes/uterus, cervix, upper vagina
52
Prostatic utricle/cyst
normal; terminal remnant of the mullerian duct arising from posterior urethra
53
most common childhood sarcoma
rhabdomyosarcoma; occurs equally in head/neck and pelvis ; most common bladder cancer <10 yo; infiltrative ; paratesticula mass
54
Imaging findings of rhabdomyosarcoma
bunch of grapes
55
Imaging findings of sacrococcygeal teratoma
heterogenous; detected prenatally; skin covered mass extending from midline buttock
56
Neuroblastoma associations
NF1, Hirschsprung, DiGeorge, Beckwith Widemann

CORE--Peds (7 decks)

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