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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
Q

Tissue of origin for Wilms

A

metanephric blastema

26
Q

Associations with Wilms

A

Beckwith Widemann syndrome, WAGR, horeshoe kidney, Trisomy 18; regular ultrasounds until school age to screen for Wilms

27
Q

RCC occurs in what type of kids

A

VHL

28
Q

Renal medullary carcinoma is common in what type of patients

A

Sicle cell trait

29
Q

Rhabdoid tumor can also occur where

A

Brain; agressive ill defined renal mass

30
Q

Clear cell carcinoma metastases occurs

A

bone

31
Q

Most common pediatric malignancies that met to kidneys

A

lymphoma, leukemia, neuroblastoma

32
Q

Mesoblastic nephroma age group

A

benign tumor in kids <1 yo; appears similar to Wilms

33
Q

Tissue of origin for mesoblastic nephroma

A

metanephric blastema (same as Wilms)

34
Q

Nephroblastomatosis or nephrogenic rest

A

persistence of metanephric blastema; becomes “rest” when it persist beeyond 36 weeks gestation, Wilms tumor precursor

35
Q

Imaging findings of nephroblastomatosis

A

homogenous nonenhancing renal mass; multifocal, confluent and bilateral

36
Q

Benign solid pediatric renal masses

A

mesoblastic nephroma, nephroblastomatosis, AML

37
Q

Average age for neuroblastoma

A

2 yo

38
Q

Cells of origin for neuroblastoma

A

primitive neural crest malignancy from sympathetic chain

39
Q

Imaging findings of adrenal neuroblastoma

A

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
Q

Staging system for neuroblastoma

A

INSS based on midline crossing (left neuroblastoma midline is right lateral edge of vertebral body)

41
Q

Average age for ganglioneuroma

A

6yo; older than neuroblastoma and benign

42
Q

Imaging features of ganglioneuroma

A

appears similar to neuroblastoma
MRI: does not diffusion restrict (unlike neuroblastoma)
NM: only half are positive on I-123

43
Q

Imaging adrenal hemorrhage

A

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
Q

Associations with adrenal cortical carcinoma

A

Beckwith Widemann, Li Fraumeni

45
Q

Age distribution of adrenal cortical carcinoma

A

bimodal: kids <5, adults in 30-40s

46
Q

Urachal anomalies, spectrum

A

patent urachus (most common), urachal cyst, urachal snius, vesicourachal diverticulum

47
Q

Malignancy risk with urachal anomaly

A

adenocarcinoma

48
Q

Retrorectal cyst?

A

rare; rectal duplication cyst; typically resected due to malignant potential

49
Q

Hydrometrocolpos, hydrocolpos, hematometrocolpos

A

metrocolpos: vagina/uterus
hydrocolpos: vagina
Hematometrocolpos associated with congenital imperforate hymen

50
Q

Ovarian dermoid cyst

A

mature cystic teratoma

51
Q

Mullerian duct cyst

A

occurs exclusively in males; becomes fallopian tubes/uterus, cervix, upper vagina

52
Q

Prostatic utricle/cyst

A

normal; terminal remnant of the mullerian duct arising from posterior urethra

53
Q

most common childhood sarcoma

A

rhabdomyosarcoma; occurs equally in head/neck and pelvis ; most common bladder cancer <10 yo; infiltrative ; paratesticula mass

54
Q

Imaging findings of rhabdomyosarcoma

A

bunch of grapes

55
Q

Imaging findings of sacrococcygeal teratoma

A

heterogenous; detected prenatally; skin covered mass extending from midline buttock

56
Q

Neuroblastoma associations

A

NF1, Hirschsprung, DiGeorge, Beckwith Widemann

CORE--Peds (7 decks)

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