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Summer 2014 - ABD 2 ✔️ > Pediatrics > Flashcards

Pediatrics Flashcards

0
Q

what is an infant’s age range

A

one month to two years

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1
Q

what is a neonate’s age range

A

birth to one month

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2
Q

what is children age range

A

two to twelve years

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3
Q

what is adolescent age range

A

twelve to sixteen years

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4
Q

exam prep for pediatrics

A

trust of the patient and the parents

distracting devices

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5
Q

describe jaundice

A

MOST COMMON indication for imaging the biliary tree

CONGENITAL

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6
Q

during the first few weeks of life, many neonates experience _______ jaundice

A

transient

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7
Q

if the neonate has jaundice that persists beyond ____ wks after delivery, an US may be ordered

A

2 wks

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8
Q

what are the 3 most common causes for jaundice

A

choledochal cyst

biliary atresia

hepatitis

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9
Q

where can extrahepatic obstruction jaundice come from

A

choledochal cyst
biliary atresia
perforation of the ducts

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10
Q

where can intrahepatic obstruction (hepatocellular) jaundice come from

A

hepatitis

metabolic disease

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11
Q

clinical symptoms of choledochal cyst

A

palpable mass
weight loss
jaundice and pain

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12
Q

what is a choledochal cyst

A

abn cystic dilatation of the biliary tree

looks like a cyst but is not a cyst

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13
Q

types of choledochal cyst

A

fusiform dilatation of the CBD
cystic structures communication with the ducts
dilation of the intra and extra hepatic ducts
caroli’s disease with intrahepatic duct dilation

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14
Q

what might cause hepatitis

A

metabolic
idiopathic
via vagina
catheter

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15
Q

hepatitis is asssociated with __________

A

hepatomegaly

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16
Q

hepatitis sonographically

A

increased in echogenicity

decreased visualization of vessels

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17
Q

describe biliary atresia

A

narrowing or underdevelopment of the biliary ductal system

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18
Q

clincal symptoms of biliary atresia

A 
jaundice
acholic (clay like) stools
distended abd
absent or smal GB
slight descrease in visualization of portal
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19
Q

biliary atresia will have what sign on histology

A

“triangular cord”

echogenic cord anterior to the PV - remnant of duct noted near porta hepatis

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20
Q

what is polysplenia syndrome

A

associated with biliary atresia

heart defects and situs abn’s, spleen abn’s

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21
Q

what is Kasai operation

A

associated with biliary atresia

anastomosis of liver ducts to intestine

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22
Q

biliary atresia could also be associated with ______ abn’s

A

genetic

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23
Q

what nud med test is performed for jaundice

A

hepatic scintigraphy

24
Q

describe hemangioendothelioma

A

MOST COMMON benign vasc tumor in childhood

hepatomegaly

regresses by 12-18 mos

multiple hypoechoic lesions/heterogeneous

25
Q

describe hepatoblastoma

A

MOST COMMON primary malignancy in the liver in children

associated with Beckwith-Widemann (autosomal - organomegaly)

solid, single, large
necrosis, hemorrhage, calcification
palpable mass
fever, weight loss

26
Q

what is a type of abcess that occurs in children in their liver

A

hydatid-echinococcosis

27
Q

renal abnormality can be detected in _____…_____ sonogram is indicated

A

utero

postpartum - after birth

28
Q

what do normal infantile kidney’s look like

A

fetal lobulation - incomplete fusion

medullary pyramids are large and hypoechoic

cortex is thin

arcuate arteries at the base of the medullary pyramids may appear echogenic

29
Q

describe bladder outlet obstruction

A

bilateral hydronephrosis

bladder wall thickened and trabeculated

hydronephrosis and hydroureter are usually bilateral

perirenal urinoma

30
Q

what can obstruct the bladder outlet

A

neurogenic bladder

pelvis mass

31
Q

what is the most common congenital anomaly that causes urethral obstructions in boys

A

posterior urethral valves (PUV)

32
Q

what is PUV

A

posteror urethral valves

“keyhole” sign - blockage in the urethra

33
Q

describe a ureteropelvic junction obstruction (UPJ)

A

intrinsic narrowing or extrinsic vasc compression

pelvocalyceal dilation without ureteral dilation

34
Q

describe ectopic ureterocele

A

more frequently in females on the left

ectopic insertion and cystic dilation of the ureter

seen as a fluid mass within the bladder

35
Q

describe autosomal recessive polycystic kidney disease (ARPKD)

important

A

infanile

bilateral renal enlargement

increased echogenicity

BIG, BRIGHT, BILATERAL

36
Q

describe autosomal dominant polycystic kidney disease (ADPKD)

A

more common ereditary disease

related to chromo 16

well defined cysts

bilateral renal enlargement

causes no renal impairment until adult

normal bladder filling and amniotic fluid

37
Q

describe renal vein thrombosis

A

severe dehydrated or septic infant

hematuria, proteinuria, low platelets

enlarged kidney

38
Q

describe nephroblastoma - Wilm’s tumor

A

MOST COMMON malignant renal tumor in children

unilateral

large solid - echogenic mass with calcifications

eval renal vein and IVC

pedi cause of HTN

39
Q

describe neuroblastoma

A

malignant tumor of the adrenal glands

highly echogenic

metastases

40
Q

describe adrenal hemorrhage

A

due to birth trauma

ovoid enlargement of the gland

decrease in follow up

41
Q

describe normal adrenal glands

A

more easily seen in neonates

superior to the upper pole of the kidney

42
Q

describe hypertrophic pyloric stenosis

A

congenital obstruction of pyloris due to hypertrophy of muscles

narrows the pyloric canal

abn thickened muscle

43
Q

what is the pyloric canal

A

stomach to duodenum

44
Q

HPS is more prevalent in

A

male first born infants 2-10 weeks

rarely at birth or greater than 6 mos

45
Q

clincal findings that will be seen with HPS

A

bile free vomiting in an otherwise healthy infant

dehydration and weight loss

olive shaped mass in the RUQ - “olive sign”

surgery - pyloromyotomy

46
Q

how to image HPS

A

supine and RLD

high frequency linear array 5-7 MHz

oral feeding to facilitate imaging

47
Q

measurements for HPS

A

pyloric channel length > 14-17 mm

pyloric muscle thickness long axis - one wall > 3.5-4 mm

pyloric diameter > 10-15 mm

no peristalsis thru pylorus

48
Q

describe appendicitis

A

RLQ pain and vomiting
pelvic survey - localized pain
right flank with a linear transducer
graded compressions

49
Q

appendicitis sonographically

A

outer diameter greater than 6 mm

increased flow with color

free fluid

appendicolith - hyperechoic

50
Q

describe intussusception

A

MOST COMMON acute abd disorder in early childhood - 6 mos to 2 yrs

bowels prolapses into distal bowel

causes obstruction

higher incidence in males

51
Q

clinical findings of intussusception

A 
colicky abd pain
vomiting
bloody stools
abd distention
palpable mass
52
Q

intussusception sonographically

A

TRV - “target” or “donut” sign

LONG - “pseudokidney” or “sandwich” sign

linear array - graded compressions

53
Q

describe midgut malroatation - volvulus

A

failure of rotation of bowel

upper GI - imaging choice

sonographically - note the position of the SMA and SMV (fluid filled duodenum)

ladd operation to treat malrotation

54
Q

name the six congenital uterine/mullerian anomalies

A 
agenesis
unicornuate
didelphys
bicornuate
septate
DES drug related
55
Q

what is mullerian anomaly class II

A

unicornuate uterus

one mullerian duct so only half uterus is formed - rare

56
Q

what is mullerian anomaly class III

A

uterus didelphys

complete failure of fusion of the ducts - 2 separate ut, cx, vag
widely separate endometrial cavities

57
Q

what is mullerian anomaly class IV

A

bicornuate uterus

MOST COMMON uterine anomaly

58
Q

what is mullerian anomaly class V

A

septate uterus

endometrial cavities separated by a thin member
often associated with miscarriages
can be treated by hysteroscopic resection

Summer 2014 - ABD 2 ✔️ (9 decks)

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