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KB-GI radiology > Peds/fetal GI > Flashcards

Peds/fetal GI Flashcards

1
Q
  1. What is the first DDx for a pancreatic tumour in the 1st decade of life?
  2. What does it look like?
A
  1. pancreatoblastoma
  2. large w/calcs & liver mets.
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2
Q
  1. What part of the duodenum is narrowed w/annular pancreas?
A
  1. 2nd.
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3
Q

Neonatal low/distal bowel obstruction: megacystis microcolon intestinal hypoperistalsis syndrome

  1. Common?
  2. Path?
  3. Ix?
  4. Prognosis?
A

1.

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4
Q

Anorectal malformations: imperforate anus

  1. What is the role of radiology in these?
    1. How is this done?
  2. What is assoc w/a high ARM in males vs. females?
    1. What other 2 associations?
  3. What is Tx in either sex for a high lesion?
  4. Tx for low lesion?
  5. How to clinically diagnose high vs. low?
  6. Ix used to diagnose?
A

1.

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5
Q

Neonatal low/distal bowel obstruction: meconium ileus

  1. Path?
  2. Complication?
    1. Ix Fx-2.
  3. What is meconium ileus the earliest manifestation of?
    1. What is the relationship here?
  4. Classic Ix findings-2
  5. Tx-2
A

1.

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6
Q

Peds GI ED: malrotation/midgut volvulus:

  1. Path; what actually causes the volvulus?
  2. Typical presentation.
  3. How to rule it out?
  4. Can you have malrotation w/o volvulus?
  5. What % of infants present in 1st month? % that are symptomatic w/in 1 year?
  6. The 2 most important anatomy to show on every UGIS?
    1. Location of a normal duodenojejunal junction?
  7. Classic XR finding of midgut volvulus?
  8. Classic UGI finding?
  9. Ix clues to the presence of malrotation-5
  10. Tx?
A

1.

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7
Q

Pediatric lymphoproliferative disorder:

  1. How are kids different than adults?
  2. What % of peds xplant pts develop this?
  3. Which xplanted organs are less at risk of this?
A
  1. They’re 2-3x at greater risk.
  2. 15%
  3. Renal.
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8
Q

Neonatal low/distal bowel obstruction: Hirschsprung disease

  1. Path; what does this cause?
    1. Specific path?
  2. How often is the entire colon affected?
  3. 1/3 of kids develop what?
  4. 5% of kids w/this have what?
  5. Typical Ix Fx.
  6. How does this compare to functional immaturity of the colon, i.e., meconium plug?
  7. Gold standard Dx?
  8. Tx?
A
  1. Aganglionosis of the distal bowel that starts at the anus, causing pinching/lack of bowel relaxation.
    1. The vagal neural crest cells don’t migrate fully to the bum.
  2. Rarely, 1-3% is the whole colon affected.
  3. 1/3 develop enterocolitis similar to NEC.
  4. T21.
  5. Rectum will be smaller than dilated sigmoid (usually is the other way around).
  6. Hirsch is tapered rather than abrupt.
  7. Bx.
  8. Tx=surgical.
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9
Q

Fetal GI: esophageal atresia

1.

A

1.

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10
Q
  1. What is the first DDx for pt w/pancolitis, who recently was on abx?
  2. Ix findings?
  3. What can this progress to & mortality?
A
  1. Pseudomembranous colitis.
  2. Marked, diffuse wall thickening w/paucity of adjacent fat inflammation.
  3. toxic megacolon in 5% of cases w/35% mortality.
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11
Q

Solid liver/biliary masses: HCC

  1. Similar to adults, when is this seen in kids?
  2. Causes of the above-5
  3. Tumour markers?
A

1.

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12
Q

Neonatal bowel obstruction: duodenal atresia, stenosis, web:

  1. Classic Ix sign for atresia.
  2. Classic Ix sign for web.
  3. Duodenal anomalies have associated abnormalities in what % of cases?
    1. Most common abnormality?
    2. What % of babies w/duodenal atresia have Down?
    3. Name 3 other associated abnormalities.
  4. DDx double bubble + distal bowel gas.
A
  1. double bubble
  2. windsock deformity
  3. 50%
    1. T21
    2. 30% of atresias have T21
    3. VACTERL, malrotation, annular pancreas (in 20% of babies w/atresia)
  4. DDx:
    1. Annular pancreas
    2. duodenal web
    3. malrotation
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13
Q

Fetal GI: distal bowel obstruction

1.

A

1.

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14
Q

Fetal GI: general

1.

A

1.

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15
Q

Childhood bowel obstruction: DDx

  1. DDx of the most common causes:
A
  1. DDx: AAIIMM
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16
Q

Solid liver/biliary masses: liver mets

  1. 2 most common liver mets in kids?
A

1.

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17
Q

Hepatobiliary neoplasia/masses: cystic: mesenchymal hamartoma

  1. Benign/malignant?
  2. Path?
  3. Tumour markers?
  4. Ix-2
  5. Tx?
A

1.

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18
Q

Childhood bowel obstruction: Crohn disease

  1. What % of newly diagnosed Crohn’s pts are kids?
A
  1. 30%
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19
Q

Neonatal cholestatic jaundice: approach

  1. Diff b/w unconjugated & conjugated hyperbili?
  2. Which one is always abnormal in the neonate?
    1. Generally, what causes this?
  3. DDx conjugated, the big ones.
  4. Goal of imaging in conjugated hyperbili?
    1. Test of choice?
    2. What is done to prep for this test?
    3. How does the test work?
A
  1. .
  2. .
  3. DDx: biliary atresia (25%), Alagille syndrome, alpha-1-antitrypsin deficiency.
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20
Q

Normal midgut rotation:

  1. How many degrees, in what rotation?
    1. Around what structure?
  2. At what GA does this occur?
  3. At what fetal age does the physiologic bowel herniation disappear?
A

1.

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21
Q

Fetal GI: meconium manifestations

1.

A

1.

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22
Q

Hepatobiliary neoplasia/masses: cystic: GB hydrops

  1. Ix?
  2. Association?
A
  1. Pathologically distended GB w/no signs of infection.
  2. Kawasaki disease.
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23
Q

Solid liver/biliary masses: hepatoblastoma

  1. Malignant?
  2. Notoriety?
    1. Commonality relative to Wilms & neuroblastoma?
  3. Age group relative to infantile hemangioma?
  4. 3 associated syndromes?
  5. Tumour marker?
  6. Classic Ix finding
  7. Other Ix findings-4
24
Q

Peds miscellaneous GI: meconium spectrum

  1. Name the 5 meconium entities & what each causes.
25
Q

Peds GI ED: hypertrophic pyloric stenosis

  1. Path
  2. Ex-2, age
  3. Ix:
    1. XR sign
    2. US: Dx criteria-2
    3. DDx-1; how to differentiate
  4. Tx-2
A
  1. .
  2. .
    1. Age = 2-8wks.
26
Q

Solid liver/biliary masses: infantile hemangioma/hemangioendothelioma:

  1. What do they commonly cause (25%)?
  2. Tumour markers?
  3. Which syndrome are these associated w/?
  4. Ix app
    1. What particular vascular Ix finding here?
  5. Clinical course?
27
Q

Peds miscellaneous GI: abdo calcs

1.

28
Q

Solid liver/biliary masses: undifferentiated embryonal sarcoma (malignant mesenchymoma)

  1. Kid age?
  2. Tumour marker?
29
Q

Fetal GI: omphalocele

  1. Midline or off midline?
  2. Covering or no covering?
  3. Diff b/w a small or giant?
  4. Which one has more associated anomalies–omph or gastrischis?
A
  1. Midline! (Think, oomph! You get punched in the midline when someone punches you.)
  2. Covering.
  3. Small <5cm & more likely to contain only bowel; giant >5cm, are more likely to contain other viscera.
  4. Omphalocele! Especially T13 & T18.
30
Q

Neonatal bowel obstruction: overview

  1. Time for presentation.
  2. Diff b/w neonates & adults re: bowel & XR.
  3. Goal of Ix in neonatal obstruction.
  4. Neonate bowel XR approach:
    1. Defns of both.
  5. Tx for proximal obstruction.
  6. Ix for suspected prox obstruction.
    1. What does this rule out?
    2. Primary purpose for an UGI & Tx.
  7. Ix for suspected distal obstruction?
    1. What contrast is used for this?
31
Q

Childhood bowel obstruction: inguinal hernia

  1. Path of indirect hernia.
    1. Where does direct vs. indirect hernia go.
32
Q

Peds congenital GE: tracheoesophageal fistula:

  1. 50% of pts w/TEF have what?
  2. Again, what does the acronym stand for?
  3. Name the 3 most common types.
    1. What is the most common of these 3? Appearance on babygram?
    2. Next most common & appearance?
    3. Next most common?
  4. What morphology does the H-type have?
A
  1. .
  2. .
  3. .
  4. H-type: a continuous esophagus w/o atresia (so a catheter will pass), and with upper esophageal TEF. Presents later in childhood w/recurrent aspiration.
33
Q

Solid liver/biliary masses: classification

  1. Draw the flowchart of high vs. low flow peds vascular malformations/neoplasms.
  2. Which high-flow vascular neoplasm can metastasize?
34
Q

Peds congenital GE: gastric atresia

  1. Sx?
  2. How does the Sx differ from HPS (hypertrophic pyloric stenosis)?
  3. Less severe variant?
  4. Ix finding?
35
Q

Fetal GI: pentalogy of Cantrell

1.

36
Q

Neonatal low/distal bowel obstruction: ileal/colonic atresia

  1. Where does the microcolon occur here?
  2. Is colonic atresia common?
  3. How do these differ from meconium ileus?
  4. What most commonly causes microcolon?
  5. What does the colon look like if the atresia is in the proximal jejunum?
A
  1. .
  2. .
  3. .
  4. Distal small bowel obstruction.
  5. Microcolon may not be present as succus entericus produced by the distal bowel is sufficient to distend the colon.
37
Q

Hepatobiliary neoplasia/masses: general

  1. Which 3 factors can be used to narrow the DDx of a hepatobiliary mass?
38
Q
  1. What is the most common surgically treated cause of vomiting in infants?
  2. What’s the most common reason to perform abdo surgery in any child?
A
  1. Hypertrophic pyloric stenosis.
  2. Appendicits.
39
Q

Peds GI ED: intussusception

  1. Which part is which: intussuscipiens vs. intussusceptum.
  2. Most common location?
  3. Sx-3?
  4. DDx bloody stool & thick-walled bowel on US?
  5. Primary Ix for Dx?
    1. Sign name?
  6. 1st line Tx?
    1. Rule of 3s re: reduction?
    2. Contrainds to pneumatic reduction-3.
40
Q

Fetal GI: duodenal atresia

1.

41
Q

Neonatal cholestatic jaundice: biliary atresia

  1. Which ducts affected?
  2. HIDA normal finding?
    1. HIDA abnormal finding?
    2. How do you definitively rule out atresia w/HIDA?
  3. Tx?
    1. What is done in this Sx?
    2. Prognosis?
42
Q

Fetal GI: hyperechoic small bowel

1.

43
Q
  1. What syndrome is Caroli disease part of?
A
  1. Autosomal recessive polycystic kidney disease, so look at the kidneys!
44
Q

Neonatal low/distal bowel obstruction: Ladd bands:

  1. Rare/common?
45
Q

Neonatal proximal bowel obstruction: jejunal atresia/stenosis:

  1. Path?
  2. Classic babygram appearance?
46
Q

VACTERL:

  1. What is this?
A

Vertebral segmentation anomalies

Anal atresia

Cardiac anomalies

TracheoEsophageal fistula

Renal anomalies

Limb (radial ray) anomalies

47
Q

Neonatal low/distal bowel obstruction: small left colon/functional immaturity of the colon (FIC)/meconium plug syndrome

  1. Path?
  2. When is this diagnosed?
  3. RFs-3.
  4. Like meconium ileus, does this cause microcolon?
  5. Is this associated w/CF, like meconium ileus?
  6. Ix Fx:
    1. Where is the abnormality located generally?
  7. Primary DDx?
    1. How do they differ?
  8. Tx?
A
  1. Path: immaturity of colon ganglion cells.
  2. It is the most common Dx in neonates who fail to pass meconium.
  3. RFs: neonates; born to mums who received Mg for pre-eclampsia; born to mums w/DM.
  4. No! This is not microcolon.
  5. NO! Not associated w/CF.
  6. Ix: distal obstructive pattern.
    1. Will see a narrowed distal colon extending up to the splenic flexure w/ more proximally dilated bowel.
  7. DDx: high Hirschsprung disease, and these cannot be differentiated w/o Bx.
    1. Although Hirsch won’t have a distensible rectum & will not resolve after enema.
  8. Water-soluble enema; this will generally resolve in 2 days.
48
Q

Neonatal low/distal bowel obstruction: DDx microcolon

  1. How to diagnose & approach.
  2. Why are low osmolar, water-soluble contrast agents used?
  3. Defn microcolon.
  4. Path? Where does this normally occur & why?
  5. 2 most common causes?
  6. DDx microcolon-4
  7. Why does jejunal atresia not cause microcolon?
    1. What is succus entericus?
49
Q

Peds GI ED: necrotizing enterocolitis

  1. Who does it affect-4
    1. What % of neonates w/NEC are full-term?
  2. Path?
  3. IxFx, early-2
    1. Late-3
      1. 2 common XR pneumoperitoneum findings?
      2. Most common bowel parts involved?
  4. Tx: early?
    1. Late?
  5. Most common delayed complication?
  6. Prognosis?
  7. What Ix findings are diagnostic of NEC?
A
  1. 1-3 wks post-delivery of a preterm infant.
    1. 10%.
  2. .
  3. .
  4. .
  5. .
  6. .
  7. pneumatosis + portal venous gas.
50
Q

Peds congenital GE: esophageal atresia

  1. What is this?
  2. Path?
  3. What is this almost always associated with?
  4. When should esophageal atresia be considered at fetal US?
  5. Ix babygram-2?
    1. Ix: fetal US.
51
Q

Peds GI ED: appendicitis

1.

52
Q

Fetal GI: gastroschisis

  1. Associated w/other anomalies?
  2. Where does the herniation lie relative to the umbilical cord?
  3. Usually any other organs outside?
A
  1. No, omphalocele has other anomalies.
  2. To the right.
  3. No, that’s omphalocele.
53
Q

Neonatal cholestatic jaundice: hepatitis

  1. Can US tell this apart from biliary atresia?
  2. HIDA finding-2?
54
Q

What’s the most common DDx for a complete microcolon?

A

DDx: meconium ileus or ileal atresia.

56
Q

Peds miscellaneous GI: Meckels

  1. Of what is this a remnant?
    1. What is on the spectrum of a Meckel? …and what can this cause, clinically?
    2. On what side of the mid/distal ileum is a Meckel located?
  2. What is the most common manifestation in young kids?
    1. …and under what circumstance?
  3. What can a Meckel less commonly do?
  4. What are the 2 top Meckel complications in adults?
  5. List the rule of 2s.
  6. How to Dx a Meckel causing rectal bleeding?
    1. When is the only time this is positive?
57
Q
  1. How to differentiate a GI duplication cyst from a lymphatic malformation when diagnosing an abdominopelvic cystic structure?
A
  1. Mesenteric lymphatic malformation may contain thin septations in addition to rim enhancement.

KB-GI radiology (11 decks)

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