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CORE > Peds GU > Flashcards

Peds GU Flashcards

1
Q

vesicoureteral reflux –> predisposes to what?

A

predispose to acute pyelonephritis –> renal scarring –> irrev loss of renal fx

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2
Q

vesicoureteral reflux –> grading?

A 
I: reflux into ureter
II: reflux into renal pelvis
III: blunted calyces
IV: mod hydroureter
V: severe tortuous hydroureter
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3
Q

vesicoureteral reflux –> what nuc med studies can evaluate VUR? (2)

A
  • radionuclide cystogram (RNC)

- Tc-99m DMSA renal scintigraphy (DMSA scan)

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4
Q

vesicoureteral reflux –> preferred initial study?

A

VCUG

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5
Q

vesicoureteral reflux –> most sensitive study?

A

radionuclide cystogram (RNC)

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6
Q

radionuclide cystogram (RNC) –> grading?

A

1: ureteral reflux
2: reflux up to calyces
3: hydroureter

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7
Q

renal cortical scarring –> gold standard study?

A

Tc-99m DMSA renal scintigraphy (DMSA scan)

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8
Q

radionuclide cystogram (RNC) –> what radionuclide?

A

Tc-99m pertechnetate

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9
Q

what is Weigert-Meyer rule?

A

renal duplex system:

  • upper moiety –> ectopic insertion –> inf-med
  • lower moiety –> orthotopic insertion –> sup-lat
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10
Q

renal duplex system –> upper vs lower moiety –> predisposed to what?

A
  • upper moiety –> ureterocele –> obstruction

- lower moiety –> VUR

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11
Q

hydronephrosis –> ddx? (2)

A
  • VUR

- UPJ obstruction

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12
Q

hydroureteronephrosis –> at UVJ level –> ddx? (2)

A
  • VUR

- UVJ obstruction

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13
Q

what is renal ptosis (nephroptosis?

A

“floating kidney” –> kidney drops down into pelvis when pt stand

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14
Q

hydronephrosis –> unilat –> MCC?

A

UPJ obstruction

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15
Q

UPJ obstruction –> cause? (3)

A
  • aberrant renal A –> compress ureter
  • ureter –> aperistaltic segment
  • idiopathic
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16
Q

congenital bladder outlet obstruction –> MCC?

A

posterior urethral valve

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17
Q

posterior urethral valve –> bladder –> US findings?

A

dilated bladder –> trabeculations

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18
Q

posterior urethral valve –> what is “keyhole”?

A

dilated posterior urethra + bladder

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19
Q

posterior urethral valve –> which structures will be dilated? (3)

A
  • prostatic urethra
  • bladder
  • renal collecting system
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20
Q

prune belly synd –> consists of what triad?

A
  • hydroureteronephrosis, renal dysplasia
  • ant abd underdevelopmt
  • cryptorchidism
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21
Q

urethra, bladder, renal collecting system –> dilated –> ddx? (2) how to differentiate?

A
  • posterior urethral valve –> only posterior urethra dilated
  • prune belly synd –> entire urethra dilated
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22
Q

ureterocele –> 2 types?

A
  • ectopic –> ectopic ureter

- simple –> orthotopic ureter

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23
Q

ureterocele –> US appearance?

A

cyst within bladder

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24
Q

ureterocele –> VCUG appearance?

A

round filling defect in the bladder

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25
Q

obstruction at the UVJ–> causes? (2)

A
  • ureterocele

- primary obstructive megaureter

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26
Q

bladder outlet obstruction –> causes? (2)

A
  • posterior urethral valve

- neurogenic bladder

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27
Q

multicystic dysplastic kidney –> pathophys?

A

fetal urinary obstruction –> progressive renal dysplasia –> kidney gradually involutes

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28
Q

multicystic dysplastic kidney –> key finding?

A

mult NON-communicating cysts –> replace renal parenchyma

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29
Q

isolated simple renal cyst –> common or rare in children?

A

rare

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30
Q

isolated simple renal cyst –> if seen, may reflect what condition? (2)

A
  • tuberous sclerosis

- von Hippel-Lindau

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31
Q

tuberous sclerosis –> synd? (6)

A
  • renal cysts
  • renal angiomyolipoma
  • cardiac rhabdomyoma
  • CNS cortical hamartoma
  • subependymal nodule
  • subependymal giant cell astrocytoma
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32
Q

von Hippel-Lindau –> synd? (5)

A
  • renal cysts
  • RCC
  • adrenal pheochromocytoma
  • pancreatic cyst/islet cell tumor/serous cystadenoma
  • brain/spinal cord hemangioblastoma
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33
Q

multilocular cystic nephroma –> benign or malig?

A

benign

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34
Q

multilocular cystic nephroma –> epidemiology?

A
  • 3mo-2yo M

- middle age F

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35
Q

multilocular cystic nephroma –> appearance?

A

multiseptated cystic mass –> enhancing septa

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36
Q

multilocular cystic nephroma –> characteristic finding?

A

herniate into renal pelvis –> hydronephrosis

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37
Q

kidney –> multiseptated cystic mass –> ddx? (2)

A
  • multilocular cystic nephroma

- cystic Wilms tumor

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38
Q

pediatric population –> ADPKD or ARPKD?

A

recessive

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39
Q

ARPKD –> kidneys –> US appearance?

A

cysts too small to see –> kidneys are enlrged & echogenic

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40
Q

ARPKD –> assoc w what fetal conditions? (2)

A
  • oligohydramnios

- pulm hypoplasia

41
Q

Wilms tumor –> arises from what embryologic tissue?

A

persistent metanephric blastema

42
Q

what conditions have increased risk for Wilms tumor? (4)

A
  • Beckwith-Wiedemann synd
  • WAGR synd
  • horseshoe kidney
  • trisomy 18
43
Q

Beckwith-Wiedemann synd –> synd? (5)

A
  • hemihypertrophy
  • macroglossia
  • omphalocele
  • neonatal hypoglycemia
  • childhood malig (ie Wilms tumor, hepatoblastoma)
44
Q

WAGR synd –> synd? (4)

A
  • Wilms tumor
  • aniridia
  • GU anomaly
  • mental retard
45
Q

Wilms tumor –> imaging appearance?

A

heterogeneous solid renal mass

46
Q

heterogeneous solid renal mass –> pediatric –> ddx? (2) how to differentiate?

A
  • Wilms tumor: 3-5yo

- mesoblastic nephroma: <1yo

47
Q

what is claw sign?

A

normal parenchyma surrounding large mass –> indicates that the mass is arising from that organ

48
Q

Wilms tumor –> like to metastasize where? (3)

A
  • liver
  • lung
  • bone
49
Q

sickle cell –> predisposed to what kind of RCC?

A

renal medullary CA

50
Q

rhabdoid tumor –> occurs in what organ? (2)

A
  • kidney

- brain

51
Q

rhabdoid tumor –> imaging appearance?

A

lrg heterogeneous soft tissue mass –> ill-defined –> infiltrate renal hilum

52
Q

clear cell sarcoma –> like to metastasize where? (1)

A

bone

53
Q

pediatric –> renal mets –> MC primary? (2)

A
  • neuroblastoma

- leukemia/lymphoma

54
Q

lymphoma –> renal mets –> imaging appearance? (2)

A
  • mass

- diffuse infiltration

55
Q

mesoblastic nephroma –> benign or malig?

A

benign

56
Q

heterogeneous solid renal mass –> may be benign mesoblastic nephroma –> tx? why?

A

can’t differentiate from Wilms tumor –> surgical resection

57
Q

mesoblastic nephroma –> arises from what embryologic tissue?

A

persistent mesonephric blastema

58
Q

what is nephroblastomatosis?

A

persistence of metanephric blastema

59
Q

nephroblastomatosis –> imaging appearance?

A

bilateral enlrged kidneys –> nonenhancing lobular masses/nodules

60
Q

nephroblastomatosis –> precursor to what condition?

A

Wilms tumor

61
Q

multiple renal angiomyolipomas –> what condition?

A

tuberous sclerosis

62
Q

renal AML –> what size (cm) has risk of hemorrhage?

A

> 4cm

63
Q

renal AML –> key imaging characteristic?

A

macroscopic fat

64
Q

persistent metanephric blastema –> can lead to what condition? (3)

A
  • Wilms tumor
  • mesoblastic nephroma
  • nephroblastomatosis
65
Q

pediatric –> mult solid renal masses –> ddx? (4)

A
  • nephroblastomatosis
  • lymphoma
  • multifocal pyelonephritis
  • multiple infarcts
66
Q

neuroblastoma –> arises from what kind of tissue?

A

primitive neural crest cell –> sympathetic change

67
Q

neuroblastoma –> MC arises from what organ?

A

adrenal gland

68
Q

Wilms tumor –> displace or encase vessels?

A

displace

69
Q

neuroblastoma –> displace or encase vessels?

A

encase

70
Q

neuroblastoma –> calcifications or no calcifications?

A

50% have calcifications

71
Q

neuroblastoma –> MRI –> does it demonstrate restricted diffuse? why?

A

hypercellular –> restricted diffusion

72
Q

what NM scan can be used to evaluate neuroblastoma?

A

I-123 MIBG scintigraphy

73
Q

metastatic neuroblastoma –> classic presentation?

A

intracranial subdural mass arising from BM

74
Q

neuroblastoma –> MRI –> often seen invading into what?

A

neuroforamina & spinal canal

75
Q

neuroblastoma –> mets –> MC organ?

A

BM

76
Q

imaging features suggestive of neuroblastoma –> what is another differential consideration?

A

ganglioneuroma

77
Q

ganglioneuroma –> benign or malig?

A

benign

78
Q

neuroblastoma vs ganglioneuroma –> how to differentiate? (2)

A

neuroblastoma: very young (2yo) –> MRI restricted diffusion
ganglioneuroma: slightly older (6yo) –> no restricted diffusion

79
Q

neuroblastoma –> benign or malig?

A

malig

80
Q

adrenal hemorrhage –> US appearance?

A

hypoechoic avascular suprarenal mass

81
Q

hypoechoic avascular suprarenal mass –> ddx? (2)

A
  • adrenal hemorrhage

- neuroblastoma

82
Q

hypoechoic avascular suprarenal mass –> adrenal hemorrhage vs neuroblastoma –> how to differentiate? (2)

A

followup:
- adrenal hemorrhage –> involute
- neuroblastoma –> not involute

83
Q

adrenal cortical CA –> assoc w what condition? (2)

A
  • Beckwith-Wiedemann synd

- Li-Fraumeni synd

84
Q

urachal anomaly –> possible complication?

A

adenoCA

85
Q

urachal anomaly –> 4 types?

A
  • patent urachus
  • urachal cyst
  • urachal sinus
  • vesicourachal diverticulum
86
Q

what is duplication cyst?

A

rare congenital cystic malformation of GI tract

87
Q

rectal duplication cyst –> locaiton?

A

retrorectal space

88
Q

rectal duplication cyst –> tx? why?

A

malig potential –> surgical resect

89
Q

what is hydrometrocolpos? can be seen in what pt pop?

A

neonatal –> fluid-filled vagina + uterus

90
Q

what is hematometrocolpos? can be seen in what pt pop?

A

puberty –> blood-filled vagina + uterus

91
Q

hydrometrocolpos or hematometrocolpos –> what does it indicate?

A

outflow tract obstruction (ie. congenital imperforate hymen)

92
Q

mullerian duct cyst –> occur in M or F?

A

M only

93
Q

mullerian duct cyst –> location?

A

midline pelvis –> usu prostate

94
Q

midline prostatic cyst –> ddx? (2) how to differentiate? (3)

A

mullerian duct cyst:

  • present 30s-40s yo
  • not comm w urethra
  • usu larger than utricle cyst –> extend above prostate

prostatic utricle cyst

  • 10s-20s yo
  • comm w urethra
  • small –> not extend above prostate
95
Q

what is prostatic utricle? normal or abnormal?

A

terminal remnant of Mullerian duct –> normal

96
Q

MC sarcoma of childhood?

A

rhabdomyosarcoma

97
Q

rhabdomyosarcoma –> MC locations? (2)

A
  • head/neck

- pelvis

98
Q

8yo –> painless proptosis –> no infx –> dx?

A

rhabdomyosarcoma

99
Q

US –> unilat empty renal fossa –> ddx? (2)

A
  • renal agenesis

- cross fused renal ectopia

CORE (33 decks)

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