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PEDS MT review questions Flashcards

1
Q

the primodial gut is divided into what 3 parts?

A
  1. foregut
  2. midgut
  3. hindgut
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2
Q

which primordial gut forms the physiological herniation? When is this seen?

A

mid gut

- seen at 8-12 weeks GA

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3
Q

what emryological structure forms the ligamentum teres?

A

left umbilical vein

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4
Q

what embryological structure forms the ligamentum venosum?

A

ductus venosus

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5
Q

2 types of buds that form the pancreas and what they form?

A
  1. ventral- uncinate/head

2. dorsal: body/tail

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6
Q

what are the three embryological primitice kidneys called?

A
  1. pronephros
  2. mesonephros
  3. metanephros
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7
Q

2 parts of the adrenal gland?

A
  1. medulla

2. cortex

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8
Q

7 year old boy presents for abdo scan. Presents with abdominal pain and distention. Ultrasound demonstrated a large, complex mass in RT lobe of liver with a hyperechoic rim. Anechoic areas are seen along with a few calcifications. Lab reveals normal AFP level. What is the most likely diagnosis?

A

Mesenchymal sarcoma

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9
Q

abdominal scan ordered on 10 year old with cystic fibrosis. What finding may be expected? (4)

A
  • fatty liver/cirrhosis
  • gallstones/sludge
  • echogenic panc.
  • meconium ileus
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10
Q

ectoderm gives rise to which tissues?

A
  • skin

- nervous system

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11
Q

50% of perdiatric US workload is gyne-torsion, hemorrhagic cysts and PID? True of false?

A

false

- 50% renal tract

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12
Q

A tumor marker often increases in cases of HCC, hepatoblastoma, and testicular cancer?

A

AFP

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13
Q

Patients with hemangioendotelioma typically are asymptomatic? T or F?

A

False

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14
Q

most common perdiatric liver mass?

A

Hepatoblastoma

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15
Q

most common tumor of liver in neonates?

A

hemangioma

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16
Q

5 month old presents with palpable liver. Ultrasound reveals a solid, vascular mass with Linear foci within the lesion. Appears rather benign on ultrasound. What is it?

A

Hemangioendothelioma

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17
Q

A 4yr old boy with glycogen storage disease suddenly presents with liver failure and GI bleeding. Ultrasound demonstrates solid hyperechoic mass occupying the entire liver.

A

HCC

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18
Q

A 2 year old boy presents with a tummy ache after eating french fries. Sometimes he has nausea. Most common finding on U/S would be?

A

cholelithiasis

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19
Q

A 7year old girl, with a previous history of Crohn’s disease, presents with RUQ pain and jaundice. Ultrasound reveals severely thickened walls of bile ducts. The most likely diagnosis for this would be?

A

sclerosing cholangitis

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20
Q

20 day old baby boy presents with absent femoral pulses and blanching of the lower extremities. Ultrasound reveals echogenic material within the aortic lumen.

A

aortic thrombus

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21
Q

A 4 week old newborn presents with jaundice. Ultrasound reveals a gallbladder of less than 1.5cm in length. The neonate most likely has?

A

biliary atresia

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22
Q

A 5 year old boy presents with increasing abdominal girth and jaundice. Sonographic findings demonstrate a solid, hypoechoic mass within the bile ducts. This boy has?

A

Rhabdomyosarcoma

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23
Q

5 month old girl presents with palpable RUQ mass. U/S demonstrated normal liver and GB. A 3cm cystic mass is seen in area of porta hepatis and appears to be separate from GB. Low-level echoes are seen in the dependent portion of the cyst and appear to change position when the patient is rolled into decube. what is the most likely diagnosis?

A

Type 1 choledochal cyst with sludge

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24
Q

Patient presents with Wilms tumor for an U/S. You see an echogenic mass within the lumen of the IVC and hypoechoic, oval masses surrounding the aorta and IVC. whats the most likely diagnosis?

A
  • ivc thrombus with lymphadenopathy
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25
A child presents with severe hypertention, headaches, and fatigue. Most likely diagnosis?
coarctation of aorta
26
Tumor invasion of IVC occurs from? (5)
``` Wilms tumor Neuroblastoma Sarcoma HCC Lymphoma ```
27
US of liver in patients with acute hepatitis may appear normal. T or F?
True
28
List the types of liver abscesses? (3)
1. fungal 2. amebic 3. pyogenic
29
``` Which condition(s) does NOT cause cirrhosis? Biliary atresia Malnutrition Cystic fibrosis Chronic hepatitis Hyperalimentation Medications ```
Malnutrition and hyperalimentation | they can cause fatty liver
30
Which pathologies casue increase in AFP?
Hepatoblastoma and HCC
31
Biliary atresia causes increase in what?
Conjugated / Direct bilirubin
32
Name the three common symptoms of choledochal cyst?
Abdo pain Palpable mass Jaundice
33
Describe the most common type of choledochal cyst?
Type 1, concentric / fusiform dilatation of CBD
34
Biliary atresia is strongly associated with IBD? T or F?
False | Sclerosing cholangitis is strongly assoc. with IBD
35
The most common cause of pancreatitis in children?
Blunt abdo trauma
36
List the four m/c complications of pancreatitis?
1. psedocyst 2. phlegmon 3. hemorrhage 4. abscess
37
Sonographic findings in Budd-Chiari syndrome? main? (3) secondary? (3)
Hepatomegaly Echogenic clot in HVs Absence of flow in HVs Secondary findings Ascites Pleural effusion GB wall edema
38
Clinical signs of insulinoma. Is the tumor typically small or large at presentation? Why?
Hypoglycemia leads to - Erratic behavior - Seizures - Small, because it’s functioning - Clinical signs show early
39
``` Gallstones are not common in pediatric population. However, certain conditions predispose a child to developing gallstones. Which of the following conditions does NOT predispose a pt to gallstones? A) sickle cell disease B) cystic fibrosis C) hemolytic anemia D) pancreatitis ```
pancreatitis
40
If increases BUN what does this indicate?
kidney damage
41
increased creatinine indicates?
decreased renal function
42
What is azotemia/uremia?
elevated nitrogen-containing substances in blood (BUN and creatinine)
43
What is micturition?
voiding/discharge of urine
44
What is hyperalimentation?
The administration of nutrients through IV feeding
45
Liver parenchyma arises from?
endoderm
46
What is the significance of mesonephros?
provides partial function while permanent kidneys continue to develop
47
An infant presents with a history of vomiting. While evaluating the patient, you notice a vessel immediately anterior to the SMA. With further evaluation, this vessel is identified as SMV. What condition is associated with this finding?
midgut malrotation
48
What abdominal pathology might you expect to find in a pt with cystic fibrosis during scan?
Fatty liver / Liver cirrohis Gallstones / GB sludge Echogenic pancreas Meconium ileus
49
The stomach in hypertrophic pyloric stenosis is often filled with fluid even if the pt has been fasting. T or F?
True
50
Patients with hemangioendothelioma typically are asymptomatic. True/ False?
False
51
Which disease results in the absence of the intrahepatic and extrahepatic ducts and possibly the absence of the GB?
Biliary atresia
52
Which disease results in the absence of the intrahepatic and extrahepatic ducts and possibly the absence of the GB?
Biliary atresia
53
What may cause cirrhosis of the liver? (3)
Biliary atresia Cystic fibrosis Metabolic diseases
54
With hypertrophic pyloric stenosis the stomach wall is grossly enlarged. T or F?
False
55
Most common pediatric liver mass?
Hepatoblastoma
56
It is the 2nd most common cause of obstructive jaundice in children Arises from the biliary tract Solid, malignant
Rhabdomyosarcoma
57
3 D/D for hepatoblastoma?
1. hepatoma 2. infantile hemangioendothelioma 3. mesenchymal hamartoma
58
The IVC may be interrapted and drain via?
azygous vein
59
These structures may be mistaken for a renal cyst in infants and young children?
renal pyramid
60
What’s enuresis?
Involuntary discharge of urine during sleep
61
What is vesicoureteral reflux?
When valves at the junction of the ureter and bladder allow urine from bladder to back up into ureter and kidney
62
An overly distended urinary bladder is common in cases of bilateral renal agenesis. T or F?
False
63
Prune belly syndrome associated with all of the following except? Cryptorchidism Dysplastic kidneys Wilm’s tumor Absent abdominal muscles
Wilm's tumor
64
Male neonate Rt kidney – NAD Lt kindey – composed of multiple cysts of varying sizes. No normal parenchyma or sinus visualized. What’s the most likely diagnosis?
Multicystic dysplastic kidney
65
A neonate born with a palpable left flank mass. US – large solid homogeneous mass in lt kidney. Very little normal renal parenchyma is seen. Most likely diagnosis?
Mesoblastic nephroma
66
Most common cause of hydronephrosis in pediatrics?
UPJ obstruction
67
2- month old infant presents with enlarging, palpable left flank mass and mild hypertension. Sono shows large, solid, ill-defined echogenic mass seen superior to left kidney. Calcifications with shadowing are present within the mass. The kidney appears to be displaced inferiorly. What is the most likely diagnosis?
neuroblastoma
68
what is the most common children adrenal tumor??
neuroblastoma
69
When is adrenal hemorrhage typically diagnosed?
1 week old
70
Angyomyolipomas closely associated with?
Tuberous sclerosis
71
The three most common causes of hydronephrosis are?
- UPJ obstruction - UVJ obstruction - duplication of collecting system
72
The most common sonographic finding in cases of pyelonephritis is?
enlargement of kidneys
73
Neuroblastoma typically have defined borders. T or F?
False
74
Why adrenal glands in neonates susceptible to hemorrhage? | When does this pathology commonly identified?
large size and vasularity 1st week of life
75
Children with cystic fibrosis are predisposed to gallstones t/f ?
True
76
What is the typical clinical presentation in pt with insulinoma?
Hypoglycemia - Erratic behaviour - Seizures
77
US appearance in chronic pancreatitis?
- Shrunken pancreas - Irregular borders - echogenic due to fibrosis - Calcifications
78
Causes of portal vein thrombosis?
- thrombosis due to dehydration, catheterization, shock, portal hypertension - tumor invasion from HCC or hepatoblastoma
79
3 most common causes of jaundice are?
1. hepatitis 2. biliary atresia 3. choledochal cyst
80
3 most common clinical symptoms of choledochal cysts?
- mass - pain - jaundice

Peds (18 decks)

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