WHOLE LOTTA REVIEW QUESTIONS Flashcards
What is micturition?
Voiding, discharge of urine
What is hyperalimentation
The administration of nutrients through IV feeding
Advantages of ultrasound
- Soft tissue information
- No ionizing radiation
- Serial studies in children-Dynamic information
- Inexpensive
Disadvantages of US
- Bowel gas/bone
- Operator dependence
- Patient size/resolution trade-off
- Cooperation
- Ternderness
Liver parenchyma arises from
a. Endoderm
b. Mesoderm
c. Ectoderm
Endoderm
What is the significance of Mesonephros?
provides partial function while permanent kidneys continue to develop
→ the mesonephric ducts/ Wolffian ducts (male genital structures), disappear in female
Which organs originate from foregut
Pharynxoral cavity upper/lower respiratory system esophagus stomach duodenum liver bile ducts pancreas
Name the parts of primordial gut
Foregut, midgut, hindgut
What is duct of Santorini?
Accessory pancreatic duct
What is the role of metanephros?
Metanephros becomes the permanent kidneys
What is the meaning of “coarctation”
Narrowing or constriction
What is the histological difference between
hemangioendotelioma and
cavernous hemangioma?
cavernous hemangioma = 1 endothelial layer & asymptomatic
hemangioendotelioma= 2 endothelial & symptomatic
A tumor marker often increased in cases of HCC, hepatoblastoma, and testicular cancer
AFP
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
List the causes of fatty infiltration of the liver in the pediatric population (9)
Malnutition hyperalimentation cystic fibrosis glycogen storage disease malabsorption syndrome steroid therapy acute hepatitis obesity cushings syndrome
What abdominal pathology might you expect to find in a pt with cystic fibrosis during scan? (4)
Fatty liver / Liver cirrohis
Gallstones / GB sludge
Echogenic pancreas
Meconium ileus
The stomach in hypertrophic pyloric stenosis is often filled with fluid even if the pt has been fasting
T/F
True
Patients with hemangioendothelioma typically are asymptomatic
t/f
False
Which disease results in the absence of the intrahepatic and extrahepatic ducts and possibly the absence of the GB?
biliary atresia
Which of the following may cause cirrhosis of the liver?
Biliary atresia
Cystic fibrosis
Metabolic diseases
all of the above
With hypertrophic pyloric stenosis the stomach wall is grossly enlarged.
t/f
false
Most common pediatric liver mass?
Hepatoblastoma
It is the 2nd most common cause of obstructive jaundice in children
Arises from the biliary tract
Solid, malignant
Rhabdomyosarcoma
Diff. diagnosis for a hepatoblastoma include (3)
Hepatoma
infantile hemangioendothelioma
mesenchyma hamartoma
The IVC may be interrapted and drain via _______.
azygous vein
Wedge-shaped, round or oval area of decreased echogenicity with good margins in liver.
Changes from hypo to hyper to calcification over time
hepatic infarction
These structures may be mistaken for a renal cyst in infants and young children
renal pyramids
Normal neonatal kidneys
- echogenic kidneys with prominent pyramids
- isoechoic to liver kidneys with prominent renal pyramids
- hypoechoic kidneys with hyperechoic renal sinus
- echogenic kidneys with dilated pelvis up to 2cm (AP)
- echogenic kidneys with prominent pyramids
What’s enuresis?
Involuntary discharge of urine during sleep
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
An overly distended urinary bladder is common in cases of bilateral renal agenesis
T/F
False, the bladder is usually absent
Prune belly syndrome associated with all of the following except
Cryptorchidism
Dysplastic kidneys
Wilm’s tumor
Absent abdominal muscles
Wilms tumor
Most common malignant renal tumor in pediatric patients.
Wilms
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
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?
Renal cell carcinoma
Mesoblastic nephroma
Wilm’s tumor
Neuroblastoma
Mesoblastic nephroma
Most common cause of hydronephrosis in pediatrics
UPJ obstruction
A 2 month old with an enlarging palpable left flank mass and mild hypertension. Sonographically, a late, solid, ill defined echogenic mass is seen superior to the left kidney. Calcifications wit shadowing are present with the mass. The kidney appears to be displaced inferiorly. What is the most likely diagnosis.
a. Wilms
b. adrenal hemorrhage
c. Neuroblastoma
d. adrenal mets
c. Neuroblastoma
what is the most common children adrenal tumor
nueroblastoma
which of the following is false
a. Adrenal hemorrhage is typically diagnosed when infant is 1 month
b. infants who are premature or have neonatal sepsis, hypoxia and birth trauma may develop an adrenal hemorrhage
c. Jaundice may occur, as well as scrotal discolouration in male infants
d. Blunt abdo trauma or child abuse may cause hemorrhage in older infants
a. Adrenal hemorrhage is typically diagnosed when infant is 1 month
(first week)
Angyomyolipomas closely associated with ….
Tuberous sclerosis
The three most common causes of hydronephrosis are …
UPJ obstruction
UVJ obstruction
duplication of collecting system
The most common sonographic finding in cases of pyelonephritis is ….
enlargement of the kidneys
Neuroblastoma typically have defined borders.
t/f
False
Why adrenal glands in neonates susceptible to hemorrhage?
When does this pathology commonly identified?
- Large size and vascularity
- First week of life
Children with cystic fibrosis are predisposed to gallstones
T/f
True
What is the typical clinical presentation in pt with insulinoma? (3)
Hypoglycemia
- Erratic behaviour
- Seizures
US appearance in chronic pancreatitis
- Shrunken pancreas
- Irregular borders
- Echogenic due to fibrosis
- Calcifications
This condition is closely associated with IBD
Biliary atresia Sclerosing cholangitis Caroli’s dx Choledochal cyst GB hydrops
sclerosis cholangitis
Sono features of portal hypertention in children
5
Hepatofugal portal flow Varices Splenomegaly Ascities Cirrhosis
Causes of portal vein thrombosis
- thrombosis due to dehydration, catheterization, shock, portal hypertension
- tumor invasion from HCC or hepatoblastoma
3 most common causes of jaundice are:
Hepatitis,Biliary atresiaCholedochal cysts
3 most common clinical symptoms of choledochal cysts
Mass, pain, jaundice
Clinical symptoms of intussusception (5)
- Dark red stool (currant-jelly stool)
- Palpable abdominal mass
- Abdominal distension
- Intermittent colicky abdominal pain
- Vomiting
Asplenia does not affect the quality of life in children.
T/F
False, higher levels of morbidity and mortality
