Autopsy 4: Pediatric Flashcards
(105 cards)
1
Q
which week differentiates a fetus from a surgical vs autopsy specimen
A
20 weeks
2
Q
define premature
A
birth before 37 weeks
3
Q
define stillbirth
A
fetus born with no signs of life after 28 weeks
4
Q
define full term
A
child born between 37 and 42 weeks
5
Q
what is IUFD
A
intrauterine fetal demise
6
Q
what are some cases in which the medical examiner will take a fetal case
A
SIDS, neglect, poisoning, homicide
7
Q
what is a gravida para (GXPX)
A
pregnancies and live births
g refers to how many times a female has been pregnant
P refers to how many times a female has delivered a live baby
8
Q
what are the two most common birth injury of the skeletal system in a fetus
A
clavicular and humeral fractures
9
Q
what are the best sources of cytogenetics cultures for a fetus
A
fascia
lung
Achilles tendon
chorionic villi
cartilage
10
Q
what solution should fetal cytogenetic samples be sent in
A
Hank Solution
11
Q
what causes 64% of intrauterine fetal deaths
A
abnormalities within the placenta
12
Q
what are the grades of maceration
A
grading scale of fetuses who died while still in their mother
scale is from 0-5
fetus has progressively more skin slippage and erythema (congestion)
13
Q
how long does mummification take of a fetus who dies while still inside the uterus
A
2 weeks
14
Q
what is the crown-rump length
A
length of a fetus from anterior fontanel to base of coccyx
15
Q
what is the crown-heel length
A
length of a fetus from anterior fontanel to tip of heel
16
Q
where should one take an abdominal circumference of a fetus
A
at the level of the umbilicus
17
Q
where should one take an chest circumference of a fetus
A
at the level of the nipple
18
Q
what crown length is usually ___ that of the crown-heel length
A
2/3rds
19
Q
what are the four facial measurements one should take of a fetus
A
outer and inner canthus
inter pupillary distance
philtrum
20
Q
what is the correct position of the ears on a fetus
A
lateral canthus should be line with the upper portion of the helix
21
Q
what is the term used for a enlarged tongue
A
macroglossia
22
Q
what is the term used for a recessed mandible
A
micrognathia
23
Q
what is the term for severe malnutrition
A
marasmus
24
Q
what is the term for extreme wasting usually due to systemic disease like cancer
A
cachexia
25
what is the term for gray-blue spots on the sacrum of children
Mongolian spots
26
what is the word for a missing anus
imperforate anus
27
when is the differentiation of male and female external genitalia complete
12 weeks
28
what is the term for a congenital abnormality in the male urethra
hypospadias
29
what is the term for a bald spot at the top of the head in a fetus
cutis aplasia
30
what is the term for a bulging of the abdominal cavity, typically due to an issue with the linea alba
diastases recti
31
a single palmar crease can be associated with which genetic condition
trisomy 21 - downs syndrome
32
how do you check for a pneumothorax in an infant
open the chest cavity under water and look for bubbling
33
where do you pull a blood sample from in a fetus
right atrium
34
what is the best autopsy technique to use on a fetus
the en masse method - aka removing the entire block
35
what is the single largest cause of neonatal deaths globally
infections - they usually arise from the placenta
36
what is necrotizing enterocolitis
inflammation of the intestines cause a distended and thinning appearance - can eventually lead to a perforation
37
what are some consequences of rubella in a child
deafness
heart issues (patent ductus ateriosus)
hepatosplenomegaly
microcephaly (small head)
38
what is pneumatosis intestinalis
gas bubbles seen in the colon
39
what three things can cytomegalovirus cause in a child
myocarditis
intestinal pneumonia
sialadenitis
40
what does the ADAM complex stand for
amniotic deformities, adhesions, mutilations
41
what is the term for lack of amniotic fluid
oligohydraminos
42
what is Potter sequence
group of abnormalities that can be seen in babies that experience oligohydraminos
1.) pulmonary hypoplasia
2.) arthrogryposis (joint contractures)
3.) limb deformities
4.) limb edema/congestion
5.) brain defects
43
what are three facial features associated with oligohydraminos
slanting forehead
blunt-tipped nose
recessed chin
44
what is nuchal umbilical cord
umbilical cord with knots and/or strictures in it
45
what is the most common cause of neonatal respiratory distress syndrome (RDS)
hyaline membrane disease (lack of pulmonary surfactant)
46
how can you test a fetus's lungs for ventilation complications
put them in a container of water - if they sink, they were poorly aerated
47
what is it important to note when evaluating the small and large intestines in situ
whether or not they're in their normal anatomy location
48
what is caput succedaneum
accumulation of interstitial fluid in the soft tissues of the scalp - head becomes edematous and swells
49
what is the most frequent cranial birth injury
cephalohematoma
50
what is a cephalohematoma
hemorrhage occurring in the scalp between the bone and periosteum
**hemorrhage does not cross suture lines**
51
what is the most common, important pathologic finding associated with birth head injuries
intracranial hemorrhage
52
how are eyes removed in a pediatric case
from above through the base of the skull
53
what is the most serious threat in fetal hydrops
CNS damage, specifically kernicterus (too much billirubin)
54
what is fetal hydrops
excessive extravascular fluid
55
what is a malformation
error in morphogenesis (single gene or chromosomal)
56
what is a disruption
issue with something that was previously normal
ex. amniotic band syndrome
57
what is a deformation
abnormal biomechanical force
ex. uterine constraint
58
what is the most common lethal genetic disease that affects the white population
cystic fibrosis (mucoviscidosis)
59
what is meconium ileus
intestinal obstruction caused by thick meconium in cystic fibrosis cases
60
what type of chromosomal abnormality is most common in spontaneous abortion cases
autosomal trisomies
61
what is the ratio of chromosomal defects at birth
1:200
62
what is a common, mild malformation in chromosome defects
single umbilical artery
63
what are some common findings in those with trisomy 21 (Downs Syndrome)
upward slanting eyes
smooth philtrum
protruding tongue
gap between first and second toes
single palmar crease
cardiac defects
64
what are some brain features of someone with trisomy 21 (Downs Syndrome)
short A-P diameter
open operculum
hypoplastic superior temporal gyrus
65
what are some common findings in those with trisomy 13 (Patau Syndrome)
midline facial defect (cleft lips and palates)
rocker bottom feet
cardiac defects
polydactyly
66
what are some common findings in those with trisomy 18 (Edwards Syndrome)
micrognathia
overlapping fingers
rocker bottom feet
renal malformations
low set ears
67
what causes Cri Du Chat Syndrome (cat cry syndrome)
partial deletion of short arm of chromosome 5
68
what are some common findings in those with Cri Du Chat Syndrome (cat cry syndrome)
round, oval face
catlike cry
growth and mental retardations
excess nuchal skin
69
how many chromosomes does a fetus with triploidy have
69
70
what are some common findings in those with triploidy
hydrocephalus
low-set, deformed ears
micrognathia
syndactyly
71
what are some common findings of those with monosomy X (Turner Syndrome)
short stature
small for gestational age
lymphedema of extremities
excess skin at nape of neck
broad chest
72
what are some common findings of those with Klinefelter syndrome (male with XXY)
gynecomastia
small testes and penis
hypogonadism
73
what is the most frequent mental retardation syndrome
fragile X syndrome - most common in males
74
what are some common findings of those with fragile X syndrome
large ears
hyper extensible joints
pectus excavatum (depressed chest)
seizures
75
what is a meningoencephalocele
neural tube defect which causes a large portion of the occipitoparietal brain tissue to protrude through a posterior fontanel
76
what is Meckel-Gruber syndrome
a fetus with a meningoencephalocele
77
what is iniencephaly
neural tube defect where there is a deficiency of the occipital bone and cervicothoracic spinal fusion
78
what is anencephaly
neural tube defect that causes absence of scalp, cranium, and most of brain
79
what is craniorachischisis
neural tube defect that causes both anencephaly and bony defect of the spine
80
what should you do if there is a suspected cardiovascular malformation in a fetal case
perfuse cavities with fixative overnight
81
what is the most common congenital abnormality of the heart
ventricular septal defect
82
what are the three most common congenital abnormalities of the heart
septal defects (holes)
stenotic lesions
outflow tract abnormalities
83
what are the two types of ventricular septal defects
perimembranous (membranous portion of interventricular septum) and muscular (entirely within muscular portion)
84
what is the most common type of atrial septal defect
atrial secundum (does not involve the fossa ovalis)
85
what is the ductus arteriosus
connection between the pulmonary artery and aorta to prevent blood from going to the lungs in a fetus
can stay open after birth (patent ductus arteriosus)
86
what are the four conditions that make up the tetralogy of fallot
1.) ventricular septal defects
2.) pulmonary valve stenosis
3.) misplaced aorta
4.) right ventricular hypertrophy
87
coarctation of aorta is associated with which syndrome
turner syndrome
88
what heart defect is most common in Downs Syndrome
atrioventricular septal defect
89
what are the three main causes of aortic stenosis
congenital
rheumatic fever
calcium build up
90
what is transposition of the great arteries
aorta is connected to the right ventricle while the pulmonary artery is connected to the left ventricle
91
what is truncus arteriosus
condition where there is only one great artery arising from the heart
92
what is cardiac ventricular non-compaction
trabeculae in the ventricles of a fetus do not compact against the myocardium over time
mostly affects the left ventricle
93
what is the most common tumor of infancy
hemangioma
94
what is the most common cardiac tumor in infants and children
rhabdomyoma
95
what are the three most common locations for a cardiac rhabdomyoma
right ventricle
left ventricle
septum
96
what are the most common teratomas of childhood
sacrococcygeal teratomas
97
what is the most common primary renal tumor of childhood
wilms tumor (nephroblastoma)
98
what are three of the most common causes for SIDS
maternal cigarette smoking
material anemia
prone sleeping
99
what are the 2 most common SIDS findings at autopsy
thymus, pleural, and epicardial petechiae
hyperated lungs with congestion
100
what is Münchausen syndrome by proxy
adult career causes or falsifies illness to a child to gain medical attention and to initiate extensive investigation
101
what are two common fetal findings in fetal alcohol syndrome cases
deceased brain weight
agenesis of the corpus callousum
102
what is an omphalocele
defect of the anterior abdominal wall (fails to develop)
abdominal contents are contained within the peritoneal membrane
103
what is gastroschisis
loops of bowel come through an opening in the abdominal wall
104
what is the rule of 2's for meckel diverticulum
2% of the population
2 feet from the IVC (in adults)
2 in long (in adults)
105
what is fetus papyraceus
compressed, macerated remains of a fetus that demises early in a multiple gestation (usually IVF)
