Exam 3 Flashcards by Christian Tinio

Know the techniques helpful in ensuring the cooperation of a pediatric patient during examination

-Speak softly
-make steady eye contact
-allow child to become familiar w/ room
-feed infant during exam
-parent hold child’s hand
-use warm gel
distract child
-scan between screaming child’s breaths

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Know wilson’s disease

Rare
Faulty copper metabolism
eventually results in severe damage to liver & brain
Diagnosis: Blood & urine test + liver biopsy
Treatment: penicillamine
Signs: eyes may have a green ring around them

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Hemangioendothelioma in the pediatric patient is considered dangerous in relation to risk of?

Hemmorage

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Know most common primary malignant liver neoplasm

Hematoblastoma

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Congenital anomaly that is discovered in a pediatric patient is a choledochal cyst this anomaly is associated with?

Congenital cyst-like dilation of CBD
Different types
Most common is a cyst like mass in the porta-hepatis region
Diagnosed in patients w/ intermittent RUQ pain, Jaundice, palpable RUQ mass

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Know biliary atresia in pediatric patient

Ducts from liver to duodenum are obliterated
Prognosis depends on duration of condition
Important to differentiate from neonatal hepatitis
US Appearance: Non visualization of GB, GB is less than 1.5cm

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Location of neuroblastoma

Adrenals

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Hemorrhage of adrenal glands most seen in patents?

2-7 days old

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Sonographic appearance of thyroid adenoma

US appearance varies
Majority solid & hypoechoic (98%)
May be isoechoic or hypoechoic
Peripheral echolucent halo (doesn’t rule out thyroid carcinoma)
degenerating adenomas may be complex in appearance (containing solid components)

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US appearance/ characteristics of Hashimoto’s Thyroiditis

Enlarged
Heterogeneous
Coarse
Hypervascularity
May have discreet nodules
Calcifications

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Signs and symptoms of Grave’s disease

Anxiety
Irretability
Tremor in hands & fingers
Heat sensitive
Bulging eyes
Goiter (Enlarged thyroid glands)
Thick red skin

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Parathyroid adenoma produces an excess of?

parathyroid hormone

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Location of thyroglossal duct?

ML anterior to trachea
anterior to thyroid
superior to thyroid

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Most likely to be mistakenly interpreted as a mass of thyroid or parathyroid gland?

Longus Colli

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Most common type of thyroid carcinoma?

Papillary 60-70%

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US features of thyroid carcinoma

Irregular borders
Tiny calcifications
Cystic & Solid components
Thick incomplete halos
many times hypoechoic

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Tissue that connects both thyroid lobes?

Isthamus

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Signs and Symptoms of hypothyroidism

Fatigue
Flakey dry skin
Weight gain
Heavy menses
Intolerance to cold

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Location of ____________ lateral to carotid arteries.

cyst

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Parathyroid adenoma lab values

increased/elevated calcium or hypercalcemia

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Location of Mcburney’s Point

RLQ

Symptoms & signs of appendicitis

Pain @ preumbilical region and localizing to RLQ (Mcburney’s)
Rebound tenderness
Anorexia, Nausea, vomiting, Diarrhea
Fever
Leukocytosis

Risk of developing appendicitis in ___________ population.

young adults

Size of normal Appendix

less than 6mm

Appearance of appendicitis in TRV and SAG planes

Bull's eye - TRV | Finger like - SAG

Normal size of lymph nodes in the pelvis and abdomen

<1cm

Location of lymph nodes

- Neck - Armpits - Collarbones - Armpits

Which type of lymphoma has less cure rate/ or higher cure rate - hodgkins or non hodgkins?

Hodgkins - high cure rate | Non-Hodgkins - low cure rate

US characteristics of normal and enlarged lymph nodes

Bladder outlet obstruction in newborns is caused by _____________?

Posterior urethral Valves

Review mesenchymal hamartoma

- Rare - Occurs in infants and children under 2 - Derived from embryonal tissue - US: variable, well circumscribed, may have stellate appearance may have trabecular appearance

Know US appearance of infant kidneys

- central portion less echogenic - Echogenicity of cortex isoechoic to liver or hypoechoic to liver if premature - Pyramids larger & more prominent - Contour may be lobulated due to residual fetal lobulation

Causes of hydronephrosis in neonates, which one is most common

-Most common cause is ureteropelvic junction obstruction (UPJ)

Know appendicitis care fully + types | acute chromatic gangrenous

US appearance of appendicolith

May be present w/ distal shadowing

US appearance of bowel wall

Hypoechoic with echogenic rim

Large popcorn type calcifications seen on mammography are associated with________?

Best transducer for US imaging of the breast?

7 - 12.0 MHZ linear transducer

Snowstorm sign - review it carefully

appear as dirty shadowing or noise representing a silicone granuloma

Complications of breast implants

- Hematoma - Abscess - Silicone or saline bleed - Capsular contracture - Implant rupture

Review phyllodes tumor

- Rare - Solid tumor - Benign or Malignant - Arises from stromal tissue of breast - More common in women 30-50 - Usually solitary - Large & palpable

Intracapsular rupture of silicone breast implant appear like ladder sign on US, on MRI it would appear like ______________?

Linguine Sign

Know the names of all benign breast lesions

- Fibroadenoma (most common) - simple cyst - fibrocystic change FCC - Complicated versus complex cyst - Galactocele - Sebaceous cyst - Mastitis - Abscess - Mondor Disease - Phyllodes Tumor - Lipoma - Hematoma - Seroma - Fat Necrosis - Adenoma + secretory ad - hamartoma - intraductal papilloma - papillomatosis

Do you think simple breast cysts need treatments?

Need treatment based on BIRADS designation if they meet criteria for simple cyst they can be set BIRADS 2 - benign = no treatment

Know BIRADS categories.

``` Cat 0 - inconclusibe findings; need additional imaging Cat 1 - normal Cat 2 - Benign Cat 3 - Probably Benign Cat 4 - Suspicious Cat 5 - Malignant ```

US characteristics of malignant breast lesions.

- Round, oval, or elipsed shape - Wider than tall: horizontal orientation, do not cross tissue planes - Smooth Well defined borders - Microlobulation

Know increased risk factors for development of breast cancer

Gender - Age - family history - Menstrual history - child bearing history - Hormonal factors - atypical hyperplasia - Radiation therapy - Obesity

Cranio - caudal view in Mammography is useful in ________________ mass localization

Medial or Lateral?

Which quadrant in breast is most common to find cancer?

Upper outer quadrant

Location of tail of the breast?

Tail of spence is located superio-lateral to breast almost axilla region