Pediatric Abdomen Flashcards
(83 cards)
1
Q
Transducer used for pediatric abdomen
A
Highest frequency (linear, curved array, or sector)
2
Q
For better resolution, use ____ and ____ instead of decreasing depth
A
Sequential focusing and zoom
3
Q
0-2 y/o: NPO for abdominal ultrasound ____
A
4 hours
4
Q
3-5 y/o: NPO for abdominal ultrasound ____
A
5 hours
5
Q
6+ y/o: NPO for abdominal ultrasound
A
6 hours
6
Q
Right hepatic lobe should not extend more than ___ below costal margin in young infant without pulmonary hyperaeration
A
1cm
7
Q
Normal echogenicity for neonatal/pediatric liver
A
Low to medium homogenicity w clear definition of portal venous vasculature
8
Q
CBD in neonates/pediatrics:
A
Younger= smaller
9
Q
CBD in neonates
A
<1mm
10
Q
CBD in infants up to 1 y/o
A
<2mm
11
Q
CBD in older children
A
<4mm
12
Q
CBD in adolescents and adults
A
<6-7mm
13
Q
Length of gallbladder should not exceed the length of the ____
A
Kidney
14
Q
Infants <1 y/o: length of gallbladder is:
A
1.5-3cm
15
Q
Length of gallbladder in older children:
A
3-7cm
16
Q
Pancreatic duct should not exceed:
A
1-2mm
17
Q
Pancreas texture is ___ compared to normal liver texture
A
Hypoechoic
18
Q
Why is the pancreas hypoechoic compared to the normal liver?
A
There is little fatty tissue in Islets of Langerhans
19
Q
Pancreatic head should measure :
A
1-2.2cm
20
Q
Pancreas body measures:
A
.4-1cm
21
Q
Pancreas tail measures:
A
.8-1.8cm
22
Q
Spleen in infants less than 3 months old measures
A
6cm
23
Q
> 12 y/o, spleen measures:
A
12cm
24
Q
Portal vein measures _____ in children <10
A
8.5mm
25
Portal vein measurement for 10-20 y/o
10mm
26
Extrahepatic obstruction in neonate may be caused by:
Choledochal cyst, biliary atresia, or spontaneous perforation of bile ducts
27
Intrahepatic causes of neonatal jaundice:
Hepatitis and metabolic disease
28
Extrahepatic/intrahepatic obstruction to bile flow causes:
Jaundice
29
If neonate has jaundice that persists beyond ______, sonography may be ordered to differentiate causes
2-weeks after delivery
30
Inspissated means:
Thickened
31
Jaundice in infants and children may be due to
Cirrhosis, benign structures, neoplastic processes
32
3 most common causes of jaundice in neonates
BILIARY ATRESIA, Hepatitis, choledochal cyst
33
In neonatal hepatitis, the infection of the liver occurs within _____ of birth
First 3 months
34
Neonatal hepatitis: infection reaches liver through the _____
Placenta(from maternal secretions, catheters/blood transfusions)
35
Most common agents of transplacental infection for neonatal hepatitis
Syphilis, toxoplasma, rubella, cytomegalovirus(CMV)
36
Neonatal hepatitis sonographic findings:
Liver normal/enlarged
Echogenic parenchyma
Decreased visibility of peripheral portal venous structures
If dysfunction is severe, GB wall may be small
37
Biliary atresia is _____ of biliary ductal system
Narrowing/underdevelopment
38
Biliary atresia is more common in
Males
39
Clinical features in neonates for biliary atresia:
Persistent jaundice
Acholic(pale) stools
Dark urine
Hepatimegaly/distended abdomen
40
Sonographic features biliary atresia
Liver is normal or enlarged
Normal or increased echogenic parenchyma with slight decrease in visualization of peripheral portal venous system
Intrahepatic ducts NOT dilated
Small triangular structure may be seen superior to porta hepatis
41
Small triangular structure seeen superior to porta hepatis is:
Hypoplastic remnant of biliary structure
42
Change in GB size after milk feeding suggests ____ of common hepatic/CBD(seen only in neonatal hepatitis)
Patency
43
Presence of ______ should determine if biliary atresia is suspected
Polysplenia
44
Abnormal cystic dilation of biliary tree that most frequently affects the CBD
Choledochal cyst
45
Most common type of choledochal cyst
Fusiform dilation of CBD
46
How many types of choledochal cysts are there
5
47
Disease associated with choledochal cysts
Caroli’s disease
48
Two most common neoplasms in pediatric population
Hemangioendothelioma(benign)
Hepatoblastoma(malignant)
49
Most common benign liver tumor
Hemangioendothelioma
50
Infantile hepatic vascular tumor:
Hemangioendothelioma
51
Most common sonographic appearance of hemangioendothelioma is:
Hepatomegaly
52
Most common malignant tumors in children
Hepatoblastoma and hepatocellular carcinoma
53
Most common primary malignant disease of liver
Hepatoblastoma
54
Most common abdominal malignancy in children
Neohroblastoma/Wilms tumor
55
2nd most common abdominal malignancy in children
Neuroblastoma(adrenal gland)
56
3rd most common abdominal malignancy in children
Hepatoblastoma
57
Hepatoblastoma is associated with:
Beckwith-Weidmann syndrome, hemihypertrophy(excess growth of one side of body)
58
Second most common malignant tumor in children
Hepatocellular carcinoma
59
Hepatocellular carcinoma is also known as
Hepatoma
60
3 conditions indicating pediatric ultrasound for extreme abdominal pain
Hypertrophic pyloric stenosis
Appendicitis
Intussesception
61
Located between stomach and duodenum
Pyloric canal
62
Hypertrophy of circular muscle of pyloric causes
Narrowing of pyloric canal
63
Hypertrophic pyloric stenosis(HPS) appears most commonly in
Male infants between 3-12 weeks pregnant old
64
Most common clinical sign for HPS
Bile-free/ projectile vomiting
65
Palpation of _____ shaped mass in RUQ is diagnostic and treated by surgical _______
Olive shaped
Pyloromyotomy
66
Appearance of a hypertrophied pyloric muscle:
Bagel/donut appearance with echogenic central canal
67
HPS: if muscle is thickened and elongated, the mucosa extends into the antrum— _____ sign
Cervix sign
68
Pyoloric muscle wall normal measurements
<3mm in trans
<15-16mm in long
69
Diagnosis of hypertrophic pyloric stenosis depends on
Pyloric muscle canal measures 15-16mm or greater
Pyloric wall muscle thickness of 3mm or more
Visualization of hypertrophied muscle
70
Most common cause of emergent surgical abdominal pain in children
Appendicitis
71
Appendicitis: transducer is moved slowly over abdomen using ____ technique
Graded compression
72
Causes of appendices non visualization
Overlying bowel
Retrocecal positon of appendix
Over-distention or nondistention of bladder
73
Sonographic features of appendicitis
Acutely inflamed
Noncompressible
Outer diameter measures >6-7mm
Hyperemia
Free peritoneal fluid
Apendicolith
Target sign
74
Most common acute abdominal disorder in early childhood
Intussusception
75
Occurs when bowel prolapses into more distal bowel and propelled in antegrade fashion
Intussusception
76
Intussusception causes ______ of bowel which then causes obstruction
Telescoping
77
Most common cause of intestinal obstruction in children under 3
Intussusception
78
Clinical signs of intussusception
Colicky abdominal pain, vomiting, bloody(currant jelly) stools
79
Intussusception sonographic features
Alternating hypo/hyperechoic rings surrounding an echogenic center—target sign, donut sign, cinnamon bun sign——transverse
Hypoechoic layers on each side of echogenic center——Pseudokidney or sandwich sign—longitudinal
80
Hair balls in young women
Trichobezoar
81
Vegetal matter
Phytobezoars
82
Incompletely dissolved powdered formula
Lactobezoar
83
Inorganic material(sand, asphalt, shellac, “concrete”)
Concretion
