Radiology

Question 1

injuries that can be sustained during birthing process

Answer 1

extracalvarial bleeding: cephalhematoma and caput succadaneum

Question 2

soft, fluctuant mass or swelling of the scalp located in middle and posterior parietal regions and occiput

Answer 2

cephalhematoma

Question 3

t/f incision and drainage is done in cephalhematoma

Answer 3

false, due to risk of infection

Question 4

uniform thickening of the scalp that crosses the calvarial sutures

Answer 4

caput succadaneum

Question 5

differential diagnosis for caput succadaneum

Answer 5

cranium meningocoele: (+) pulsations, (+) baby cries when pressure is applied

Question 6

origin location and shape of epidural hematomas

Answer 6

o: arterial
l: above the dura
s: elliptical/lentiform/biconvex (lemon)

Question 7

location of epidural hemorrhages in relation to tentorium cerebelli and regions of the brain

Answer 7

tc: 95% supratentorial
regions: 60% temporoparietal, 20% frontal, 20% parieto-occipital

Question 8

origin location and shape of subdural hematoma

Answer 8

o: dural vessels
l: beneath the dura
s: crescentic (banana)

Question 9

t/f ct scan is more requested than mri for hematomas

Answer 9

true

Question 10

t/f subdural hematomas are limited by sutures

Answer 10

false

Question 11

subdural hematomas are related to __

Answer 11

increased pressure in the brain

Question 12

origin and location of subarachnoid hematomas

Answer 12

o: pia and arachnoid arteries
l: between arachnoid and inner leptomeningeal, collects within the falx and brain sulci

Question 13

intracranial hemorrhage in the premature infant is secondary to

Answer 13

hypoxia and prematurity (common in <35 aog and <1500 g)

Question 14

origin of ih in premature

Answer 14

subependymal germinal matrix of choroid plexus of lateral ventricles

Question 15

classification of intracranial hemorrhage

Answer 15

read

Question 16

t/f mri has twice the sensitivity of uts in detecting germinal matrix hemorrhage and intraventricular hemorrhage

Answer 16

true

Question 17

what lesion has well circumscribed hypodensity with hyerdense margins, shifted structures, and enhancement of periphery with contrast?

Answer 17

abscess or empyema

Question 18

ct scans that show enhancements of sulci, similar to subarachnoid hemorrhage

Answer 18

meningitis

Question 19

how to distinguish meningitis and subarachnoid hemorrhage

Answer 19

contrast material needed for meningitis

Question 20

causes of hydrocephalus

Answer 20

obstruction to the flow of csf
faulty absorption of csf
excessive fluid production

Question 21

communicating vs non communicating hydrocephalus

Answer 21

communicating: outside ventricles

non-communicating: within ventricles

Question 22

etiologies of congenital hydrocephalus

Answer 22

torch (toxoplasmosis, others, rubella, cmv, herpes)
congenital aqueductal stenosis
dandy walker cyst
intracranial tumors

Question 23

etiologies of acquired hydrocephalus

Answer 23

infections, hemorrhage, tumors

Question 24

ttn is not a disease and is secondary to ___

Answer 24

absence of squeezing of the thorax, apparent after 2-4 hours and resloves after 24-48 hrs

Question 25

radiologic findings in ttn

Answer 25

- fine perihilar streak opacities | - minimal coarse reticular opacities in the inner lung zones

Question 26

t/f ttn doesn't need a repeat xray after symptoms subside

Answer 26

false, need to check if it resolved spontaneously

Question 27

t/f bacterial pneumonia is smore aggressive than viral

Answer 27

true

Question 28

radiologic findings in bacterial pneumonia

Answer 28

- coarse, patchy parenchymal densities or peribronchial opacities - (+) consolidations - (+) air bronchograms - (+) pleural effusion

Question 29

radiologic findings in viral pneumonia

Answer 29

radiating parahilar streakiness | diffuse, hazy or reticulonodular opacities in both lungs

Question 30

old name for surfactant deficiency disease

Answer 30

hyaline membrane disease or rds

Question 31

radiologic findings in surfactant deficiency disease

Answer 31

ground glass opacities on both lungs

Question 32

t/f surfactant deficiency disease doesnt need an xray before administration of surfactsnt

Answer 32

false, needs xray because surfactant is expensive

Question 33

differential diagnosis for hyaline membrane disease

Answer 33

congenital heart lesions manifesting with pronounced pulmonary venous obstruction

Question 34

a hypoxia induced vagal response that results in increased gi peristaltic activity, more seen in postmature infants

Answer 34

meconium aspiration syndrome

Question 35

radiologic findings in meconium aspiration syndrome

Answer 35

lung overaeration | bilateral nodular densities

Question 36

congenital lobar overinflation is secondary to ___

Answer 36

segmental bronchial cartilage underdevelopment

Question 37

on pe, congenital lobar overinflation is seen as __

Answer 37

hyperresonant hemithorax

Question 38

radiologic findings in congenital lobar overinflation

Answer 38

40-45% left upper lobe, 30% right middle lobe, 20% right upper lobe - lobe is overdistended and lucent - shifting of mediastinum to contralateral side of involved lobe

Question 39

examples of active congestion

Answer 39

left to right shunts = reduced co = decreased tissue oxygenation lesions with preferential blood flow to lower pressure pulmonary circulation

Question 40

passive congestion is seen in cases of pulmonary venous hypertension such as

Answer 40

left side myocardial dysfunction | left side obstructive lesions

Question 41

how to distinguish increased vs normal pulmonary vascularity

Answer 41

increased: hyperdensities in inner lung zones

Question 42

what happens in decreased pulmonary vascularity

Answer 42

r-l shunt -> less blood flow to lungs -> decreased tissue oxygenation -> cyanosis cxr: pulmonary oligemia (cannot see pulmo vessels)

Question 43

radiographic findings in tof

Answer 43

boot shaped heart, upturned cardiac apex due to rvh shop for a tof

Question 44

most common cause of cyanosis, common within first 24 hrs of life

Answer 44

toga: egg on a string

Question 45

modality of choice for hydronephrosis

Answer 45

uts

Question 46

findings in congenital megacalyces

Answer 46

- enlargement of the calyces | - kidneys large for age

Question 47

classifications of renal cystic disease

Answer 47

1: infantile polycystic 2: multicystic dysplastic 3: adult polycystic 4: cortical cysts with obstructive hydronephrosis

Question 48

most common renal neoplasm in childhood but not in neonates

Answer 48

wilm's tumor

Question 49

benign and malignant forms of wilm's tumor

Answer 49

benign: renal blastoma malignant: rhabdoid form

Question 50

most common renal tumor of the neonate

Answer 50

benign fetal mesoblastic nephroma

Question 51

imaging modality of choice for transient esophageal hypotonia of the neonate

Answer 51

esophagogram

Question 52

presentation of hypertrophic pyloric stenosis

Answer 52

vomiting, regurgitation, difficulty feeding, NO BILE IN VOMITUS 2-8 weeks after birth palpable lesion at epigastric area

Question 53

modality of choice for hypertrophic pyloric stenosis

Answer 53

uts

Question 54

gastric volvulus is associated with

Answer 54

diaphragmatic hernia (stomach appears distended and inverted)

Question 55

most common gastric tumor in neonates

Answer 55

gastric teratoma: mass lesion with calcifications (any modality)

Question 56

presentation of duodenal atresia/stenosis

Answer 56

vomiting in the first hours of life, WITH BILE finding: double bubble sign

Question 57

findings in small bowel atresia

Answer 57

- multiple air fluid levels | - "soap bubble" appearance / triple bubble

Question 58

presentation of meconium plug syndrome

Answer 58

abdominal distention, vomiting, no meconium multiple dilated bowel loops and multiple filling defects

Question 59

most affected part of Hirschsprung disease

Answer 59

distal colon (rectum or rectosigmoid) finding: affected bowel small, dilated proximally

Question 60

etiologic factors for nec

Answer 60

intestinal ischemia or hypoperfusion bacterial overgrowth continued irritation of bowel by oral feedings

Question 61

findings in nec

Answer 61

intestinal distention* air in bowel wall air in portal tracts pneumoperitoneum