Test 3 Flashcards
(137 cards)
1
Q
Fetal cholelithiasis
A
echogenic GB
resolve in utero or in childhood
2
Q
choledochal cyst
A
cystic mass adjacent to fetal GB and stomach
3
Q
Agenesis of GB and associations
A
patients with biliary atresia
associated with polysplenia
4
Q
what can happen to fetal liver 6
A
hepatic cysts hemangiomas hepatomegaly teratoma adenoma mets from neuroblastoma
5
Q
what causes fetal hepatomegaly
A
rh immune disease
6
Q
what can cause splenomegaly
A
rh immune disease
7
Q
spleen variants
A
polysplenia
asplenia
splenomegaly
8
Q
esophageal atresia (EA)
A
congenital blockage of esophagus not allowing propper swallowing
9
Q
what is EA associated with
A
tracheoesophageal fistula TEF
10
Q
problems with esophageal atresia 4
A
feeding difficulties
strictures
aspiration
gastroesophageal reflux
11
Q
findings associated with esophageal atresia
A
small/absent stomach
polyhydramnios
IUGR
pouch sign
12
Q
what is the pouch sign
A
filling of esophagus fistula from swallowing
13
Q
duodenal atresia
A
blockage of duodenal lumen by a membrane
blocks passing fluid through duodenum into small bowel
14
Q
findings of duodenal atresia 2
A
double bubble
polyhydramnios
15
Q
double bubble
A
duodenal atresia
16
Q
anomalies associated with duodenal atresia 4
A
cardiac defect
horseshoe kidney
imperforated anus
atresia of small bowel
17
Q
most common site of intestinal obstruction
A
duodenum
18
Q
intestinal obstruction
A
atresia or stenosis of jejunum, ileum, small bowel
19
Q
causes of intestinal obstruction 6
A
drug use vascular accident sporatic malrotation atresia cystic fibrosis
20
Q
intestinal obstruction is at risk for:
A
meconium peritonitis
21
Q
meconium peritonitis 4
A
ascites
peritoneal calcifications
pseudocusts
common in distal atresia
22
Q
sonographic appearance of intestinal obstruction 4
A
cystic bowel loops separate from stomach
peristalsis of dilated loops
polyhydramnios
IUGR (in proximal atresia)
23
Q
meconium ileus
A
small bowel disorder with presence of thick meconium in distal ileum
24
Q
meconium ileus is most commonly seen with _____
A
cystic fibrosis
25
meconium peritonitis may occur secondary to _____
perforation of obstructed bowel
26
sonographic appearance of meconium ileus 4
dilated ileum with impacted meconium
inflammatory response from meconium leakage
tissue calcifications
pseudocyst
27
when is hyperechoic bowel observed?
2nd trimester
28
how echogenic does hyperechoic bowel have to b?
as bright as bone without harmonics
29
most common cause of hyperechoic bowel
bleeding
30
cause of renal agenesis
sporatic
31
what can mimic kidney in renal agenesis
bowel and adrenal
32
how do you make sure kidney is truly present
document renal arteries
33
findings in renal agenesis 2
empty renal fossa
| absent renal artery
34
fluid levels in unilateral renal agenesis
normal AFI and bladder
35
what is bilateral renal agenesis known as
potters syndrome
36
fundings in bilateral renal agenesis 5
```
anhydramnios
absent bladder
absent stomach
empty renal fossa
absent renal arteries
```
37
pyelectasis
enlarged fluid filled renal pelvis without caluceal dilation
38
abnormal kidney pelvis measurements
```
1st tri: >3mm
14-22 weeks: =/>4mm
22-33 weeks: >5mm
>33 weeks: >7mm
>10mm = pathologic
```
39
pyelectasis indicates eval for 4
renal, bladder and ureter anomalies
| other soft markers
40
ureteropelvic junction obstruction
upper urinary tract obstruction with urine backup into kidneys
41
findings of UPJ obstruction 4
hydronephrosis involving calyces
kidney enlargement
cortical thinning
42
multicystic dysplastic kidney findings
renal parenchyma replaced by non-communicating cysts
+- renal artery
enlarged kidney
43
unilateral MCDK is associated with what other findings in other kidney 3
UPJ
renal agenesis
renal hypoplasia
44
ARPCKD and findings 8
single gene - bilateral, symmetric, enlarged, cyctic kidneys
oligo
small/absent bladder
pulmonary hypoplasia
45
how many ARPCDK kids will need transplant by age 20
50%
46
most common cause of fetal lower urinary obstruction
posterior urethral valve causing bladder outlet obstruction
47
who's effected by posterior uretheral valve
boys only
48
differentials for posterior uretheral valves 3
prune belly syndrome
cloacal malformation
urethral atresia
49
US findings of posterior urethral valve 8
```
distended bladder with keyhole sign
oligohydramnios - NOT anhydramnios
small chest
pulmonary hypoplasia
hydroureter
+- urinary ascites/urinoma
+- urine in thorax
+- peritoneal calcifications
```
50
complication of PUV
rupture of bladder leading to ascites/urinoma, urine in thorax and peritoneal calcifications
51
abnormalities associated with PUV 2
cardiac
| VACTERL
52
what do you do after diagnosing PUV 2
urine chemistires for renal function
| check for renal dysplasia
53
prune belly syndrome classic characteristics 3
collecting system dilation (large bladder, hydroureter and hydronephrosis)
deficient abdominal muscle
cryptorchidism
+/- oligohydramnios
54
when is prune belly more common 2
twin pregnancies
| male
55
what does prognosis of prune belly syndrome depend on 2
oligo
| renal damage
56
ureterocele
congenital dilation of intramucosal segment of ureter with prolapse into bladder lumen
57
appearance of ureter 5
thin walled mass inside bladder
ureter dilation
hydronephrosis
oligo
58
ambiguous genitalia
not typical of male or female
59
female pseudohermaphrodism maternal causes 2
maternal excessive androgens
| synthetic progesterens
60
female pseudohermaphrodism fetal causes
congenital adrenal hyperplasia (CAH)
61
causes of male pseudohermaphrodism 2
autosomal recessive condition
| decrease in production/pickup of testosterone
62
XY findings in pseudohermaphrodism 4
hypospadias
microphallus
bifid penis
scrotum mimics labia
63
hypospadias 2
abnormal position of penis
| abnormal urethral opening
64
TMC cause of ambiguous genitalia
hypospadias
65
microphallus
small penis that looks like clitoris
66
XX findings in pseudohermaphrodism 3
clitoromegally
mimicking of penis/hypospadias
prominent or fused labia
67
what does CNS arise from and what is the process called
ectoderm from neural plate
| neuralation
68
when do cranial and caudal neuropored close
24-26 days
69
when is rhombencephalon seen and what does it look like
7-9 weeks
| cystic structure in the brain
70
steps in maturation of neural tissue 6
6 weeks - reflexes of face and neck
12 weeks - nerve sensitivity
16 weeks - defined periods of activity and inactivity
20 weeks - grip objects + weak respiratory system
24 weeks - sucking reflex
28 weeks - change in brain patterns
71
most common NTD
anencephaly
72
prognosis of anencephaly
lethal
73
what is anencephaly
absence of brain
74
causes of anencephaly 3
isolated - spontaneous, low folic acid
genetic - T13, T18
sundromes - meckel-gruber, amniotic band
75
US findings of anencephaly 6
```
no brain above orbits
present brainstem
female prevalence
elevated AFP
frog-like
poly
additional NTD
```
76
exencephaly
lack of cranial vault - brain exposed to amniotic fluid
77
when in exencephaly most commonly seen
1st tri
78
precursor to anencephaly
exencephaly
79
cephalocele
bony defect - opening in skull with protrusion of brain tissue
80
common location of cephalocele
occipital
81
differential for cephalocele
cystic hygroma
82
US findings of cephalocele 5
```
body defect with paracranial mass
ventriculomegaly
microcephaly
poly and oligo
other CNS anomalies
```
83
agenesis of corpus callosum findings 7
```
absent CC
absent CSP
elevated and dilated 3rd ventricle
ventriculomegaly - teardrop
CNS anomalies
body anomalies
```
84
holoprosencephaly
failure of forebrain (prosencephalon) to divide
85
3 forms oh holophosencephaly
alobar
semilobar
lobar
86
anomalies associated with holoprosencephaly 5
facial: probascis, cyclops, hypotelorism, median ceft
chromosomal: t13
87
alobar holo findings 4
monoventricle
fused thalamus
abnormal intracranial anatomy (loss of falx)
facial anomalies (cyclopia, proboscis, median cleft)
88
semilobar holo findings 4
singular ventricular cavity
partial formation of occipital horns
partial/complete fusion of thalamus
rudimentary formation
89
lobar holo findings 5
```
separate hemispheres
separate ventricles
fused fornices
separate thalami
+- hypotelorism
```
90
findings in septooptic dysplasia 6
```
absent CSP
frontal horns of lat. ventricles communicate
CC may be thinned
mild ventriculomegaly
hypoplastic optic nerves
hypothalamic pituitary dysfunction
```
91
how do you differentiate between septo-optic dysplasia vs corpus callosum agenesis
MRI
92
what are septo-optic dysplasia babies at risk for postnatally
schizencephaly
93
schizencephaly
gray matter lined cleft in brain parenchyma from inner table of skull to ventricle
94
gold standard for schizencephaly
MRI
95
imaging findings of schizencephaly 6
absent CSP in 70%
wedge shaped cerebrospinal fluid filled defect
normal face
calcifications within interior walls of ventricle
ventriculomegaly
96
cause of choroid plexus cyst
cerebrospinal fluid trapped in choroid plexus
97
prognosis of choroid plexus cyst 4
normal in 2-4%
not associated with t18 in low risky
>10mm increased risk
common in t18 babies
98
aqueductal stenosis
narrowing/occlusion of aqueduct sylvius causing obstructive hydrocephalus
99
measurement considered hydrocephalus
>15mm
100
imaging to do with aqueductal stenosis and why
MRI to evaluate cortical mantle thinning
101
imaging findings with aqueductal stenosis 6
```
hydrocephalus with normal posterior fossa
3rd ventricle dilation
dangling choroid plexus
CC thinned or invisible
CSP smashed/absent
head too large
```
102
differentials for aqueductal stenosis
holoprosencephaly
| hydrancephaly
103
arnold chiary malformation and when is it seen
hindbrain herniation
| almost always seen with spina bifida
104
imaging findings win arnold chiari 6
```
posterior fossa obliterated by herniated cerebellum
banana shaped cerebellum
lemon head sign
ventriculomegaly
head size small to normal
NTD
```
105
dandy walker malformation
abnormal cerebellum, 4th ventricle and posterior fossa
106
prognosis for dandy walker
70-90% with additional anomalies
107
US findings of dandy walker 4
partial to complete agenesis of cerebellar vermis
abnormal 4th ventricle - communicates with posterior fossa cyst
splayed cerebellum
hydracephalus
108
vermian dysgenesis
failure of closure of vermis leading to communication of 4th ventricle and posterior fossa
keyhole appearance of 4th ventricle
109
when is incomplete vermis normal
110
mega cisterna magna
cisterna magna >10mm with normal cerebellum
111
hydranencephaly
destruction of cerebral hemispheres with fluid filled skill and residual brainstem present
112
destruction of cerebral hemispheres (hydranencephaly) is caused by 5
occlusion of internal carotid arteries
viral
hemorrhage
toxins
113
differentials for hydranencephaly
severe hydrocephalus
114
image findings in hydranencephaly 4
fluid filled cranium with diffuse echoes
present falx
normal posterior fossa
normal head size
115
difference between hydrocephalus and hydrancephaly
circle of willis intact in hydrocephalus
| absent in hydrancephaly
116
arachnoid cyst
fluid collection within arachnoid layers but sonographically normal brain
117
vein of galen aneurysm
irregular cystic space in midline, posterosuperior to 3rd ventricle and turbulent flow
118
microcephaly and causes 2
head circumference more than 2 deviations below mean
| IUGR vs abnormality
119
abnormal skull shape causes 3
spina bifida - lemon head
cranio-stenosis - cloverleaf
t18 - strawberry
120
most common spina bifida location
lumbar and sacral spine
121
spina bifida
open NTD with neural content exposure and cranial abnormalities
122
vertebral findings with spina bifida and best view
splaying of vertebral bodies
| TRV is best, coronal best for extent
123
meningocele
anechoic cystic mass with meninges only
124
meningomyelocele
complex cystic mass with meninges and neural elements
125
myeloschisis
open spinal cord
126
spina bifida occulta
small bony defect covered by skin
| skin dimple with turf of hair and subcutanous lipoma
127
brain findings with spina bifida
99% - chiari 2 malformation
128
chiari 2 malformation 4
```
(seen with spina bifida)
obliterated CM
banana sign
vetnriculomegaly (10mm or >)
lemon shaped calvarium
```
129
associated anomalies with spina bifida 3
club feet
scoliosis
additional abnormalities
130
caudal regression syndrome
sacral agenesis - distal neural tube disruption causing abnormal distal spine, sacrum and extremities
131
risk factors for caudal regression syndrome
maternal diabetes (hyperglycemia interrupting 4th week development)
132
US findings of caudal regression syndrome in 1st tri 4
short CRL
protuberance of lower spine
increased NT
133
US findings of caudal regression syndrome in 2nd and 3rd tri 8
```
abrupt termination of spine
short trunk
lower extremity contractures
normal to poly
GI abnormalities (anorectal or duodenal atresia)
CNS anomalies (chiari)
genitourinary anomalies (penile agenesis, cryptorchidism, dilated bladder and hydronephrosis)
CHD
```
134
sacrococcygeal teratoma
neoplastm from all 3 germ cell layers
135
presentation of sacrococcygeal teratoma
exophytic complex mass from sacrum with normal spine
136
US findings of sacrococcygeal teratoma 7
```
heterogenous/complex mass
+- calcifications
may extend into pelvis and abd
hydrops
poly
intratumoral hemorrhage
associated malformations
```
137
types of sacrococcygeal teratoma 4
type 1 - external or minimal presacral component
type 2 - external and internal extending into presacral space
type 3 - external and internal extending into abdomen
4 completely internal. likely to undergo malignant transformation. more likely solid
