Vascular Anomalies

Question 1

Vascular malformations are present after birth

Answer 1

F Vascular malformations are present at birth

Question 2

Sclerotherapy is one potential intervention for venous and
lymphatic malformations.

Answer 2

T

Question 3

Hemangiomas are the most common tumor of infancy

Answer 3

T Hemangiomas are the most common tumor of infancy and occur
at a rate of 11 in 10 infants

Question 4

Hemangiomas present at birth

Answer 4

not present at birth
and are commonly visualized at approximately 2 weeks after birth

Question 5

These tumors are more common in females (3:1) and Caucasians (1
in 10) with the most common location occurring in the head and
neck region

Answer 5

T

Question 6

Infantile hemangiomas can be diagnosed with urine test?

Answer 6

Infantile hemangiomas are positive for glucose transporter 1 (GLUT-I) on biopsy of the lesion as well as within the urine

Question 7

Imaging play an important role in hemangioma diagnoses

Answer 7

F. imaging is not commonly required.

Question 8

The pulsed dye laser reducing bleeding from the site of haemangioma

Answer 8

T. the pulsed dye laser to lighten the color of the hemangioma and improve skin texture while reducing bleeding from the site

Question 9

What the doses of predinsilon and for how long is given?

Answer 9

2-3mg /kg /day. For 4-6 week in proliferate phase

Question 10

The initial response of steroid start in 1-2 week of therapy

Answer 10

T

Question 11

The intial responce to systemic steriod in haemangioma start after 1-2 week

Answer 11

T

Question 12

Intralesional corticosteroid vs systemic steriod

Answer 12

Intralesional corticosteroid delivery is another method of drug administration that has lower risks of systemic side effects, but similar potential to prevent further growth and induce tumor regression.

Question 13

topical corticosteroid application is also effective in hemangioma

Answer 13

F. Although injectable steroid is known to be effective, topical corticosteroid application is ineffective.

Question 14

Beta blocker in mor effective than steriod

Answer 14

F. it remains unclear whether beta blockers are more or less effective than steroids

Question 15

Topical beta blockers such as timolol are also effective

Answer 15

T

Question 16

Beta blockers, most commonly propranolol,
are administered at a dose of2 mg/kg/d and are most effective when
initiated during the proliferative phase

Answer 16

T

Question 17

Responce to nterferon alpha-2A considred very fast in haemngioma

Answer 17

F. response is usually seen within 6 to 10 months

Question 18

Beta blockers have a role . for Kasabach-Merritt syndrome.

Answer 18

F. Interferon alpha-2A is indicated for Kasabach-Merritt syndrome.

Question 19

vincristine has preferable side effect

Answer 19

F. . As this is a chemotherapeutic agent, side effects include peripheral neuropathy, infections, and hair loss. Although the response rate is thought to approach over 80%, patients are required to have a central line for administration

Question 20

Interferon alpha-2A is considered a second-line treatment At a subcutaneous dose of 2 to 3 mU/
m2

Answer 20

T

Question 21

Haemangioma lesions may remain highly vascular even in the resolution phase

Answer 21

T

Question 22

congenital hemangiomas are negative for GLUT-I, whereas infantile hemangiomas are positive.

Answer 22

T

Question 23

agents used to treat hemangiomas including beta blockers and steroids are usually can be use in haemangioendothiloma

Answer 23

F. agents used to treat hemangiomas including beta blockers and steroids are usually ineffective for this indication. Vincrstin only

Question 24

the main goal of care. Hemangioendotheliomas is surgical excision

Answer 24

F. necessitating symptomatic management as the main goal of care.

Question 25

Hemangioendotheliomas can present at birth and post nataly

Answer 25

T

Question 26

Hemangioendotheliomas mor common in female

Answer 26

F. are equally common in males and females

Question 27

platelet transfusions may exacerbate swelling so should be avoided unless indicated for uncontrolled bleeding in this circumstance. In haemangioendothilioma

Answer 27

T

Question 28

, resection is commonly possible in haemangioendothlioma

Answer 28

F. , resection is not commonly possible

Question 29

All hemangioendothelioma regress by 2 years of age.

Answer 29

F some hemangioendotheliomas regress by 2 years of age, many of these lesions do not involute with time,

Question 30

Capillary Malformations influenced by the autonomic nervous system

Answer 30

T For example, Sturge-Weber syndrome is defined by a capillary malformation within the Vl trigeminal nerve distribution.

Question 31

Capillary malformations occur equally in males and females.

Answer 31

F Capillary malformations occur with greater frequency among female children

Question 32

Isolated cutaneous capillary malformations do not require imaging

Answer 32

T unless uncertainty exists with regard to the presence of visceral lesions or to more clearly define the extent of these lesions

Question 33

Capillary malformation in Ultrasound show high flow

Answer 33

T

Question 34

MRI finding on Lymphatic Malformations show

Answer 34

MRI findings include a soft-tissue mass with low signal on the Tl window and high signal with fluid levels on the T2 window

Question 35

Microcystic lesions are commonly treated with sclerosing agents such as doxycycline, ethanol

Answer 35

F Macrocystic lesions are commonly treated with sclerosing agents such as doxycycline, ethanol

Question 36

Venous malformations are composed of numerous thin-walled veins, many of which lack valves and smooth muscle control

Answer 36

F lack valves and normal smooth muscle control

Question 37

MRI finding of venous malformation

Answer 37

MRI demonstrates isointense signal within the lesion on the Tl window and high signal with signal voids at sites of phleboliths on the T2 window

Question 38

MRI demonstrates soft tissue thickening with flow voids on the Tl window with a variable increase in signal and similar flow voids in the T2 in AVM

Answer 38

T

Question 39

lesions with an arterial component are fast flow, whereas all other lesions including venous, capillary, and lymphatic malformations are slow flow

Answer 39

T

Question 40

Does imaging is useful in VM?

Answer 40

Imaging is useful when determining the extent of the lesion as well as the amount of flow, particularly for vascular malformations

Question 41

Infantile Hemangiomas Phases?

Answer 41

proliferation (0 to 12 months), involution (12 months to 10 years), and finally, regression (after 10 years).

Question 42

When we should do a surgical intervention for IH?

Answer 42

hemangiomas that result in amblyopia, distortion of critical anatomic structures, ulceration and bleeding complications, or airway compromise

Question 43

Hormonal alterations over time can affect the involution face of haemangioma

Answer 43

T

Question 44

imaging may further complicate the diagnosis in IH

Answer 44

T imaging may further complicate the diagnosis given that these are not the only lesions that demonstrate fast flow on ultrasound

Question 45

MRI finding in IH ?

Answer 45

proliferating hemangiomas are isointense on Tl view and hyperintense on T2 view, with confluent enhancement and flow voids with contrast.

Question 46

most hemangiomas are treated nonoperatively

Answer 46

T

Question 47

We can use PDL for. deep haemangioma

Answer 47

This is particularly effective for superficial hemangiomas as the depth of penetration of the pulsed dye laser is approximately 0.75 to 1.2 mm

Question 48

Patients must also pass a thorough cardiopulmonary evaluation prior to drug initiation of beta blocker?

Answer 48

T

Question 49

Side effect of interferon-alpha 2A side effect

Answer 49

spastic diplegia, fevers, transaminitis, neutropenia, and anemia

Question 50

the first technique for surgical excision of IH ?

Answer 50

Circular excision with purse-string closure is one potential technique

Question 51

Hemangiomas ofthe lip can also cause significant deformity that even after involution results in soft-tissue laxity and discoloration.

Answer 51

T

Question 52

Tissue expansion can be used in IH ?

Answer 52

For larger lesions, concomitant tissue expansion may be required to facilitate soft-tissue coverage

Question 53

Tissue expanders in the back and extremities are excellent option for vascular anomalies in these locations in pediatric patient populations

Answer 53

T

Question 54

preoperative embolization always required in IH

Answer 54

preoperative embolization may be required

Question 55

Difference between congenital haemangioma and IH ?

Answer 55

Characteristic appearance associated with their development, which includes a surrounding whitish halo, the pale central portion of the lesion, and an otherwise reddish hue Congenital haemangioma is present e within the fetus and are fully grown at birth.

Question 56

Hemangioendothelioma can be metastasize

Answer 56

F these lesions do not metastasize are locally aggressive enlarge beyond 5 cm in diameter

Question 57

When Hemangioendotheliomas lesions are suspected, biopsy should be considered to rule out malignancy

Answer 57

T

Question 58

biopsy should be considered always for VM ?

Answer 58

biopsy should be considered for any lesion when there is uncertainty regarding the diagnosis

Question 59

Von Hippel-Lindau disease associated with developmental delay

Answer 59

T

Question 60

Option of Capillary malformation Managment?

Answer 60

Observation PDL for ulcerated and bleeding type Debulking

Question 61

Microcystic lesions are commonly treated with sclerosing agents such as doxycycline, ethanol, and sodium tetradecyl sulfate

Answer 61

F Macrocystic lesions are commonly treated with sclerosing agents such as doxycycline, ethanol, and sodium tetradecyl sulfate

Question 62

Direct excision and liposuction are potential techniques utilized for operative intervention.for lymphatic malformation

Answer 62

T

Question 63

Causes of pain wih Venous Malformations

Answer 63

phleboliths and chronic inflammation

Question 64

Options of Treatment in Venoue Malformation

Answer 64

Treatment of venous malformations is similar to that of lymphatic malformations. Options include observation, compression wraps, sclerotherapy, and excision for debulking. Low-dose aspirin therapy is helpful for pain due to microthrombi

Question 65

Stages of Arterial Venous Malformation?

Answer 65

-Quiescent lesions may or may not be evident at birth - Stage 2 consists of an expansion of the AVM, which can manifest as a thrill or bruit on physical examination - stage 3 destructive phases, episodes of bleeding, pain, and local-tissue damage become apparent. - Stage 4 is associated with heart failure and continued local-tissue destruction

Question 66

Osler-Weber-Rendu disease

Answer 66

Cutaneous telangiectasias, frequent nosebleeds, AVMs of viscera

Question 67

There are two main types of congenital hemangiomas: noninvoluting congenital hemangiomas (NICH) and rapidly involuting congenital hemangiomas. Although both commonly present within the head and neck region, noninvoluting hemangiomas demonstrate persistent fast flow and do not regress, whereas rapidly involuting hemangiomas substantially regress within a few months of birth.

Answer 67

t

Question 68

AVMs begin as quiescent lesions that may or may not be evident at birth

Answer 68

T