GIT

Question 1

What is the most common cause of chronic liver disease in childhood?

Answer 1

NAFLD

NAFLD stands for Non-Alcoholic Fatty Liver Disease.

Question 2

What imaging technique can be used to quantify hepatic steatosis?

Answer 2

MR

MR stands for Magnetic Resonance imaging.

Question 3

What is the purpose of MRE in patients with NAFLD?

Answer 3

Monitoring the development of hepatic fibrosis

MRE stands for Magnetic Resonance Elastography.

Question 4

In primary or hereditary hemochromatosis, what is a characteristic feature?

Answer 4

Pancreatic iron deposition

This condition is related to iron overload in the body.

Question 5

What type of iron deposition is seen in transfusional iron overload?

Answer 5

Splenic iron deposition

This occurs due to repeated blood transfusions.

Question 6

Patients with alpha-1 antitrypsin deficiency (AAT) may present similarly to which condition?

Answer 6

Biliary atresia

They may show similar findings on hepatobiliary scans.

Question 7

What does abdominal ultrasound typically show in patients with AAT deficiency?

Answer 7

Normal gallbladder

This is a common finding in these patients.

Question 8

What is the significance of arterial hyperenhancement and portal venous phase washout in a cirrhotic liver?

Answer 8

HCC until proven otherwise

HCC stands for Hepatocellular Carcinoma.

Question 9

Focal iron sparing in a siderotic liver should be viewed with suspicion for HCC because?

Answer 9

Tumor cells do not usually take up iron significantly

This indicates a potential malignancy.

Question 10

What is the goal of treatment for cirrhosis?

Answer 10

• Slow the progression
• Prevent or treat symptoms and complications

Treatment depends on the cause and extent of liver damage.

Question 11

What therapies can be used as a bridge to transplant in cirrhosis patients?

Answer 11

• Chemotherapy
• Ablative therapies

These may also be used in patients not candidates for liver transplantation.

Question 12

What is the age group commonly associated with Hepatoblastoma?

Answer 12

Children under 1 year

AFP levels are elevated in Hepatoblastoma.

Question 13

What are the AFP levels in Hepatocellular carcinoma?

Answer 13

Elevated

This type of tumor is often associated with underlying liver disease.

Question 14

What is a key imaging feature of Fibrolamellar carcinoma?

Answer 14

Solid mass with invasion of veins

AFP levels are normal in this type of tumor.

Question 15

What is the age group for Undifferentiated embryonal sarcoma?

Answer 15

Children under 5 years

AFP levels are normal.

Question 16

What are the clinical features of Embryonal rhabdomyosarcoma?

Answer 16

AFP levels: normal

Often presents in young children.

Question 17

What is the age group for Liver hemangioma?

Answer 17

Young children

AFP levels are normal.

Question 18

What is a common imaging feature of Mesenchymal hamartoma?

Answer 18

Cystic on CT and MRI

Solid on ultrasound.

Question 19

What is the age group for Focal nodular hyperplasia?

Answer 19

Adolescents ≥10 years

AFP levels are normal.

Question 20

What is a key characteristic of Adenoma?

Answer 20

Solid, homogeneous lesion enhancement

AFP levels are normal.

Question 21

What is the imaging feature of Hepatoblastoma regarding calcifications?

Answer 21

Coarse, chunky calcifications

This is a distinguishing feature in imaging.

Question 22

True or false: Fibrolamellar carcinoma typically has elevated AFP levels.

Answer 22

FALSE

AFP levels are normal in Fibrolamellar carcinoma.

Question 23

What is a common cause of cardiac heart failure in liver tumors?

Answer 23

Underlying liver disease

This can be associated with various liver tumors.

Question 24

What is the imaging feature of Adenoma regarding enhancement?

Answer 24

Homogeneous enhancement

No central scar is present.

Question 25

What is the age group for **Hepatocellular carcinoma**?

Answer 25

Adolescents ## Footnote AFP levels are elevated in this type of tumor.

Question 26

What is a distinguishing feature of **Liver hemangioma**?

Answer 26

Cystic lesion with solid portion enhancement ## Footnote No calcification is typically present.

Question 27

What is the **H-type tracheoesophageal fistula**?

Answer 27

A fistula connecting the upper cervical esophagus to the trachea ## Footnote Demonstrated in a 7-day-old boy with imperforate anus.

Question 28

What technique is used to demonstrate an **H-type fistula**?

Answer 28

Contrast injection through a feeding tube with careful volume control ## Footnote This method allows visualization of the fistula.

Question 29

What are the **types** of laryngotracheoesophageal clefts according to the Benjamin-Inglis Classification?

Answer 29

* Type I: Interarytenoid defect to the level of the vocal cords * Type II: Extension below vocal cords with incomplete extension through posterior cricoid * Type III: Complete extension through the posterior cricoid cartilage to the cervical trachea and esophagus * Type IV: Extension to the intrathoracic trachea and esophagus ## Footnote Each type describes the extent of the cleft and its anatomical implications.

Question 30

What are some **associated anomalies** with laryngotracheoesophageal clefts?

Answer 30

* Esophageal atresia * VACTERL association * Pulmonary hypoplasia * Hypospadias * Coarctation of the aorta ## Footnote These anomalies may occur alongside laryngotracheoesophageal clefts.

Question 31

True or false: Symptoms of respiratory distress in laryngotracheoesophageal clefts typically improve with herniation into the defect.

Answer 31

FALSE ## Footnote Symptoms typically worsen due to airway compromise.

Question 32

What does the **Modified Bell Staging Criteria** assess?

Answer 32

Severity of necrotizing enterocolitis (NEC) ## Footnote The criteria include systemic and abdominal findings along with X-ray results.

Question 33

What are the **systemic findings** for Stage IA, B in the Modified Bell Staging Criteria?

Answer 33

* Apnea * Bradycardia * Temperature instability ## Footnote These findings indicate suspected necrotizing enterocolitis.

Question 34

What abdominal findings are associated with **Stage IIA** of the Modified Bell Staging Criteria?

Answer 34

* Absent bowel sounds * Ileus * Pneumatosis * +/- Abdominal tenderness ## Footnote This stage indicates definite, mild severity of NEC.

Question 35

What systemic findings are present in **Stage IIB** of the Modified Bell Staging Criteria?

Answer 35

* Metabolic acidosis * Thrombocytopenia ## Footnote This stage indicates definite, moderate severity of NEC.

Question 36

What are the **abdominal findings** for Stage IIIA in the Modified Bell Staging Criteria?

Answer 36

* Abdominal distension * Abdominal tenderness * Signs of peritonitis * Ileus * Pneumatosis * Ascites ## Footnote This stage indicates definite, severe necrotizing enterocolitis.

Question 37

True or false: **Pneumoperitoneum** is a hallmark of Stage IB disease.

Answer 37

TRUE ## Footnote It is seen on ultrasound as gas anterior to the liver.

Question 38

What is the significance of **lipopolysaccharide** in the context of necrotizing enterocolitis?

Answer 38

Its expression is associated with increased severity of NEC ## Footnote Concentration falls precipitously during the disease progression.

Question 39

What does the presence of **portal venous gas** indicate in necrotizing enterocolitis?

Answer 39

Increased severity of the condition ## Footnote It is often seen alongside pneumatosis.

Question 40

What are the **systemic findings** for Stage IIIA in the Modified Bell Staging Criteria?

Answer 40

* Apnea * Hypotension * Bradycardia * Metabolic and respiratory acidosis * Neutropenia * DIC ## Footnote This stage indicates severe necrotizing enterocolitis.

Question 41

What does **DIC** stand for in the context of systemic findings for necrotizing enterocolitis?

Answer 41

Disseminated Intravascular Coagulation ## Footnote It is a serious condition that can occur in severe cases.

Question 42

What is a common **abdominal finding** in Stage IIIB of the Modified Bell Staging Criteria?

Answer 42

Pneumoperitoneum ## Footnote This stage indicates definite, severe bowel perforation.