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Peds GU Flashcards

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1
Q

vesicoureteral reflux –> predisposes to what?

A

predispose to acute pyelonephritis –> renal scarring –> irrev loss of renal fx

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2
Q

vesicoureteral reflux –> grading?

A 
I: reflux into ureter
II: reflux into renal pelvis
III: blunted calyces
IV: mod hydroureter
V: severe tortuous hydroureter
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3
Q

vesicoureteral reflux –> what nuc med studies can evaluate VUR? (2)

A
  • radionuclide cystogram (RNC)

- Tc-99m DMSA renal scintigraphy (DMSA scan)

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4
Q

vesicoureteral reflux –> preferred initial study?

A

VCUG

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5
Q

vesicoureteral reflux –> most sensitive study?

A

radionuclide cystogram (RNC)

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6
Q

radionuclide cystogram (RNC) –> grading?

A

1: ureteral reflux
2: reflux up to calyces
3: hydroureter

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7
Q

renal cortical scarring –> gold standard study?

A

Tc-99m DMSA renal scintigraphy (DMSA scan)

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8
Q

radionuclide cystogram (RNC) –> what radionuclide?

A

Tc-99m pertechnetate

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9
Q

what is Weigert-Meyer rule?

A

renal duplex system:

  • upper moiety –> ectopic insertion –> inf-med
  • lower moiety –> orthotopic insertion –> sup-lat
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10
Q

renal duplex system –> upper vs lower moiety –> predisposed to what?

A
  • upper moiety –> ureterocele –> obstruction

- lower moiety –> VUR

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11
Q

hydronephrosis –> ddx? (2)

A
  • VUR

- UPJ obstruction

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12
Q

hydroureteronephrosis –> at UVJ level –> ddx? (2)

A
  • VUR

- UVJ obstruction

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13
Q

what is renal ptosis (nephroptosis?

A

“floating kidney” –> kidney drops down into pelvis when pt stand

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14
Q

hydronephrosis –> unilat –> MCC?

A

UPJ obstruction

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15
Q

UPJ obstruction –> cause? (3)

A
  • aberrant renal A –> compress ureter
  • ureter –> aperistaltic segment
  • idiopathic
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16
Q

congenital bladder outlet obstruction –> MCC?

A

posterior urethral valve

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17
Q

posterior urethral valve –> bladder –> US findings?

A

dilated bladder –> trabeculations

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18
Q

posterior urethral valve –> what is “keyhole”?

A

dilated posterior urethra + bladder

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19
Q

posterior urethral valve –> which structures will be dilated? (3)

A
  • prostatic urethra
  • bladder
  • renal collecting system
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20
Q

prune belly synd –> consists of what triad?

A
  • hydroureteronephrosis, renal dysplasia
  • ant abd underdevelopmt
  • cryptorchidism
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21
Q

urethra, bladder, renal collecting system –> dilated –> ddx? (2) how to differentiate?

A
  • posterior urethral valve –> only posterior urethra dilated
  • prune belly synd –> entire urethra dilated
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22
Q

ureterocele –> 2 types?

A
  • ectopic –> ectopic ureter

- simple –> orthotopic ureter

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23
Q

ureterocele –> US appearance?

A

cyst within bladder

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24
Q

ureterocele –> VCUG appearance?

A

round filling defect in the bladder

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25
obstruction at the UVJ--> causes? (2)
- ureterocele | - primary obstructive megaureter
26
bladder outlet obstruction --> causes? (2)
- posterior urethral valve | - neurogenic bladder
27
multicystic dysplastic kidney --> pathophys?
fetal urinary obstruction --> progressive renal dysplasia --> kidney gradually involutes
28
multicystic dysplastic kidney --> key finding?
mult NON-communicating cysts --> replace renal parenchyma
29
isolated simple renal cyst --> common or rare in children?
rare
30
isolated simple renal cyst --> if seen, may reflect what condition? (2)
- tuberous sclerosis | - von Hippel-Lindau
31
tuberous sclerosis --> synd? (6)
- renal cysts - renal angiomyolipoma - cardiac rhabdomyoma - CNS cortical hamartoma - subependymal nodule - subependymal giant cell astrocytoma
32
von Hippel-Lindau --> synd? (5)
- renal cysts - RCC - adrenal pheochromocytoma - pancreatic cyst/islet cell tumor/serous cystadenoma - brain/spinal cord hemangioblastoma
33
multilocular cystic nephroma --> benign or malig?
benign
34
multilocular cystic nephroma --> epidemiology?
- 3mo-2yo M | - middle age F
35
multilocular cystic nephroma --> appearance?
multiseptated cystic mass --> enhancing septa
36
multilocular cystic nephroma --> characteristic finding?
herniate into renal pelvis --> hydronephrosis
37
kidney --> multiseptated cystic mass --> ddx? (2)
- multilocular cystic nephroma | - cystic Wilms tumor
38
pediatric population --> ADPKD or ARPKD?
recessive
39
ARPKD --> kidneys --> US appearance?
cysts too small to see --> kidneys are enlrged & echogenic
40
ARPKD --> assoc w what fetal conditions? (2)
- oligohydramnios | - pulm hypoplasia
41
Wilms tumor --> arises from what embryologic tissue?
persistent metanephric blastema
42
what conditions have increased risk for Wilms tumor? (4)
- Beckwith-Wiedemann synd - WAGR synd - horseshoe kidney - trisomy 18
43
Beckwith-Wiedemann synd --> synd? (5)
- hemihypertrophy - macroglossia - omphalocele - neonatal hypoglycemia - childhood malig (ie Wilms tumor, hepatoblastoma)
44
WAGR synd --> synd? (4)
- Wilms tumor - aniridia - GU anomaly - mental retard
45
Wilms tumor --> imaging appearance?
heterogeneous solid renal mass
46
heterogeneous solid renal mass --> pediatric --> ddx? (2) how to differentiate?
- Wilms tumor: 3-5yo | - mesoblastic nephroma: <1yo
47
what is claw sign?
normal parenchyma surrounding large mass --> indicates that the mass is arising from that organ
48
Wilms tumor --> like to metastasize where? (3)
- liver - lung - bone
49
sickle cell --> predisposed to what kind of RCC?
renal medullary CA
50
rhabdoid tumor --> occurs in what organ? (2)
- kidney | - brain
51
rhabdoid tumor --> imaging appearance?
lrg heterogeneous soft tissue mass --> ill-defined --> infiltrate renal hilum
52
clear cell sarcoma --> like to metastasize where? (1)
bone
53
pediatric --> renal mets --> MC primary? (2)
- neuroblastoma | - leukemia/lymphoma
54
lymphoma --> renal mets --> imaging appearance? (2)
- mass | - diffuse infiltration
55
mesoblastic nephroma --> benign or malig?
benign
56
heterogeneous solid renal mass --> may be benign mesoblastic nephroma --> tx? why?
can't differentiate from Wilms tumor --> surgical resection
57
mesoblastic nephroma --> arises from what embryologic tissue?
persistent mesonephric blastema
58
what is nephroblastomatosis?
persistence of metanephric blastema
59
nephroblastomatosis --> imaging appearance?
bilateral enlrged kidneys --> nonenhancing lobular masses/nodules
60
nephroblastomatosis --> precursor to what condition?
Wilms tumor
61
multiple renal angiomyolipomas --> what condition?
tuberous sclerosis
62
renal AML --> what size (cm) has risk of hemorrhage?
>4cm
63
renal AML --> key imaging characteristic?
macroscopic fat
64
persistent metanephric blastema --> can lead to what condition? (3)
- Wilms tumor - mesoblastic nephroma - nephroblastomatosis
65
pediatric --> mult solid renal masses --> ddx? (4)
- nephroblastomatosis - lymphoma - multifocal pyelonephritis - multiple infarcts
66
neuroblastoma --> arises from what kind of tissue?
primitive neural crest cell --> sympathetic change
67
neuroblastoma --> MC arises from what organ?
adrenal gland
68
Wilms tumor --> displace or encase vessels?
displace
69
neuroblastoma --> displace or encase vessels?
encase
70
neuroblastoma --> calcifications or no calcifications?
50% have calcifications
71
neuroblastoma --> MRI --> does it demonstrate restricted diffuse? why?
hypercellular --> restricted diffusion
72
what NM scan can be used to evaluate neuroblastoma?
I-123 MIBG scintigraphy
73
metastatic neuroblastoma --> classic presentation?
intracranial subdural mass arising from BM
74
neuroblastoma --> MRI --> often seen invading into what?
neuroforamina & spinal canal
75
neuroblastoma --> mets --> MC organ?
BM
76
imaging features suggestive of neuroblastoma --> what is another differential consideration?
ganglioneuroma
77
ganglioneuroma --> benign or malig?
benign
78
neuroblastoma vs ganglioneuroma --> how to differentiate? (2)
neuroblastoma: very young (2yo) --> MRI restricted diffusion ganglioneuroma: slightly older (6yo) --> no restricted diffusion
79
neuroblastoma --> benign or malig?
malig
80
adrenal hemorrhage --> US appearance?
hypoechoic avascular suprarenal mass
81
hypoechoic avascular suprarenal mass --> ddx? (2)
- adrenal hemorrhage | - neuroblastoma
82
hypoechoic avascular suprarenal mass --> adrenal hemorrhage vs neuroblastoma --> how to differentiate? (2)
followup: - adrenal hemorrhage --> involute - neuroblastoma --> not involute
83
adrenal cortical CA --> assoc w what condition? (2)
- Beckwith-Wiedemann synd | - Li-Fraumeni synd
84
urachal anomaly --> possible complication?
adenoCA
85
urachal anomaly --> 4 types?
- patent urachus - urachal cyst - urachal sinus - vesicourachal diverticulum
86
what is duplication cyst?
rare congenital cystic malformation of GI tract
87
rectal duplication cyst --> locaiton?
retrorectal space
88
rectal duplication cyst --> tx? why?
malig potential --> surgical resect
89
what is hydrometrocolpos? can be seen in what pt pop?
neonatal --> fluid-filled vagina + uterus
90
what is hematometrocolpos? can be seen in what pt pop?
puberty --> blood-filled vagina + uterus
91
hydrometrocolpos or hematometrocolpos --> what does it indicate?
outflow tract obstruction (ie. congenital imperforate hymen)
92
mullerian duct cyst --> occur in M or F?
M only
93
mullerian duct cyst --> location?
midline pelvis --> usu prostate
94
midline prostatic cyst --> ddx? (2) how to differentiate? (3)
mullerian duct cyst: - present 30s-40s yo - not comm w urethra - usu larger than utricle cyst --> extend above prostate prostatic utricle cyst - 10s-20s yo - comm w urethra - small --> not extend above prostate
95
what is prostatic utricle? normal or abnormal?
terminal remnant of Mullerian duct --> normal
96
MC sarcoma of childhood?
rhabdomyosarcoma
97
rhabdomyosarcoma --> MC locations? (2)
- head/neck | - pelvis
98
8yo --> painless proptosis --> no infx --> dx?
rhabdomyosarcoma
99
US --> unilat empty renal fossa --> ddx? (2)
- renal agenesis | - cross fused renal ectopia
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