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WorksheetsPediatric Abdomen Study Quiz
Total questions: 44
Worksheet time: 25mins
What does an abnormal appendix look like on ultrasound?
Enlarged, noncompressible tubular structure
Decreased diameter (<6mm)
Decreased blood flow
Free or loculated fluid
Increased Diameter (>6mm)
What is the most likely cause of unilateral hydronephrosis in an infant?
Ureteropelvic Junction (UPJ)
Pyloric Stenosis
Intussusception
Appendicitis
In the case of pyloric stenosis, what ultrasound findings would you expect to see?
Distended stomach
Visualization of gastric emptying
Canal length >16mm
Hypertrophies pyloric muscle
Muscle thickness <3.5mm
Most common congenital abdominal neoplasm in neonates:
benign, connective tissue tumor replaces the renal parenchyma
Mesoblastic nephroma
Nephroblastoma (Wilms)
Hepatoblastoma
Intussuseption
How does mesoblastic nephroma appear on ultrasound?
Solid, homogenous echogenic mass- may be heterogeneous w/ necrosis or hemorrhage
Enlarged hyperechoic liver, ascites, splenomegaly
Echogenic, poorly defined adrenal mass
Heterogenous, solid mass, may contain calcifications w/ necrosis or hemorrhage
What is the ultrasound appearance of a patent urachus?
Cystic mass extending from bladder dome to umbilicus
Solid, homogenous echogenic mass
Hyperechoic/complex mass
Echogenic, poorly defined cystic mass
When should the urachus close?
between 4-6 months gestation
between 6-8 months gestation
between 1-3 months gestation
between 2-6 months gestation
Most common benign vascular liver tumor in infants
Hemangioendothelioma
Nephroblastoma (Wilms)
Appendicitis
Pyloric Stenosis
Hepatoblastoma
Malignant renal tumor, solid mass, peak 3-4 years
Nephroblastoma (Wilms)
Infantile polycystic kidney disease
Hemangioendothelioma
Hepatoblastoma
Bilateral enlarged echogenic kidneys, poor differentiation, autosomal recessive
Infantile polycystic kidney disease
Nephroblastoma
Hemangioendothelioma
Wilson's disease
Reyes Syndrome
Rare, Non-obstructive dilation of intrahepatic ducts, assoc. with polycystic kidney disease and congenital hepatic fibrosis
Caroli's Disease
Reyes syndrome
Wilson's disease
Hepatoblastoma
Pyloric Stenosis
Linked to use of aspirin for viral infection; kids 3-16 y/o →brain and liver damage following respiratory tract infection
Reyes syndrome
Wilsons disease
Hepatoblastoma
Hemangioendothelioma
Hepatitis
Rare inherited disorder, copper metabolism defect → results in severe damage to liver and brain
Wilsons disease
Caroli's disease
Reyes Syndrome
Intussusception
Most common malignant liver tumor in kids; peak 1–2 yrs; elevated AFP; hepatomegaly, palpable mass; fever; pain
Hepatoblastoma
Hemangioendothelioma
Appendicitis
Caroli's disease
Mesoblastic Nephroma
Abnormal thickening of the pyloric muscle of the stomach
Pyloric stenosis
Appendicitis
Intussusception
Hepatoblastoma
Noncompressible tubular appendix, >6mm
Appendicolith
Appendicitis
Hemangioendothelioma
Hepatitis
Most common bowel obstruction in children (6mo-2yrs) , occurs when a segment of bowel prolapses into a more distal segment, target sign (TRV), Pseudokidney sign (SAG)
Intussusception
Nephroblastoma
Pyloric stenosis
Wilsons disease
What does the adrenal medulla look like on ultrasound?
Thick echogenic line surrounded by hyperechoic cortex
Thin echogenic line surrounded by hypoechoic cortex
Select what describes posterior urethral valve obstruction:
Congenital flap of tissue in male urethra
Congenital flap of tissue in female urethra
Causes bilateral hydronephrosis
Causes contracted bladder with thin walls
Causes dilated bladder with thickened walls
What is the normal size of the appendix?
<2cm
>4mm
<6mm
>6cm
What age group is most prone to developing appendicitis?
Children <12 years old
Children and Young adults, especially <14 years old
Young adults and Teens, especially <16 years old
Infants and Young Children, <6 years old
Describe the ultrasound appearance of Intussusception
Target/ Donut sign (TRV)
Triangular cord sign
String of Beads sign
Pseudokidney (SAG)
Describe the ultrasound appearance of Biliary Atresia
Non-visualized or small gallbladder
Echogenic, poorly defined mass
Triangular cord sign
Lobulated contour
Hepatomegaly, ascites, splenomegaly
What is the most common surgical emergency of the abdomen in a child?
Appendicitis
Biliary Atresia
Pyloric Stenosis
Multicystic Dysplastic Kidney
Appendicolith
What is Reyes syndrome linked to?
Aspirin use during viral infections
Hereditary, ureteral obstruction in utero
Copper metabolism defect
Underdevelopment of biliary system
Select the symptoms of Intussusception:
Abdominal pain and Distension
Palpable abdominal mass
Vomiting
Anorexia
Bloody stools
What is the most common age group to develop pyloric stenosis?
Male infants, 2-10 weeks old
Female infants, 2-10 weeks old
Select what describes the ultrasound appearance of an infant kidney:
Hyperechoic cortex
Large hypoechoic renal pyramids
Lobulated contour
Hypoechoic cortex
More echogenic renal sinus due to fat
Non-hereditary, ureteral obstruction caused by normal tissue replacement by multiple non-communicating cysts
Multicystic Dysplastic Kidney
Caroli's Disease
Neuroblastoma
Posterior Urethral Valves
Caroli's disease is associated with which ultrasound sign?
String of Beads Sign
Bullseye sign
Starry Sky Sign
Pseudokidney sign
Malignant adrenal medulla tumor
Neuroblastoma
Hepatoblastoma
Lymphoma
Infantile Hemangioendothelioma
When do children usually develop Neuroblastoma?
During gestation
2 months- 6 months
2 months - 4 years
2-4 years
Common in neonates (birth trauma, hypoxia, sepsis).
Adrenal hemorrhage
Appendicolith
Hepatoblastoma
Infantile Hemangioendothelioma
Describe an appendicolith:
Echogenic focus in the liver
Echogenic focus in the appendix
Posterior acoustic shadowing
Dirty shadowing
Calcification in the appendix
What is the normal size of the pyloric muscle?
<3.5 mm thickness
>3.5mm thickness
<3.5 cm thickness
>3.5 cm thickness
The pyloric channel should be __ mm in length
< 16 mm
< 20 mm
<16 cm
<10 mm
The bowel wall should show the __ sign
Target/ Bulls-eye sign
Pseudokidney sign
String of beads sign
Triangular cord sign
What is the most common benign liver tumor in children?
Infantile Hemangioendothelioma
Hepatoblastoma
Nephroblastoma
Lymphoma
When would you see the triangle sign on ultrasound?
Biliary atresia
Intussusception
Appendicitis
Hypertrophic pyloric stenosis
What does the pylorus connect?
Stomach to the Duodenum
Duodenum to the Large Intestine
Large and Small Intestines
Stomach to the Large Intestine
Select what describes Lymphadenopathy
Enlarged lymph nodes
Abscess formation
Hypoechoic, poor through-transmission
Homogenous echogenic mass
Heterogenous with necrosis/hemorrhage
What other conditions is appendicitis associated with?
Perforation
Abscess formation
Appendicolith
Appendicitis
Obstruction
Select what describes Intussusception:
Most common bowel obstruction
Target/donut sign & Pseudokidney sign
Triangular cord sign
Oblong mass, hyperechoic
Most common congenital renal tumor
Most common congenital abdominal neoplasm in neonates, benign CT tumor replacing renal parenchyma
Mesoblastic Nephroma
Hepatoblastoma
Infantile Hemangioendothelioma
Bilateral Renal Agenesis
