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PEDIATRIC ARDMS REVIEW LATEST FINAL EXAM UPDATED FOR 2025
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Most common malignant liver tumor in children? Hepatoblastoma 2nd most common malignant liver tumor in children. Seen w/ hep B and Wilsons disease. HCC Most common benign hepatic tumor of childhood. Infantile Hemangioendothelioma Benign liver lesion made up of small blood filled spaces lined w/ endothelial cells Cavernous Hemangioma Congenital benign liver tumor originating along portal triads Mesenchymal Hamartoma (aka Lymphangioma) Congenital cystic dilatation of intrahepatic ducts. Caroli disease Which biliary tract pathology has an increased risk of Cholangiocarcinoma? Caroli disease What is the most common cause of hyperbilirubinemia? Biliary atresia What procedure can be done to preserve the liver in cases of biliary atresia? Kasai procedure What is the most common (but rare) neoplasm of the biliary tract in children? Rhabdomyosarcoma Most common malignant Splenic neoplasm
Lymphoma What may cause multiple hypoechoic masses in the spleen? Langerhans cell histocytosis Solid complex mass in spleen. Rare but mets to liver, bone, lymph nodes. Angiosarcoma Autosomal recessive disorder that presents w/ Hepatosplenomegaly and bone infarctions. Gaucher storage disease When is Pyloric Stenosis most common? 2 - 6 weeks (boys) Common cause of delayed emptying of stomach, antral narrowing & causes vomiting Pylorospasm (aka Antral Dyskinesia) Most common malignant neoplasm of GI tract in children. Lymphoma Most common cause of congenital duodenal obstruction in newborns. Duodenal atresia Midgut malrotation SMV positioned left of SMA Most common acute abdominal disorder in early childhood? Intussusception Most common inflammatory disease of small bowel. Crohn disease Most common small bowel malignancy in childhood. Non-Hodgkin's Lymphoma Most common surgical emergency in children. appendicitis (more common in girls)
Infantile type of pancreatic carcinoma. May be seen w/ Beckwith-Wiedemann Syndrome. Pancreaticoblastoma Most common islet cell tumor Insulinoma 2nd most common islet cell tumor Gastrinoma Malignant ovarian tumor. Usually larger than 10cm. Germ cell tumor Name the 2 Sex Cord-Stromal Tumors
- Granulosa cell
- Sertoli-Leydig Which ovarian tumor is due to excessive Estrogen production? Granulosa cell Which ovarian tumor is due to excessive Androgen production? Sertoli-Leydig Most common tumor of the genitourinary tract in children? Rhabdomyosarcoma (malignant vaginal tumor) Pyloric muscle is thickened when
3mm Pyloric channel is elongated when 17mm Diameter of intussuscepted bowel 3cm Normal hip Alpha angle 60 degrees or greater Normal hip Beta angle
55 degrees or less The smaller the ______ angle and the larger the ______ angle, the more likely that dysplasia is present. Alpha; Beta Normal appendix should not exceed 6mm Name 3 types of Dorsal Stigmata seen with Occult spinal dysraphism: sacral dimples skin tags abnormal hair growth Which Occult spinal dysraphism is often associated with a tight filum terminale? Lipomyelocele Lipomyelomeningocele What is it called when a sagittal cleft is present in the spinal cord causing it to divide into 2 cords Diastematomyelia Types of Overt Spinal Dysraphism (non-skin covered) Myelocele Myelomeningocele Heterogeneous fluid within dorsal & ventral epidural space Lumbar puncture hematoma What is the #1 cause for congenital hydro? UPJ obstruction What are the small segmented pouches called within the colon? Haustra How to get low flow in kidneys to show? decrease PRF Nutcracker Syndrome Compression of left renal vein between SMA and aorta
Best position of hip to obtain Alpha measurement? infant lateral decubitus femur extended Split Cord Malformation (Diastematomyelia) sagittal cleft in spinal cord dividing it into 2 hemicords A child under 5 years old presenting with weight loss and a RUQ mass may have: Hepatoblastoma When might you see a flattened adrenal gland? with renal agenesis Normal measurement of filum terminale? < 2mm Caroli disease associated findings saccular dilation of intrahepatic bile ducts calculus formation cholangitis hepatic fibrosis portal HTN Arnold-Chiari malformation is a complex brain anomaly associated with what 3 things? cerebellar dysplasia spinal dysraphism encephalocele or myelomeningocele Name the 6 cranial bones: frontal parietal temporal occipital sphenoid ethmoid Which cranial bone has a "batwing" shape? Sphenoid Name the 5 major sutures of the skull: Coronal
Frontal/Metopic Lamboidal Sagittal Squamosal Which 2 bones form the Metopic suture? 2 frontal bones Which 2 bones form the Lamboidal suture? Occipital Parietal Which 2 bones form the Sagittal suture? 2 parietal bones Which 2 bones form the Squamosal suture? Temporal Parietal What is the term for premature fusion of the lamboidal, coronal and sagittal sutures? Craniosynostosis What is the term for premature fusion of the lamboidal and coronal sutures? (creates a "Trilobed" skull appearance) Cloverleaf skull Name the 4 fontanelles anterior posterior sphenoid mastoid Name the divisions of the brain: Prosencephalon (telencephalon and diencephalon) Mesencephalon Rhombencephalon (metencephalon and myelencephalon) Spinal cord The Prosencephalon consists of: telencephalon and diencephalon The
between dura mater and skull Where is the subdural space located? between dura mater and arachnoid mater Where is the subarachnoid space located? between arachnoid and pia mater Most important reflection that separates the cerebellum and brainstem from the occipital lobes of cerebrum Tentorium cerebelli What separates the 2 hemispheres of the brain? (lies within the interhemispheric fissure) Falx cerebri Name the 4 major subarachnoid cisterns Cisterna magna Pontine cistern Interpeduncular cistern Quadrigeminal cistern What vessel runs through the quadrigeminal cistern? Vein of galen The M3 branch of the MCA supplies what region of the brain? Insula (contains Broca's area which controls speech, reading, writing) What is the largest white matter structure in the brain? Corpus callosum What purpose does the corpus callosum serve? Connects right and left hemispheres What structure in the neonatal brain may be confused with a subependymal germinal matrix hemorrhage? Caudothalamic groove
What is the landmark used to assist in detection of a subependymal germinal matrix hemorrhage? Caudothalamic groove Purpose of the Massa Intermedia? connects the 2 thalamic bodies When is the Massa Intermedia seen? when the 3rd ventricle is dilated What does the hypothalamus control? body temperature appetite thirst anger circadian cycles What structure of the basal ganglia is concerned with learning and memory? Caudate nucleus Name functions of the Cerebellum fine movement balance equilibrium muscle tone Name the parts of the brainstem midbrain pons medulla oblongata What structures connect the pons to the cerebrum? cerebral peduncles Name the 4 ventricles of the brain 2 lateral 3rd ventricle 4th ventricle What is the thin structure that separates the lateral ventricles? Septum pellucidum
Describe a Grade II intracranial hemorrhage: Intraventricular hemorrhage NO ventricular dilation Describe a Grade III intracranial hemorrhage: Intraventricular hemorrhage YES ventricular dilation Describe a Grade IV intracranial hemorrhage: Intraventricular hemorrhage AND Intraparenchymal hemorrhage (IPH) What happens as a result of "Shaken baby" syndrome? Posterior fossa subdural hemorrhage What is the congenital anomaly of the brain thought to be caused by bilateral ICA occlusions during fetal development? Hydrancephaly Hydrocephaly vs. Ventriculomegaly hydrocephaly is ventriculomegaly with increased ICP and head size Cerebral edema vs. Encephalitis edema: increased brain echogenicity with "slit-like" ventricles encephalitis: increased brain echogenicity What is the failure of diverticulation of the Prosencephalon? Holoprosencephaly 3 types of Holoprosencephaly Alobar (most severe, no separation) Lobar (partial separation) Semilobar (more cerebral tissue) ALL forms of Holoprosencephaly have absence of.... Septum pellucidum Identification of the Septum pellucidum rules out....
Holoprosencephaly What structure runs along the lateral margin of the thalami? Sylvian fissure What vessel is seen pulsating in the sylvian fissure? MCA Which syndrome is associated with Aniridia? WAGR (wilm's tumor, aniridia, GU anomalies, retardation) WAGR syndrome Wilm's tumor Aniridia (absence of iris) GU anomalies Retardation (mental and motor) Most common Arnold-Chiari malformation Chiari II A "batwing" configuration of the frontal horns of the lateral ventricle indicates: Chiari malformation Dilated, fluid filled central sinus of the spinal cord Hydromelia (Syringomelia) Fatty filum vs. Filar lipoma fatty filum - normal variant filar lipoma - >2mm causing mass effect (associated w/ tethered cord) 2 types of caudal regression Sacral agenesis (mildest) Sirenomelia (severe) Absent gyri/sulci indicates: Lissencephaly ("smooth" brain)
parotid (largest) submandibular sublingual Which salivary gland contains Stensen's duct and drains into the oral cavity? parotid Which salivary gland is triangular in shape and contains Wharton's duct? submandibular Which salivary gland is the smallest and may contain ranulae (mucus retention cysts) sublingual What type of adrenal tumor appears as an echogenic mass and is associated with propagation speed artifact? Myelolipoma (speed is slower in fat) Most common cause of neonatal adrenal mass adrenal hemorrhage What is the rare adrenal tumor that releases excessive amounts of epinephrine and norepinephrine? pheochromocytoma Wolman disease Rare lipidosis. Enlarged, calcified adrenal glands. Usually fatal at an early age. Most common cause of acute scrotum in POST-PUBERTAL male? epididymitis Most common cause of acute scrotum in pediatric patient? torsion 2 different types of testicular torsion extravaginal (neonates in utero) intravaginal (adolescents) Testicular torsion has approx 100% salvage rate if surgery is performed within how many hours? 4 - 6 hours (enlarged & hypoecoic)
A patient presents with left testicular swelling. Upon sonographic evaluation, an enlarged left testicle is seen along with a hydrocele. Color flow is normal. What is the most likely cause? Nutcracker syndrome In what pathologic condition would you see the "whirlpool" sign? Midgut malrotation (volvulus) What is the name for a mass trapped in the GI system? Bezoar 2 types of Bezoars Trichobezoar (hair) Lactobezoar (milk) 4 types of hernias Indirect inguinal (congenital) Direct inguinal (acquired) Femoral Spigelian Relationship of an INDIRECT inguinal hernia to vascular structures: superior/lateral to prox inferior epigastric artery Relationship of a DIRECT inguinal hernia to vascular structures: inferior/medial to prox inferior epigastric artery Which type of inguinal hernia is more common in infants and is more likely to extend into the scrotum? Indirect Relationship of femoral hernia to vascular structures: medial to CFV Relationship of spigelian hernia to vascular structures: lateral to inferior epigastric vessels Large,fluid-filled RLQ structure with an "onion" skin appearance may indicate:
line stand for? peripherally inserted central catheter Name 5 risk factors for DDH first born female frank breech family hx oligohydramnio s Which 3 specific structures should be imaged when evaluating for septic hip? femoral head/neck joint capsule iliopsoas muscle Which 3 bones form the hip? ilium ischium pubis Name the 2 stress maneuvers used for evaluation of the infant hip Barlow Ortolani Describe the Barlow maneuver dislocation of the hip by ADDUCTING and pushing leg posterior Describe the Ortolani maneuver relocation of the hip by ABDUCTING the leg Name the angle between the ilium and the roof of the labrum; < 55 degrees is normal. Beta Name the angle between the acetabular roof and the ilium; > 60 degrees is normal. Alpha Pyomyositis
Infection of skeletal muscle Osteomyelitis inflammation of bone and bone marrow What is the difference between Transient synovitis and a septic hip? septic hip will have pain at rest and high fever (transient synovitis no pain at rest, afebrile or mild fever) What is the unusual condition occurring in athletes after a blunt injury in which the bone subsequently forms within the muscle at the site of injury? Myositis ossifications What symptoms would a patient with hypertensive vasculitis have? pain, fever, swollen joints, petechiae Where does the thymus gland lie? posterior to sternum Which gland resembles a "sail" on ultrasound thymus What is the anomaly where a segment of lung does NOT function due to anomalous blood supply and no communication with tracheobronchial tree? Pulmonary sequestration 2 types of pulmonary sequestration Intralobar (acquired) Extralobar (congential) Which type of pulmonary sequestration is more common in males and on the left? Extralobar 2 types of diaphragmatic hernias Bochdalek Morgagni What scanning approach would be optimal to assess for diaphragmatic paralysis? Intercostal
