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Pathology Chapter 58
From class review
25
Other
Undergraduate 1
12/13/2010

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Term
What age is a neonate?
Definition
The first 28 days of life
Term
Fusion of lower pole of 1 kidney to the lower pole of the contralateral kidney is called?
Definition
Horseshoe Kidney
Term
No kidney is found on the right side of the body, but there is some tissue present. No kidney is seen near the bladder. What is this?
Definition

Right Unilateral Renal Agenesis

 

(The tissue is the adrenal gland. The left kidney will be hypertrophic.)

Term
You see what appears as an L-shaped mass of renal tissue on a neonate’s left side. No renal tissue is found on the right side. Another test showed that the ureters inserted into each side of the bladder. What congenital anomaly is this?
Definition
Crossed renal ectopia
Term
A patient presents with history of intermittent umbilical discharge; no history of trauma, pain or fever. You see a tubular mass between the urinary bladder & umbilicus. What is being described?
Definition

Urachal anomaly

 

(Urachus did not close.  The discharge at the umbilicus is urine.)

Term
Most common neonatal abdominal mass. Frequently associated with obstruction.
Definition

a.       Hydronephrosis (Most common site of obstruction is UPJ)

 

OR


b.      Multicystic Dysplastic Kidney (Fatal if bilateral)

Term
4 classifications (Perinatal, infantile, juvenile, & neonatal) .  In neonate, kidneys appear enlarged and hyperechoic with a hypoechoic outer rim (cortex). Hepatic biliary duct ectasia & fibrosis of the liver.  Teenagers may present with hepatic fibrosis.
Definition

Autosomal Recessive Polycystic Kidney Disease (ARPKD)

 

(other names)

 

Potter’s Type I

 

Infantile Polycystic Kidney Disease

Term
This is the most common form of cystic disease in infants; usually unilateral; fatal if bilateral; non-hereditary. What is it?
Definition

Multicystic Dysplastic Kidney (MCDK)

 

(other names)

 

Potter’s Type II

 

Multicystic Renal Dysplasia

Term
This is inherited bilateral renal enlargement caused by many cysts in the cortex & medulla. Symptoms may not surface until the 4th-5th decades of life. Associated with Berry Aneurysm.
Definition

Autosomal Dominant Polycystic Kidney Disease (ADPKD)

 

(other names)

 

Potter’s Type III

 

Adult Polycystic Kidney Disease

Term
Symptoms include fever or flank pain; spread via bladder reflux; may see a swollen kidney; antibiotics is administered. An abscess could result if antibiotics aren’t administered.
Definition
Acute pyelonephritis
Term
Sonographically, wall is >3mm & irregular. You may see echogenic debris in the patient’s urine.
Definition

Cystitis

 

(E.Coli is often culprit for bladder infections)

Term
Sonographically, this has a variable appearance based on time.
Definition
Hematoma/hemorrhage
Term
Most common intra-abdominal malignant tumor in a child. This tumor may distort the collecting system & spread beyond the renal corpuscle
Definition

Wilm’s Tumor/nephroblastoma

 

More info:  Also most common childhood renal mass. Peak age between 2-5 years old. May be a palpable abdominal mass. Associated with Beckwith-Wiedemann syndrome. 90% survival rate. Very rapidly developing tumor. Sonographically is a large mass distorting the appearance of the kidney.

Term
 2nd most common abdominal tumor of childhood. Spreads early & widely. Appears poorly defined, heterogeneous. Between the ages of 2 months & 2 years. Sometimes palpable, but usually asymptomatic. Mets usually found at presentation. Most common childhood/infancy adrenal mass. Differential is Wilm’s tumor.
Definition
Adrenal Neuroblastoma
Term
This is the most common neonatal renal neoplasm to occur within the first few months of life. Is benign, but may spread leading to nephrectomy.
Definition

Mesoblasticnephroma

 

Other names:

 

Fetal renal hamartoma

 

Congenital Wilm’s tumor

Term
This causes masculinization. Deficiency of 21-hydroxylase (needed for cortisol production). Female genitalia may appear masculine. Causes enlarged adrenals.
Definition
Congenital adrenal hyperplasia
Term
You scan a neonate with a history of trauma at delivery; you see a suprarenal mass. Follow up exams show a decrease in size of the mass. Most frequent between days 2-7 of life. Most common neonatal adrenal mass.
Definition

Adrenal hemorrhage

 

Other info:  May be caused by anoxia. A mother who is diabetic makes the neonate more prone to this condition. Sonographic appearance changes over time. Need to differentiate from neuroblastoma by demonstrating a decrease in size over time.

Term
Most common malignant tumor of GI tract
Definition
Adenocarcinoma
Term
3rd leading cause of cancer deaths
Definition
Colon Cancer
Term
Most common GI tract tumor in chldren < 10
Definition
Lymphoma
Term
Symptoms include RLQ pain, McBurney's Point tenderness, leukocytosis, N&V
Definition
Acute Appendicitis
Term
Abdominal target lesion sign of:
Definition
Acute Appendicitis
Term
LLQ pain, Western hemisphere, increases with age, low bulk diet
Definition

Diverticular Disease

 

(Diverticula - outpouchings

Diverticulosis - many outpouchings

Diverticulitits - infected outpouchings)

Term

Most common cause of obstruction in child < 1 yr

Rare in adults

US: Sausage shaped

Definition
Intussusecption
Term
4:1 male, projectile vomitting, olive shaped mass
Definition
Hypertrophic Pyloric Stenosis
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