Chapter 9 Questions ( Pediatric Mass )

A newborn boy is seen for a renal sonogram as a follow-up of an obstetric sonogram that showed a markedly distended bladder, hydronephrosis, dilated and tortuous ureters, and a keyhole appearance of the proximal urethra. These findings are most consistent with which of the following congenital obstructive disorders?

a. UPJ obstruction

b. Posterior urethral valves

c. Renal agenesis

d. Eagle-Barrett syndrome

B. Posterior Urethral valves

A 2-day-old infant is referred for an abdominal sonogram because of an echogenic liver nodule seen on the prenatal obstetric sonogram. Additionally, the infant has a strawberry-colored mass on the right side of her neck. The sonogram is most likely to reveal which type of liver mass?

1. Hepatoblastoma

2. Choledochal cyst

3. Congenital hepatic fibrosis

4. Hemangioendothelioma

Hemangioendothelioma

A newborn boy born after a prolonged labor and breech delivery presents with a questionable right upper quadrant mass. At physical examination, a swollen and bluish-discolored scrotum is noted. Laboratory analysis reveals anemia. A sonogram of the right upper quadrant and scrotum is requested. The abdominal sonogram reveals a crescent-shaped, slightly hyperechoic right suprarenal mass. What is the most likely cause for this finding?

Unilateral adrenal hemorrhage

MCDK

Wilms' tumor

Mesoblastic nephroma

Unilateral Adrenal Hemorrhage

A prenatal sonogram reveals the presence of bilateral enlarged kidneys with a loss of corticomedullary differentiation. Hepatomegaly, mildly increased hepatic echogenicity, dilated intrahepatic biliary ducts, and poorly visualized peripheral portal veins are also noted. After delivery, the infant is referred for renal sonography, which displays the same characteristic large echogenic kidneys with poor corticomedullary differentiation; macrocysts are not present. The liver abnormalities noted on prenatal sonogram are no longer evident. What is the most likely cause for these findings?

Unilateral renal agenesis

Neuroblastoma

ARPKD

MCDK

ARPKD

A 3-year-old boy with abdominal pain is seen with a large, firm, palpable mass in the left upper quadrant. He is referred for abdominal sonography. A large, spherical, heterogeneous left upper quadrant mass is identified. The sonographer can identify the organ of origin as the kidney. Evaluation of the IVC and left renal vein reveals the presence of tumor thrombus. Based on the clinical presentation and findings, what does this mass most likely represent?

Neuroblastoma

Wilms' tumor

MCDK

Mesoblastic nephrema

Wilms Tumor

A 1-year-old girl is referred for abdominal sonography after a palpable mass is noted on the right side. The child has no significant clinical signs or symptoms of disease. The sonogram reveals multiple, noncommunicating cysts in the right renal bed. What is the most likely cause for this sonographic appearance?

UPJ obstruction

UVJ obstruction

MCDK

ARPKD

MCDK

A 3-week-old infant presents with persistent jaundice, dark urine, and enlarged girth. A fasting sonogram is requested. An enlarged liver with an echogenic area superior to the portal vein bifurcation is demonstrated in the right upper quadrant. No gallbladder is identified. What is the likely diagnosis for this patient?

Hemangioendothelioma

Hepatoblastoma

Choledochal cyst

Biliary atresia

Biliary Atresia

A 1-month-old infant is referred for sonographic evaluation of a palpable abdominal mass. No other clinical signs or symptoms have been noted. Laboratory tests reveal elevated catecholamine levels. The sonogram reveals a 5-cm homogeneous left suprarenal mass; calcifications within the mass are noted. Doppler reveals moderate blood flow within the mass. What does this mass likely represent?

1. Neuroblastoma

2. Adrenal hemorrhage

3. Wilms tumor

4. MCDK

Neuroblastoma

A 1-year-old boy is referred for an abdominal sonogram. The history reveals that he was delivered prematurely. He presented with hepatomegaly and elevated alpha-fetoprotein levels. A 9-cm hepatic mass with calcification is noted. The mass appears to have invaded the adjacent portal vein. What do the clinical history and features of this mass suggest?

Neuroblastoma

Hepatoblastoma

Hemangioendothelioma

Biliary atresia

Hepatoblastoma

1 A 3-year-old girl is referred for renal sonography following a 6-month history of recurrent urinary tract infections. The sonogram reveals a duplicated collecting system on the right kidney. Mild to moderate hydronephrosis is evident. A mildly dilated right ureter can be followed to its insertion into the bladder, where a ureterocele is noted. What condition does this describe?

1. UPJ obstruction

2. UVJ obstruction

3. Posterior urethral valves

4. MCDK

UVJ obstruction