SPR 2019 Fetal Course SAM Session - Session 8

Friday, September 13th

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* 1. According to the Multidisciplinary Consensus on the Classification of Prenatal and Postnatal Urinary Tract Dilation, which is the most appropriate terminology?

Hydronephrosis

Urinary tract dilation

Pyelectasis

Pelviectasis

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* 2. Which ultrasound finding is associated with the greatest risk for postnatal nephropathy? The appearance of the jejunum and ileum are readily distinguishable on fetal MR imaging.

32 week prenatal APRPD 8 mm, no other findings

Postnatal APRPD 8mm with peripheral calyceal dilation

22 week prenatal APRPD 6mm with central calyceal dilation

Postnatal APRPD 10 mm with hyperechoic parenchyma

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* 3. Which one of the following statements best describe an MCDK?

Autosomal recessive inheritance, cysts in the cortex and medulla, presence of renal pelvis

Autosomal dominant inheritance, cysts in cortex only, presence of renal pelvis

Cysts in cortex and medulla, no collecting system, no renal function

Cysts in cortex and medulla, renal pelvis present, no real function

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* 4. The causes of renal cystic dysplasia involve all the following except:

Meckel- Gruber syndrome

Isolated, sporadic event.

Lower urinary tract obstruction (LUTO)

HNF1beta/TCF2 mutation

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* 5. When do fetal kidneys start to contribute up to 2/3 of the amniotic fluid volume?

8 weeks GA

10 weeks GA

12 weeks GA

14 weeks GA

16 weeks GA

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* 6. Which of the following diagnosis typically present with dilated kidneys, bladder and ureters?

Posterior Urethral Valves

Prune Belly Syndrome

Meatal Stenosis

All of the above

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* 7. Which of the following findings can help differentiate Prune Belly Syndrome from posterior urethral valves?

Presence of megacystis

Presence of hydronephrosis

Presence of urachus

Presence of cortical cysts

Presence of hydroureters

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* 8. What are the most predictive factors of poor renal outcome in the setting of Posterior Urethral Valves:

Nadir Cr and renal dysplasia

VUR without infection

Hydronephrosis

Bladder size

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* 9. In the setting of a small premature infant with posterior urethral valves, if the cystoscope is too big to enter the urethra, what is the best alternative option:

Vesicostomy

Bilateral ureterostomy

Percutaneous nephrostomy tubes

Suprapubic tube

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* 10. Which of the following may be noted in cloacal malformation by ultrasound?

Fluid filled dilated rectum with enteroliths

Progressive hydrocolpos

Peritoneal calcificagtion

Hydronephrosis

All of the above

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* 11. What is NOT commonly associated with cloacal exstrophy/ OEIS Complex?

Imperforate anus

Omphalocele

Chiari II malformation

Ambiguous genitalia

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* 12. Which of the following anomalies will result in an admixture of meconium and urine?

Urogenital Sinus

Persistent Cloaca

Megacystis microcolon intestinal hypoperistalsis syndrome

Ileal atresia

Prune Belly Syndrome

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