27 Congenital - Vascular Flashcards

(27 cards)

1
Q

What are the clinical differences b/w a hemangioma and vascular malformation

A

Vascular malformations are present at birth, grow proportionately with the child, and are associated with distortion or destruction of surrounding bone or cartilage; hemangiomas generally emerge after birth, proliferate and then regress, and do not affect surrounding bone or cartilage.

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2
Q

What are the typical clinical features of venous malformations

A

Soft, compressible, nonpulsatile mass m/c found on lip or cheek w/in H&N; also can be found w/in masseter muscle or mandible

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3
Q

What are the clinical features of AVM

A

brightly erythematous lesions of skin w/ an assoc thrill and bruit

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4
Q

What % of infants have a hemangioma by age 1

A

12%

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5
Q

What is the incidence of hemangiomas in premature infants weighing < 1000 g

A

23%

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6
Q

B/w what ages do hemangiomas grow most rapidly

A

8-18 months

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7
Q

What percent of hemangiomas regress by age 7

A

70%

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8
Q

Where exactly are most subglottic hemangiomas located

A

Posterolaterally and submucosally

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9
Q

What % of pts w/ subglottic hemangioma have an assoc cutaneous hemangioma

A

50%

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10
Q

What is m/c tx for hemangiomas

A

observation, parental reassurance

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11
Q

When is intervention for hemangioma warranted

A
  • For massive, ulcerative, disfiguring lesions
  • Hematologic, CV, upper aerodigestive tract compromise
  • Large periorbital lesions obstructing vision
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12
Q

What syndrome is characterized by profound thrombocytopenia a/w hemangioma

A

Kasabach-Merritt syndrome

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13
Q

What are the 4 main types of vascular malformations

A

Capillary, venous, lymphatic, and arteriovenous malformations

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14
Q

What is m/c vascular malformation

A

Port wine stain (a capillary type)

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15
Q

What syndrome is characterized by capillary hemangiomas along the distribution of V1 w/ concomitant capillary, venous, and AVM of the leptomeninges

A

Sturge-Weber syndrome

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16
Q

What is the optimal tx for port wine stains

A

Argon laser in darker-skinned adults; flashlamp pulsed tunable dye laser in kids and lighter skinned adults

17
Q

Which lesions respond best to PDL

A

Lesions less than 20 cm2 in kids < 1 year old

18
Q

What are the 4 categories of lymphatic malformations

A

Capillary, cavernous, cystic (hygroma), and lymphangiohemangioma

19
Q

Which lymphatic malformation is a/w episodic bleeding

A

Lymphangiohemangioma

20
Q

Which lymphatic malformation is m/c found on tongue or floor of mouth

21
Q

Which lymphatic malformation is a/w location in posterior triangle of neck

A

Cystic hygroma

22
Q

Which lymphatic malformation is more likely to rapidly enlarge during an upper respiratory tract infection

A

Lymphangiohemangioma

23
Q

“An infant has a left-sided suprahyoid lymphatic malformation. Using the DeSerres classification system, which class is this?

24
Q

What are the indications for definitive tx of lymphatic malformations

A

When vital structures are endangered, when episodic hemorrhage occurs, or if macroglossia is present

25
Which lymphatic lesions are less likely to respond to sclerosis with OK-432 (Picibanil)
Microcystic, previously operated on, and those with massive craniofacial involvement
26
What condition is seen in adolescent pts with severe frequently recurring epistaxis and pulm AVMs
HHT (Auto Dom)
27
What are the advantages of using argon plasma coagulation for tx of HHT
- Noncontact application - Limited and controlled tissue penetration with low risk of septal perforation - No safety measures required (i.e. for lasers) - Low thermal damage to adjacent tissue - Inexpensive