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HomeStretch/Numbers > HomeStretch CRACK vol 1. PEDS > Flashcards

HomeStretch CRACK vol 1. PEDS Flashcards

1
Q

Trigonocephaly

A

Metopic synostosis

“quizzical eye appearance”

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2
Q

Brachycephaly

A

Coronal synostosis

“Harlequin eye” if unilateral

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3
Q

Turricephaly

A

(bilateral) lambdoid synostosis

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4
Q

Sagittal synostosis

A

Scaphocephaly

Dolecocephaly

“scaphodolecocephaly”

(associated with Marfans [both are tall and Skinny).

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5
Q

When I say “bone defect in the region of the lambdoid suture” or “asterion defect” you say?

A

NF1

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6
Q

Kleeblattschädel

A

clover leaf skull

premature synostosis of coronal and lambdoid sutures +/- sagittal suture

assocaciated with: thanatophoric dysplasia, Apert and crouzon’s

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7
Q

Apert Syndrome

A

Craniosynostosis (brachycephaly) + Fused fingers aka syndactyly (making an “A”) - typically symmetric fused hands and feet.

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8
Q

Crouzon’s

A

Craniosynostosis (brachycephaly)

1st arch structures (maxillary and mandibular hypoplasia)

Hydrocephalus

Chiari 1 malformations

associated with patent ductus and aortic coarctation

short central long bones (rhizomelia)

Crouzon’s Cs = Coronal suture craniosynostosis, Can’t Chew (first arch structures), Chiari I, Coarctation, hydroCephalus, Central bones short (rhizomelia), Crazy eyes (exophthalmos).

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9
Q

Lückenschädel Skull

A

Aka Lacunar skull

due to defective bone matrix

classically associated with Chiari II and neural tube defects

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10
Q

Wormian Bone Mnemonic

A

“Wormian PORK CHOPS”

Pyknodysostosis (sclerosing bone dysplasia; osteopetrosis with wormian bones; lysosomal storage disorder)

Osteogenesis Imperfecta (Collagen type I disorder)

Rickets (vitamin D deficiency [metephyseal fraying, splaying and cupping])

Kinky hair syndrome = Menke’s = X-linked recessive disorder AKA Fucked up Copper Metabolism -> fine, silvery brittle hair)

Cleidocranial dysostosis

Hypothyroidism/Hypophosphatasia

One too many 21 chromosomes (downs)

Primary Acro-osteolysis = Hajdu-cheney syndrome = connective tissue disorder

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11
Q

Acro-Osteolysis Mnemonic

A

the resorbed distal phalanx is “FO PINCHing”

F: familial, e.g. Hajdu-Cheney syndrome

O: other, e.g. polyvinyl chloride exposure, progeria

P: psoriasis/pyknodysostosis

I: injury, e.g. thermal burn, frost bite

N: neuropathy, e.g. diabetes mellitus, leprosy

C: collagen vascular disease, e.g. scleroderma, Raynaud disease

H: hyperparathyroidism

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12
Q

Pediatric scalp trauma - what are the three blood collections, superficial to deep, and which crosses sutures?

A
  1. Caput Succedaneum = Crosses sutures - resolves on its own
  2. Subgaleal hemorrhage = crosses sutures, potentially life-threatening and seen after vacuum extractions
  3. Cephalhematoma = limited by suture lines
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13
Q

scalp laceration + depressed fracture = ?

? + dural tear = ??

A

Compound fracture

compound fracture + dural tear = penetrating fx

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14
Q

What is a leptomeningeal cyst?

A

“Growing Skull Fracture”

fractured noggin + dural tail with leptomeninges herniating through torn dura and over time progressively widens

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15
Q

What is sinus pericranii

A

Dural venous sinus in the pericranium

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16
Q

CHARGE Syndrome

A

Coloboma

Heart Defects

Atresia (Choanal)

Retard

Genitourinary Abnormalities

Ear Anomalies

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17
Q

Treacher Collins syndrome

A

Mandibulo-facial dysostosis

problems with first and second branchela arches.

concave curve of the horizontal ramus

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18
Q

PHACES syndrome

A

P: posterior fossa malformations (e.g. Dandy-Walker malformation)

H: hemangiomas

A: arterial anomalies

C: coarctation of the aorta and cardiac anomalies

E: eye (ocular) anomalies

S: subglottic hemangiomas / sternal cleft / supraumbilical raphe

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19
Q

Neonatal CXR

High volumes + Perihilar Streaky

A

MNoPpT

Meconium aspiration (+pneumothorax)

Non-GB neonatal pneumonia (with pleuarl effusions)

TTN

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20
Q

Neonatal CXR

low volumes (or normal) + Granular

A

Surfactant deficiency disease

GBS neonatal pneumonia

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21
Q

Potter Sequence

A

Babies who can’t Pee in utero develop POTTER seuqence

Pulmonary hypoplasia

Oligohydramnios

Twisted face

Twisted skin

Extremity defects

Renal failure

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22
Q

Pleuropulmonary blastoma

A

Normal 2nd trimester US + infant with lung tumor = Primary lung tumor (rather than a congenital malformation)

Big Fucking Mass in the chest of a 1-2 yo.

Shouldn’t have eat up rib (Askin tumors often do)

Multilocular cystic nephroma 10% of the time.

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23
Q

Inflammatory Myofibroblastic Tumor (IMT)

A

Most common primary lung tumor in children. It is benign (unlike pleuropulmnonary blastoma). These are solid masses, lobulated and calcified, and T2 bright because of their myxoid appearance.

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24
Q

What is neonatal atypical peripheral atelectasis?

A

Uncle to round pneumonia in children - essentially the same thing but peripheral.

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25
Q

What is Swyer-James syndrome?

A

Post-infectious obliterative bronchiolitis (not hyperexpanded).

26
Q

DDx mnemonic for GI obstruction in a child?

A

AAIIMM

Appendicitis, Adhesions

Inguinal hernia, Intussusception

Midgut volvulus, Meckels

27
Q

Pentalogy of Cantrel

A
  1. Omphalocele
  2. Ectopia cordis (abnormal position of the heart)
  3. Diaphragmatic defect
  4. Pericardial defect or sternal cleft
  5. Cardiovascular malformations
28
Q

Liver mass DDx ages 0-3

A

The 3 H’s

  1. Infantile Hemangioma (basically a hemangioma. . .)
  2. Hepatoblastoma (HCC of childhood, most common primary liver tumor < 5 yo, associated with Wilms, AFP and precocious puberty [due to bHCG secretion])
  3. Mesenchymal Hamartoma (cystic mass with large feeding portal vein branch)
29
Q

Liver mass DDx > 5yo

A

HCC

Fibrolamellar HCC

Undifferentiated embryonal sarcoma = pissed off cousin of the mesenchymal hamartoma.

30
Q

Caroli’s disease is associated with what renal stuff?

A

Polycystic disease and medullary sponge kidney

31
Q

Vesicoureteric Reflux Grading

A

grade 1: reflux limited to the ureter

grade 2: reflux up to the renal pelvis

grade 3: mild dilatation of ureter and pelvicalyceal system

grade 4: tortuous ureter with moderate dilatation blunting of fornices but preserved papillary impressions

grade 5: tortuous ureter with severe dilatation of ureter and pelvicalyceal system loss of fornices and papillary impressions

32
Q

What cancer does urachal remnants and bladder exstrophy get?

A

AdenoCA

33
Q

DDx for neonatol renal lesions

A

Nephroblastomatosis (nephrogenic rests)

Mesoblastic nephroma (ie neonatal Wilms)

Multicystic dysplasic kidney

34
Q

DDx for renal masses around age 4

how about teenager?

A

Wilms, Wilms variants (clear cell and rhabdoid), lymphoma, multilocular cystic nephroma

Teenager = RCC and Lymhoma

35
Q

Syndrome associated with Wilm’s tumor

A
  • Overgrowth
    • Beckwith-Wiedemann syndrome = wilms, omphalocele, hepatoblastoma, macroglossia
    • Soto = macrocephaly, retarded, ugly face
  • Non-Overgrowth
    • WAGR = wilms, aniridia, gential, growth retard
    • Drash = Wilms + pseudohermaphroditism, progressive glomerulonephritis
36
Q

What subtype of testicular cancer is associated with Peutz-Jeghers syndrome?

A

sertoli (non-germinomatous)

37
Q

How does one tell between a dead thanatophoric dwarf from a dead Asphyxiating thoracic dystrophy (Jeune) dwarf?

A

By looking at their vertebral bodies - The Jeune Dwarf bodies will be normal.

38
Q

Additional Randomw Dwarf Trivia

What are these dwarves:

Ellis-Van Crevald

Pseudoachondroplasia

Pyknodysostosis

A
  • Ellis-Van Crevald = dwarf with polydactyly
  • Pseudoachondroplasia = weird thing not present at birth, and spares the skull
  • Pyknodysostosis = dwarf with osteopetrosis, wide angled jaw, wormian bones and acro-osteolysis.
39
Q

Gorlin Syndrome

A

Bifid ribs, falx calcifications, basal cell cancers, odontogenic keratocysts (lytic jaw lesions).

40
Q

Radial dysplasia ddx

A

VACTERL, Hold-Oram, Fanconi Anemia, Thrombocytopenia Absent Radius (TAR, which have a thamb).

41
Q

talocalcaneal coalition signs

A
  • Continuous C sign - produced from an absent middle facet
  • talar beak
42
Q

Calcaneonavicular coalition signs

A

Anteater sign = elongated anterior process of the calcaneus

43
Q

Lucent Metaphysla Bands DDx

A

LINE

Leukemia

Infection (TORCH)

Neuroblastoma mets

Endrocrine (Rickets, Scurvy)

44
Q

Currarino Triad

A

CurrArino TriAd

Anterior Sacral Meningocele

Anorectal Malformations

Sacrococcygeal Osseous Defect (scimitar sacrum).

45
Q

Spinal Dysraphisms

Open

Closed (w/ and w/o subcutaneous mass)

A
  • Open
    • Myelomeningocele
    • Myelocele
  • Closed with a subcutaneous mass
    • Meningocele
    • Lipomyelocele/lipomyelomeningocele
    • terminal myelocystocele
  • Closed without subcutaneous mass
    • Intradural lipomas
    • fatty filum (fibrolipoma of the filum terminale)
    • tight filum terminale
    • Dermal sinus
46
Q

Situs Solitus

A

Normal

47
Q

Situs Inversus

A

Complete mirror image

48
Q

situs ambiguous = heterotaxy, of which you can have right or left “isomerism”

Visceral heterotaxy with thoracic right isomerism

A

Everything on the right moves towards the left

  • Two fissures in left (ie b/l minor fissures - minor fissure should only be on right and moves over to left)
  • Asplenia (right liver moves into its place to the left)
  • Increased cardiac malformations (think of the right middle lobe crossing over and fucking up the heart)
  • Reversed aorta/IVC
49
Q

situs ambiguous = heterotaxy, of which you can have right or left “isomerism”

Visceral heterotaxy with thoracic left isomerism

A

Everything on the left moves over to the right

  • Absent minor fissure on the right (i.e. no minor fissures)
  • Polysplenia (liver on left moves over to the right)
  • Less cardiac malformations (just moves over from left to right)
  • Azygous continuation of the IVC
50
Q

Weigert Meyer Rule

A

Inferior pole (IR) refluxes; orthotopic ureteral insertion

Upper pole = ureterocele = obstructs (the more dialated one); ectopic ureteral insertion (inferior and medial)

51
Q

Intralobar versus extralobar pulmonary sequestrations

A

intra = recurrent Infections, presents later

Extra = presents earlier due to “extra things” ie malformations

52
Q

Anterior mediastinal mass

< 10 yo; > 10 yo

A

< 10 yo = Thymus

> 10 yo = lymphoma

53
Q

Posterior mediastinal mass

< 10 yo

> 10 yo

A

< 10 yo think malignant (ie neuroblastoma)

> 10 year old think benign

54
Q

BFM in the chest of a kid

A

Askin tumor = 10 + yo with eaten up rip

Pleuropulmonary blastoma age < 2 yo

55
Q

Microcolon ddx

A

Meconium ileus = CF and the contrast fills TI

distal ileal atresia = the contrast won’t get to TI

56
Q

Peds pancreatic mass at years 1, 6 and 15 yo

A

1 yo = pancreatoblastoma

6 yo = adenoCA

15 yo = SPEN

57
Q

Double aortic arch

A

most common vascular ring

impression on anterior trachea and posterior esophagus

58
Q

Right art with aberrant left subclavian

A

second most common vascular ring

anterior depression on trachea and posterior impression on esophagus

59
Q

pulmonary sling

A

anomalous origin of the left PA from right PA, which courses between trachea and esophagus

posterior impression on trachea and anterior impression on esophagus

(only sling to produce ANTERIOR impression on the esophagus

60
Q

Left aortic arch with aberrant right subclavian

A

not a real ring or sling

dysphagia lusoria

61
Q

What cancers are associated with horseshoe kidneys?

A

Wilms, TCC and RENAL CARCINOID

HomeStretch/Numbers (24 decks)

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