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FRCR 2a Flashcards > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Lymphoma staging:

A

Lugano classification:

Stage I - One node/group of node.
Stage 1e - One extra-lymphatic site only (i.e. hepatic lymphoma, small bowel lymphoma WITHOUT nodal disease)

Stage II - two nodal groups on SAME side of diaphragm
Stage IIe - extralymphatic spread from a node

Stage III - nodes both sides of the diaphragm

Stage IV - nodal and separate extra nodal disease/ multiple extra nodal disease

A - absence of symptoms
B - presence of symptoms

Bulky - Single nodal mass >10cm, or 1/3 of thoracic diameter

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2
Q

What is VACTERL?

A

Conditions that are commonly seen together

V - Vertebreal anaomalies
A - Anal (imperforate anus 63%)
C - Cardiac
TE - Tracheoesophageal fistula
R - Renal
L - Limb (radial ray 58%)

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3
Q

Li Fraumeni syndrome - associated cancers

A

SCAB

Sarcomas - Osteosarcoma, Rhabdos
CNS tumours - glioma
Adrenal cortical tumours
Breast cancer

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4
Q

What are the diagnostic measurements for pyloric stenosis?

A

Pyloric length - >15mm
Transverse diameter - >12mm
Pyloric thickness - >3mm

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5
Q

What are the signs for congenial biliary atresia on USS?

A

Triangular cord sign - echogenic fibrous tissue adjacent to the portal vein

Absent gall bladder

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6
Q

What does double bubble sign suggest?

A

Duodenal dilatation.
Causes include: duodenal web, atresia, stenosis, annular pancreas

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7
Q

What is a leptomeningeal cyst?

A

Leptomeninges herniate through a skull fracture.
The fracture grows overtime as the CSF pulsates within the meninges

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8
Q

What is the most common cause of macrocephaly?

A

BESSI
Benign enlargement of the subarachnoid space in infancy

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9
Q

What is periventricular leukomalacia?

A

Ischaemia secondary to birthing.

Early - periventricular necrosis
Late - periventricular cyst formation

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10
Q

What is the grading for germinal matrix haemorrhage?

A
  1. Blood in caudo thalamic groove
  2. Blood in ventricles no dilatation.
  3. Blood in ventricles with dilation.
  4. Blood in brain parenchyma
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11
Q

What is pyriform aperture stenosis associated with?

A

Midline developmental problems.

Holoprocencephaly
Pituitary dysfunction
Central mega incisor.

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12
Q

Classic imaging appearances of a branchial cleft cyst?

A

Second arch cyst is most common

Cyst at level of angle of mandible
Lateral to the submandibular gland
Between the internal and external carotid arteries

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13
Q

How do you treat infantile haemangiomas?

A

Beta blockers

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14
Q

Classic imaging features of a cystic hygroma and what are its associations?

A

Lymphatic malformations
Cystic mass in the posterior triangle of the neck
Associated with Turners disease and Downs

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15
Q

Classic imaging features of Fibromatosis coli?

A

Torticollis
Enlarged sternocleidomastoid.

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16
Q

Average age for Croup and what infection causes it?

A

6mnths to 1 year
Parainfluenza virus

(Epiglottitis is 3-6 year, H. influenza)

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17
Q

Average age for epiglottitis and what infection causes it?

A

3-6 years old.
H. influenza.

(Croup is 6-12 months and parainfluenza virus).

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18
Q

Classic imaging appearance of meconium aspiration?

A

Asymmetric “ropy” lung densities.
Hyperinflation.
Pneumothorax

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19
Q

Classic imaging appearance of TTN?

A

Classic history of C-section, maternal diabetes.

Course interstitial markings
Fluid in the fissures

Findings peak at day one, and disappear by day 3.

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20
Q

Classic imaging appearance of RDS?

A

Pre term
Reduced lung volume
Bilateral diffuse ground glass (granular) opacities.

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21
Q

What is neonatal pneumonia classically caused by?

A

Group b Strep

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22
Q

What is pulmonary interstitial emphysema?

A

Ventilator pressure associated.
Cystic / linear radio lucencies with hyperinflation.
Sign of impending pneumothorax.

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23
Q

Classic imaging appearance of CPAM?

A

Multicystic lesion
Can communicate with the airway and can be filled with air

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24
Q

How can you differentiate between CPAM and sequestration?

A

Sequestration has a systemic feeding artery.
Sequestration typically left lower lobe.

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25
What is the most common primary lung malignancy in children?
Pleuro pulmonary blastoma.
26
Correct positions for UVC and UAC?
UVC - atriocaval junction UAC - initially travels inferiorly, then turns superiorly, with tip ending at T7
27
What is Swyer James syndrome?
Unilateral small hyperlucent lung due to air trapping, from post infective obliterative bronchiolitis. Bronchiectasis of the affected lung.
28
What conditions are Kleinfelter disease associated with?
BCOG Breast cancer Choroid plexus cysts Omphalocele Germ cell tumours
29
How can you differentiate Ewing's sarcoma from Pleuropulmonary blastoma?
Both present as massive thoracic masses. Ewing's destroys ribs.
30
What are the 5 types of tracheosophageal fistula?
A - isolated esophageal atresia B - proximal fistula with distal atresia C - distal fistula with proximal atresia D - proximal and distal fistula E - H type, isolated fistula
31
What are the different diagnosis for short microcolon vs long microcolon?
Short microcolon - colonic atresia Long microcolon - meconium ileus (CF patients), ileal atresia
32
Classic imaging appearance for hirshsprungs disease?
Small calibre rectum when compared with sigmoid. Can have sawtooth appearance (spasm)
33
Difference between Gastroschisis and Omphalocele?
Omphalocele surrounded by membrane Gastroschisis is on the right of midline Omphalocele can contain other organs
34
Which isomerism is polysplenia associated with?
Left isomerism
35
Where do the upper and lower pole ureters insert with duplex kidney?
Upper pole inserts lower Lower pole inserts higher Upper pole obstructs (upstructs) Lower pole refluxes
36
What are the five grades for vesico ureteric reflux?
1- halfway up the ureter 2 - reflex into non-dilated collecting system 3 - reflex into dilated collecting system 4 - mildly tortuous ureter 5 - very tortuous ureter
37
What is Beckwith Wiedermann associated with?
WHO? Wilms Hepatoblastoma Omphalocele
38
Classic imaging appearance of multilocular cystic nephroma?
Fluid filled locules that protrude into the renal pelvis
39
How do you differentiate neuroblastoma Vs Wilms?
Neuroblastoma - Encases vessels, calcifies, mets to bone Wilms - displaces/invades vessels, rarely calcifies, mets to lung
40
Classic imaging appearance of Torsion of the testicular appendage?
Blue dot sign
41
What is the normal alpha angle used for?
DDH >60⁰
42
How do you define recurrent UTI?
3 or more episodes of lower UTI 1 episode lower UTI + 1 pyelonephritis 2 episodes of pyelonephritis
43
When should children have an USS scan for UTI?
- Younger than 6 months - Recurrent UTI - Atypical UTI
44
When should children have a DSMA scan for UTI?
Younger than 3 with recurrent or atypical UTI Older than 3 with recurrent UTI Perform the DSMA scan 4-6 months post UTI
45
When should a MCUG be performed for UTI?
Younger than 6 months with atypical or recurrent UTI Between 6 months and 3 years if hydronephrosis on USS, NON Ecoli infection, reduced urine flow
46
What is a skeletal survey comprised of?
AP chest and abdomen Ribs view (obliques) Lateral spine Upper and lower limbs
47
When is a CT head added to the skeletal survey?
All children under 1 year All children with neurology
48
What is McCune Albright syndrome?
Polyostotic fibrous dysplasia Cafe au lait spots Precocious puberty IPMN GI polyps
49
What paediatric tumours commonly metastasise to the lungs?
Ewing's sarcoma Osteosarcoma Rhabdomyosarcoma Wilms
50
What age group is intralobar Vs extralobar sequestration seen in?
Intralobar seen in older kids with recurrent infections Extralobar seen in younger kids with comorbidities
51
How to differentiate Multicystic dysplastic kidney from AR-PKD?
AR-PKD is bilateral Multicystic dysplastic kidney is unilateral, associated with VUR
52
What is a hepatic mesenchymal hamartoma and how do you differentiate it from hepatoblastoma?
Large benign septate cystic mass in the liver. Hepatoblastoma raises AFP.
53
Most common solid renal tumor of INFANCY?
Mesoblastic nephroma Wilms is more common in childhood
54
What is interrupted aortic arch syndrome?
Separation between the ascending and descending thoracic aorta. Requires for survival: - Large VSD - Patent ductus arteriosus. Different types depending on where the separation occurs. Most common is type B, between left common carotid and left subclavian
55
How does Kawasaki's disease present?
Medium vessel vasculitis. Strawberry tongue Erythema and lip cracking Bilateral conjunctivitis Cervical lymphadenopathy Rash
56
Most concerning morbidity with Kawasaki's disease?
Coronary artery aneurysm
57
Most common heart disease in Patau syndrome?
Hypoplastic left heart syndrome + VSD
58
What is scimitar syndrome?
Partial anomalous pulmonary venous return + Pulmonary hypoplasia
59
How to differentiate toxoplasmosis Vs cytomegalovirus in utero infection on cranial USS
Calcification Toxoplasmosis - randomly distributed Cytomegalovirus - periventricular distribution
60
How does osteogenesis imperfecta present clinically?
Blue sclera Hearing impairment Osteoporosis
61
How is SUFE assessed?
Ap and frog leg plain films
62
Radiographic features of SUFE
AP and frog leg views AP view - line of Klein does not intersect the epiphysis Frogs leg - epiphysis slipped posterior-medially
63
How does Klinefelter syndrome typically present?
Post pubertal bilateral small volume testes. Sub fertility Gynaecomastia Increased risk of: - Breast cancer - Choroid plexus cyst - Omphalocele - Germ cell tumour
64
X-ray sign of Croup
Wine bottle sign - Narrowing of the subglottic airway
65
Most specific injuries for NAI
Skull, spine, scapular, limbs - Non parietal skull fractures - Posterior rib fractures - Scapula fractures - Corner fractures of metaphysis
66
Most common congenital cardiac abnormality?
VSD
67
Most common type of tracheoesophageal fistula?
Type 3. Proximal atresia with distal fistula.
68
Imaging features of Gaucher's disease?
Massive splenomegaly Hepatomegaly Bone infarcts Pathological #s Erlenmeyer flask deformity
69
What side is Bochdalek hernia on?
Left BochdaLek - Left MoRgagni - Right
70
Annular pancreas associations?
Oesophageal / duodenal atresia Tracheoesophageal fistula Downs syndrome
71
Classic appearance of Klippel Feil syndrome?
Short neck, low hairline. Scoliosis Sprengle deformity Vertebral fusion
72
What is a torus fracture?
Buckle fracture I.e. from compressive forces
73
What is a greenstick fracture?
Cortical disruption on one side of the bone, from bending forces
74
Most common cause for failure to pass meconium?
Meconium plug syndrome
75
Most common association with right sided aortic arch?
Tetralogy of Fallot
76
What is bronchopulmonary dysplasia?
Chronic lung disease of the newborn Typically ventilator associated, causing hyperinflation and reticular opacities.
77
What is a toddler's fracture?
Spiral fracture of the tibia
78
What is Ebstein anomaly associated with?
Turner's Downs ASD
79
What is associated with CPAM?
Renal agenesis Pleuropulmonary blastoma Mucinous adenocarcinoma

FRCR 2a Flashcards (11 decks)

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