Paediatrics Flashcards
(405 cards)
1
Q
What is craniosynostosis?
A
Premature fusion of one or several cranial sutures
2
Q
What is the order of fusion of the following cranial sutures?
Coronal
Metopic
Sagittal
Lambdoid
A
- Metopic
- Coronal
- Lambdoid
- Sagittal
3
Q
The following describes which craniosynostosis?
Metopic suture
Eyes close together (Hypotelorism)
Medial part of orbit slants up
Ethmoid sinuses underdeveloped
A
Trigonocephaly
4
Q
The following describes which craniosynostosis?
Coronal suture
Frontal bossing - contralateral frontal bone protrusion if unilateral
A
Brachycephaly
5
Q
The following describes which craniosynostosis?
Bilateral Lambdoid suture
Tall cranium
A
Turricephaly if bilateral
6
Q
The following describes which craniosynostosis?
Sagittal suture
Long narrow head
Normal IQ, no hydrocephalus
Associated with Marfans
A
Scaphocephaly
7
Q
Which is the most common form of craniosynostosis?
A
Scaphocephaly (Sagittal suture)
8
Q
The following describes which craniosynostosis?
Unilateral lambdoid suture
Contralateral frontal bossing
A
Lamdoid craniosynostosis
9
Q
What is the imaging used to diagnose craniosnostosis?
A
CT + 3D recons
10
Q
The following are findings in which syndrome?
Absence/dysplasia of the greater sphenoid wing
Tibial pseudoarthrosis
Scoliosis
Lateral thoracic meningocele
A
NF1
11
Q
The following describes which craniosynostosis?
Enlargement of head with trilobed configuration
Premature synostosis of coronal and lambdoid sutures
May involve sagittal suture
A
Clover leaf skull syndrome
12
Q
The following are findings in which syndrome?
Brachycephaly
Fused fingers (Syndactyly)
A
Aperts syndrome
13
Q
The following are findings in which syndrome?
Brachycephaly
Maxilla & Mandible hypoplasia
Hydrocephalus
Chiari I
A
Crouzons syndrome
14
Q
What causes the following skull markings?
Gyral impressions on inner table of skull
Posterior skull
A
Convolutional markings
15
Q
What causes the following skull markings?
Gyral impressions on inner table of skull
Anterior & posterior skull
A
Conditions causing increased ICP
- Craniosynostosis
- Obstructive hydrocephalus
16
Q
What causes the following skull markings?
Oval, round, finger shaped craters within inner surface of skull
Prominent in parietal bones
A
Due to defective bone matrix
- Chiari II malformation/NTD
17
Q
The following skull findings are suggestive of which condition?
Beveled hole in the skull
Lytic lesion, no sclerotic border
Vertebrae plana
Floating tooth sign (Mandible)
A
Langerhans cell histiocystosis
18
Q
The following skull findings are suggestive of which condition?
Paired round defects in the parietal bones
Delayed or incomplete ossification in underlying parietal bones
A
Parietal foramina
19
Q
What causes >10 wormian bones?
A
Osteogenesis imperfecta
20
Q
What causes >10 wormian bones and an absent clavicle?
A
Cleidocranial dysostosis
21
Q
What are the differentials for numerous wormian bones?
A
PORK CHOP
Pyknodysostosis
Osteogenesis imperfecta
Rickets
Kinky hair syndrome
Cleidocranial dysostosis
Hypothyroidism/Hypophosphatasia
One too many 21st chromosomes (Downs)
Primary Acro-osteolysis
22
Q
What is being described here?
Patietal region most common
CT - CSF Density
MRI - T1 variable, T2 bright, No enhancement
A
Epidermoid
23
Q
What is being described here?
Midline
Associated with encephaloceles
Ct - Heterogenous, calcifications (Internal/peripheral)
MR - T1 bright, T2 bright, Wall enhancement
A
Dermoid
24
Q
What is the difference between a epidermoid and dermoid?
A
Epidermoid - Only skin
Dermoid - Skin + other stuff e.g. hair/sweat glands
25
What type of scalp trauma is being described here?
Between aponeurosis & periosteum
Not limited by suture lines
Due to vacuum extraction
Subgaleal haemorrhage
26
What type of scalp trauma is being described here?
Under the periosteum
Limited by suture lines
Outer border may calcify
Due to instrument or vacuum extraction
Cephalohaematoma
27
What type of scalp trauma is being described here?
Superficial to the aponeurosis
Not limited by suture lines
Due to prolonged delivery
Caput succedaneum
28
Which of the 3 types of scalp haematoma are life threatening?
Subgaleal haemorrhage
29
What is the following describing?
Fracture along/involving the suture
Diastatic fracture
Most common is the lambdoid
30
What is the following describing?
Fracture with inward displacement of the bone
Depressed fracture
31
What is the following describing?
Previous fracture
Leptomeninges herniate through torn dura at fracture site
Fracture site widened by CSF
Leptomeningeal cyst
32
What is the following describing?
Focal skull defect with associated vascular malformation
Low flow vascular malformation
Sinus Pericranii
33
The following are signs of what?
Subdural haematoma
Retinal haemorrhage
DAI/Parenchymal contusion
Depressed skull #/fracture crossing suture line
NAI
34
The following suggests what kind of retroclival haematoma?
Below the tectorial membrane
Above the tectorial membrane
Below the tectorial membrane - Epidural
Above the tectorial membrane - Subdural
35
What is the following describing?
Cortical veins adjacent to inner table
Enlargement of subarachnoid spaces
Benign enlargement of the subarachnoid space in infancy
36
What is the following describing?
Collection of CSF density in the subdural space
Cortical veins displaced away from inner table
Subdural hygroma
37
What is the most common cause of macrocephaly?
Benign enlargement of the subarachnoid space in infancy (BESSI)
38
What is the cause of periventricular leukomalacia?
Result of ischaemic/haemorrhagic injury, hypoxic insult during birthing
39
What is the following describing?
Periventricular white matter necrosis (Hyperechoic relative to choroid)
Cyst formation - subacute
Periventricular leukomalacia
40
Where is the germinal matrix found?
Only exists in premature infants
By 32 weeks it is only present in the caudothalamic groove
Shouldnt be present by 36 weeks
41
Can you get a germinal matrix haemorrhage in a full term infant?
No
This would be a choroid plexus haemorrhage
42
How does choroid plexus appear on US?
Bright (Hyperechoic)
43
How can you tell choroid plexus apart from GMH?
Choroid should not extend anterior to the junction of the caudate and the thalamus (Caudothalamic groove) - Location of germinal matrix
Hyperechoic at this point is a GMH
44
What are the secondary consequences of GMH:
G1
G2/3
G4
G1 - Subependymal cyst
G2/3 - Hydrocephalus
G4 - Poroncephalic cyst
45
What is the following describing?
Medial nasal processes fused or too big in either total obstruction or stenosis of the nose
CT - Maxillary spine soft tissue extension across nostrils
Pyriform aperture stenosis
46
What is pyriform aperture stenosis associated with?
Holoprosencephaly
Pituitary dysfunction
Central mega incisor
47
What is the following describing?
Bony***/Membranous
Unilateral/bilateral posterior nasal narrowing with thickening of the vomer
Choanal atresia
48
What are the components of CHARGE syndrome?
Coloboma
Heart defect
Atresia (Choanal)
Retarded growth
GU abnormalities
Ear anomalies
49
What is the following describing?
Non enhancing
Gyriform brain like tissue
Located in the nose
Nasal glioma
50
What is the following describing?
Dural diverticulum extending through foramen caecum with tract.
Intracranial contents herniate into the tract
Encephaloceles
51
How would a nasal catheter to be displaced in an encephaloce?
Nasal catheter displaced laterally
52
What is the following describing?
Result of an obstructed nasolacrimal duct
Congenital obstruction of the nasolacrimal duct
Enhancing cystic lesion
Dacrocystocele
53
What is the following describing?
Small jaw
Small absent zygomatic arch
Mandible hypoplasia
Concave curve of horizontal ramus
Treacher Collins syndrome (Mandible-facial dysostosis)
54
Which imaging is used to identify ectopic thyroid tissue?
I-123 or Tc MIBI
55
Where is the most common location of ectopic thyroid tissue?
Lingual thyroid (Back of tongue)
56
What are the classic locations of a thyroglossal cyst?
Base of the tongue
Midline anterior to the hyoid
57
What is the following describing?
Midline cyst in the neck of a child
Thyroglossal duct cyst
58
If there is an enhancing nodule within a midline cyst in the neck of a child?
Cancer - Papillary
59
What is the following describing?
Midline cyst in neck of a child
Rim enhancement
Fatty stranding
Infected thyroglossal cyst
60
What is the following describing?
Midline sublingual/submandibular space
Sac of marbles appearance - Lobules of fat within fluid
Dermoid cyst
61
What is the following describing?
Most common branchial cleft cyst
Angle of mandible location
Extension of cyst between ICA/ECA above carotid bifurcation
2nd BCC
62
What is the following:
Lateral cyst in the neck
Midline cyst in the neck
Lateral = BCC
Midline = Thyroglossal duct cyst
63
What is the following describing?
Recent pharyngeal infection
Fusobacterium necroporum
Septic thrombophlebitis - Jugular vein thrombus with infection
64
What is the following describing?
Dilated jugular vein
No stenosis
No other signs of venous congestion
Phlebectasia
65
What is the following describing?
Skin lesion
Super T2 bright
Flow voids
Diffusely vascular on doppler
Age approx 6 months
Haemangioma of infancy
Treatment with Beta blockers
66
What is the following describing?
Cystic mass hanging off back of neck on Obstetric US
T2 bright
Does not enhance
Cystic hygroma
67
What is the following describing?
Torticollis - chin points towards the opposite side of the lesion
Enlarged SCM
Fibromatosis Coli
68
What is the following describing?
6 months to 3 yr old
Cough
Steeple sign - Loss of normal lateral convexities of subglottic trachea
Viral - Parainfluenza
Croup
69
What is the following describing?
>3 yrs
Thumb sign - Marked swelling of the epiglottis
H-Influenza
Epiglottitis
70
What is the following describing?
Linear soft tissue filling defect within the airway
Irregular tracheal walls
Staph A
6-10 yrs
Exudative tracheitis
71
What is the following describing?
6-12 months
Massive retropharyngeal soft tissue thickening on lateral XR
Retropharyngeal cellulitis and abscess
72
What is PHACES?
Posterior fossa (Dandy walker)
Haemangiomas
Arterial anomalies
Coarctation of aorta, cardiac defects
Eye abnormalities
Subglottic haemangioma/Sternal cleft/Supraumbilical raphe
73
What is the following describing?
Contrast in trachea without laryngeal penetration
Communicating defect in the posterior wall of the larynx and oesophagus/anterior hypopharynx
Laryngeal cleft
74
What is the following describing?
Lobulated grape within the airway
Solid gcavitated lung nodules
Laryngeal Papilloma
75
How do you determine if the lungs are hyper inflated in a child?
6 Anterior ribs
8 Posterior ribs
76
What is the following describing?
High lung volumes
Perihilar streak opacification
Meconium
Aspiration
Non GB Neonatal
77
What is the following describing?
Low or normal lung volumes
Granular opacities
Surfactant sufficiency disease
Group B pneumonia
78
What is the following describing?
Term or post term baby
Ropy appearance asymmetric lung disease
Hyperinflation with alternative areas of atelectasis - Air trapping
Pneumothorax
Meconium aspiration
79
What is the following describing?
Hx of c-section
Diabetic mother/maternal sedation
Onset at 6 hrs
Coarse interstitial marking and fluid in fissures
Normal to increased interstitial markings
Transient tachypnoea of the newborn
80
What is the following describing?
Premature baby
Low lung volumes
Bilateral granular opacities
No pleural effusions
Surfactant deficiency disease
81
What does a normal CXR 6 hours post delivery mean for a patient with suspected SDD?
Normal CXR in 6 hrs rules out SDD
82
What is the following describing?
Previous SDD
Bleb like lunency
Surfactant replacement therapy in SDD
83
What is the following describing?
Premature or term infants
Low lung volumes
Granular opacities
Pleural effusions
Neonatal pneumonia - Beta haemolytic strep/GBS
84
What differentiates GBS pneumonia from SDD?
Pleural effusions and SDD is only in premature infants
Both have granular opacities
85
What is the following describing?
Asymmetric perihilar densities
Pleural effusions
Hyperinflation
neonatal pneumonia (Non GBS)
86
What is the following describing?
Linear lucencies
Pulmonary interstitial emphysema
87
What causes PIE?
Surfactant deficiency and put on ventilator leads to air escaping the alveoli and into the interstitium and lymphatics
Treatment is to put bad side down
88
What is the following describing?
Premature baby + Ventilator
Alternating regions of fibrosis (Coarse reticular opacities)
Hyper-aeration (Cystic licences)
Band like opacities
Chronic lung disease/Bronchopulmonary dysplasia
89
What's the difference between PIE v CLD?
PIE - 1st week of life
CLD - 3-4 weeks post natal age
90
The following present as what on CXR in neonates?
Meconium aspiration
Transient tachypnoea of newborn
Non GBS Neonatal pneumonia
High lung volumes
91
What do the following cause in children on CXR?
Surfactant deficiency
GBS Pneumonia
Low lung volumes
92
What is the following describing?
Reduced thoracic circumference
Fetal lung:head ratio <1
Hypoplastic lungs
Pulmonary hypoplasia
93
What is potters sequence?
No kidneys - No pee - No amniotic fluid - Hypoplastic lungs
Cause of of pulmonary hypoplasia
94
What is the following describing?
Bowel within the chest
Pulmonary hypoplasia
NG tube curving into the chest
Congenital diaphragmatic hernia
95
Which is the most common congenital diaphragmatic hernia?
Bochdalek - B is back (Posterior and left)
96
What is the difference between:
Bochdalek
Mogrnani hernia
Bochdalek - Posterior and left
Morgagni - Anterior and right
97
What is the following describing?
Solitary
Unilocular
Cyst
No communication with the airway
Bronchogenic cyst
98
What is the following describing?
No communication with the airway
No communication with the pulmonary arteries
Aortic feeder vessel
Bronchopulmonary sequestration
99
What is the following describing?
Most common in LLL or RLLL
No pleural cover
Pulmonary venous drainage
Aortic feeder vessel
Intralobar bronchopulmonary sequestration
100
What is the following describing?
Majority in the LLL, may be subdiaphragmatic
Has its own pleural cover
Systemic venous drainage
Aortic feeder vessel
Extralobar bronchopulmonary sequestration
101
Which is most common Extra lobar or intra lobar BPS?
At what age do they present?
Intralobar BPS is more common
Intralobar presents in adolescence
Extralobar presents in infancy
102
What is the following describing?
Lucent
Hyper-expanded lobe +/- mass effect and mediastinal shift
Air trapping secondary to bronchial anomaly
Favours left upper lobe
Congenital lobar emphysema
103
What is the treatment for congenital lobar emphysema?
Lobectomy
104
What is the following describing?
Communicate with the airway
CCAM (Congenital Cystic adenomatoid malformation)
105
Why are CCAMs removed?
Risk of malignant transformation - pleuropulmonary blastoma or rhabdomyosarcoma
106
If you see an abnormality in a paediatric patient in the left upper lobe, what is this likely to be?
Congenital lobar emphysema
CCAM
107
If you see an abnormality in a paediatric patient in the left lower lobe what is this likely to be?
Pulmonary sequestration
Congenital diaphragmatic hernia
CCAM
108
Which type of CCAM is associated with congenital anomalies (CDH, Vertebral anomalies, Congenital heart disease)
Extralobar pulmonary sequestration
109
What is the following describing?
Absent in the 2nd trimester US
Right sided normally
Pleural based
No chest wall invasion or calcification
Pleuropulmonary blastoma
110
What renal abnormality is a pleuropulmonary blastoma linked to?
Multilocular cystic nephroma
111
What is the following describing?
Solid mass
Lobulated and calcified
Lower lobe predominant
T2 bright (Myxoid)
Inflammatory myofibroblastic tumour (Benign)
112
What line is this describing?
Umbilical vein to left portal vein to ductus venous to hepatic vein to IVC
What is the correct location for the tip?
Umbilical venous catheter
IVC - Right atrium junction
113
What line is being described here?
Umbilicus down to umbilical artery to iliac artery to aorta
What is the correct location for the tip?
Umbilical artery catheter
T8-10 or L3-5
114
What is a contraindication to a UAC?
Omphalocele
115
What is the following describing?
Deoxygenated blood removed from RA into artificial lung and infused with oxygen.
Blood goes back to the aorta
Position: RA + Aorta
Veno-arterial ECMO
116
What is the following describing?
Deoxygenated blood removed from RA into artificial lung and infused with oxygen.
Blood back into the RA
Position - RA + RA
Veno-Venous ECMO
117
What is the expected CXR appearance post ECMO?
White out
Airway pressure drops causing atelectasis, so oedema like pattern results
118
What is the following describing?
Peribronchial oedema - busy hilum
Hyperinflation
Subsegmental atelectasis
Viral infection
119
What is the following describing?
Round consolidation
Favours posterior lower lobes
Child <8 yrs old
Round pneumonia
120
What is the following describing?
Round pleural based mass in apex of lung
Resolve with treatment
Neonatal atypical peripheral atelectasis
121
What is the following describing?
Airspace opacities
CT - Low attenuation (-30 HU) within consolidation
Lipoid pneumonia
122
What is the following describing?
Air trapping - lung looks more lucent on affected side
Put affected side down - will remain lucent
Bronchial foreign body
123
What is the following describing?
Unilateral lucent lung - size is smaller than normal lobe
Post viral lung infection
Swyer James
124
What is the following describing?
Child with cardiomegaly, bone infarcts (Humeral heads)
H shaped vertebrae
Multiple pulmonary opacities
Acute sickle cell chest
125
What is the following describing?
Apical predominance
Hyperinflation
Mucus plugging (Finger in glove sign)
Bronchiectasis
Cystic fibrosis
126
What is the following describing?
Lower lobe predominant bronchiectasis
Men are infertile
Primary ciliary dyskinesia
127
What is the following describing?
Triangular shape - sail sign
Normal thymus
128
What is the following describing?
Anterior mediastinal mass
Mostly cystic
Fat and calcium
Teratoma
129
What is the following describing?
Anterior mediastinal mass
Bulky, solid, lobulated
Straddles the midline
Seminoma
130
What is the following describing?
Anterior mediastinal mass
Big and ugly
Haemorrhage and necrosis
Potential to invade the lung
NS GCT
131
What is the following describing?
Middle mediastinal mass
Water attenuation
Close to trachea or bronchus
Filled with mucus or fluid
Bronchogenic cyst
132
What is the following describing?
Middle mediastinum
Water attenuation
Close to oesophagus
May have air/fluid levels if communication with oesophageal lumen
Enteric/Oesophageal duplication cyst
133
What is the following describing?
Most common posterior mediastinal mass
Child <2yrs
Rib splaying and erosions
Calcifications
Encasement of adjacent vascular structures
Neuroblastoma
134
What is the following describing?
Less aggressive
More circumscribed
Less likely to have calcifications
Found in older children 10-20s
Ganglioneuroma
135
What is the following describing?
Solid mass in chest wall
Displace adjacent structures rather than invade early
Heterogenous
Solid parts enhance
Askin tumour - Primative neuroectodermal tumour
136
What is the following describing?
Vertebral anomalies
Cyst protruding out of unsealed canal/defect
Cyst does not communicate with CSF
Well demarcated
water density
Favours lower cervical/thoracic regions
Neuroenteric cyst
137
What is the following describing?
Hepatosplenomegaly
Soft tissue density around the spine
Below T6
Bilateral, smooth, and sharply delineated
Extramedullary haematopoeisis
138
What is the following describing?
Soft tissue mass in anterior mediastinum
Homogenous
Lymphoma/Hyperplasia
139
What is the following describing?
NG tube stopped in the upper neck
Gas in the stomach
N type fistula
Oesophageal atresia + Distal oesophageal fistula with trachea
(Most common)
140
What is the following describing?
CXR with NG tube stopped in upper neck
No gastric bubble
Oesophageal atresia
No tracheo-oesophageal fistula
141
What is the following describing?
CXR with NG tube stopped in upper neck
Gastric bubble
H Type atresia, so No oesophageal atresia only tracheo-oesophageal fistula
142
What are the components of VACTERL?
Vertebral anomalies
Anal (Imperforate anus)
Cardiac anomalies
TracheoEosophageal fistula or Eosophageal atresia
Renal anomalies
Limb abnormality (Radial ray)
143
What component would alter the surgical approach in TOF?
Right sided aortic arch
144
When is VACTERL diagnosed?
What are the most common abnormalities?
>3 anomalies, if less keep investigating
Heart & Kidneys most commonly affected
145
What is the following describing?
Posterior trachea impression
Anterior oesophageal impression
Associated with tracheal stenosis
Pulmonary sling
146
What is the following describing?
Anterior trachea impression
Posterior oesophageal impression
Double aortic arch
147
What is the following describing?
Higher anterior tracheal impression
Innominate artery compression
148
What is the following describing?
Posterior oesophageal impression
Right arch with aberrant left or left arch with aberrant right subclavian artery
149
Which vascular sling is associated with these anomalies?
Hypoplastic right lung
Horshoe lung
TE fistula
Imperforate anus
Complete tracheal rings
Pulmonary sling
150
What is the following describing?
Pouch like aneurysmal dilatation of the proximal portion of an aberrant right subclavian artery?
Diverticulum of Kommerell
151
The following cause which type of neonatal bowel obstruction?
Midgut volvulus/malrotation
Duodenal atresia
Duodenal web
Annular pancreas
Jejunal atresia
Neonatal High bowel obstruction - Upper fluoro study
152
The following are examples of what type of neonatal bowel obstruction?
Hirschsprung disease
Meconium plug syndrome
Ileal atresia
Meconium ileus
Anal atresia/Colonic atresia
Low neonatal bowel obstruction
153
What is the following describing?
Single bubble on AXR
Gastric atresia
154
What is the following describing?
Double bubble on AXR
Duodenal atresia***
155
What is the following describing?
Triple buble on AXR
Jejunal atresia (Secondary to vascular insult during development)
156
What is the following describing?
Single bubble with distal gas
Can be normal
Midgut volvulus
Proceed to UGI study
157
What is the following describing?
Double bubble with distal gas
Duodenal web
Duodenal stenosis
Midgut volvulus
158
What is the following describing?
Multiple diffusely dilated loops
Low obstruction
Contrast enema (LGI study)
159
What is the following describing?
Duodenum to right of midline
SMA to right of SMV on US/CT
Small bowel all on one side
Malrotation
160
What is the following describing?
Corkscrew duodenum
Midgut volvulus
Surgical emergency
161
What is the following describing?
Non-bilious vomiting
3-6 weeks of age
Thickened pylorus wall - 4 mm single wall
14 mm length
Hypertrophic pyloric stenosis
162
What are the key measurements for hypertrophic pyloric stenosis?
4 mm single wall
14 mm length of canal
163
What is the following describing?
Greater curvature of stomach flips over lesser curvature
Organoaxial gastric volvulus
164
What is the following describing?
Mesentary twists along short axis
Antrum flips near GEJ
Most common in kids
Mesenteroaxial gastric volvulus
165
Which abnormality is this associated with?
Windosock deformity (Web like diaphragm is stretched)
Duodenal web
166
What is the following describing?
Pancreatic tissue encircling the descending duodenum
Narrowing of the duodenum
Annular pancreas
167
What is the following describing?
Short microcolon
Colonic atresia
168
What is the following describing?
Long microcolon
Contrast reaches ideal loops
Filling defects in colon
Meconium ileus
169
What is the following describing?
Long microcolon
Contrast will not reach ileal loops
Distal ileal atresia
170
What is the following describing?
Small left colon
Transient caliber change - relieved by contrast enema
Infants of diabetic mothers who received Mg
Meconium plug syndrome
171
What is the following describing?
More common in boys
Rectum small than sigmoid <1
Rectum has sawtooth pattern
BNO >72 hrs
Forceful passage of meconium post rectal exam
Hirschsprung disease
172
What is total colonic aganglionosis?
Variant of Hirschsprungs involving all the colon including the terminal ileum
173
What is the following describing?
Calcified mass in the mid abdomen on plain film
Meconium peritonitis
Peritoneal reaction to in utero bowel perforation which seals off before birth so no leak
174
What further investigation is needed in a child with imperforate anus?
Screening US for tethered cord
175
What is the following describing?
Abdominal pain
On US - blind ending tube, non-compressible, >6 mm
Appendicitis
176
Which type of inguinal hernia is more common in children?
Indirect inguinal hernia
Lateral to inferior epigastric
177
What is the following describing?
Psuedo kidney sign
Target sign - >2.5cm
Intussueption
178
What are the contraindications to pneumatic intusseption reduction?
Pneumoperitoneum
Peritonitis
179
What is the following describing?
Paraumbilical wall defect
No surrounding membrane
Right sided
Elevated maternal AFP
Normal umbilicus
Gastroschisis
180
What is the following describing?
Congenital midline defect at base of umbilical cord
Surronding peritoneum present
Associated with other anomalies
Omphalocele
181
What is the pentalogy of cantrell?
Omphalocele
Ectopia cordis (Abnormal location of the heart)
Diaphragmatic defect
Pericardial defect/Sternal cleft
Cardiovascular malformations
182
What is the following describing?
Abdominal cyst with gut signature (Alternating bands of hyper/hypo echoic signal - different layers of bowel)
Enteric duplication cyst
183
What is the following describing?
Cyst without gut signature
Omental cyst
184
What is the following describing?
>20 yr old cystic fibrosis
Distal bowel obstruction
Ileum/Right colon
Distal intestinal obstruction syndrome (Obstruction secondary to dried up thick stool)
185
What is the following describing?
Cluster of large right lower quadrant lymph nodes
Mesenteric adenitis
186
What is the following describing?
Premature children
Cardiac patient - can be full term
Pneumatosis
Focal dilated bowel - usually terminal ileum/right colon
Featureless small bowel, separation (Oedema)
Necrotising enterocolitis
187
How do you differentiate between pneumatosis and faeces?
If not feeding - no faeces should be seen
Faeces will move, pneumatosis will not
188
What is the following describing?
Pancreatic fibrosis (Low T1 & T2 signal)
Fatty replacement (High T1 signal)
Cystic fibrosis
189
What is the following describing?
Diarrhoea
Short stature
Eczema
Schwachman diamond syndrome
2nd most common cause of pancreatic insufficiency in children
190
What is the following describing?
Absent dorsal bud - tail
Polysplenia
Dorsal pancreatic agenesis
191
What is the following describing?
Paediatric pancreatic mass age 1
Age 6
1 = Pancreatoblastoma
6 = Adenocarcinoma
192
The following liver masses are common in which age group of children?
Infantile hepatic haemangioma
Hepatoblastoma
Mesenchymal hamartoma
Age 0-3
193
What is the following describing?
Age <1 yr
Large heart on CXR
Irregular hypodense mass in the liver
Aorta above hepatic branches enlarged
May have skin lesions associated
Infantile hepatic haemangioma
Large heart = CHF
194
How do infantile hepatic hemangiomas typically resolve?
Tend to spontaneously involute without therapy, progressively calcify
195
What is the following describing?
Associated with Wilms/Beckwith wiedeman
Well circumscribed, solitary
Right sided mass
May extend into portal veins, hepatic veins and IVC
Calcifications 50% of time
Elevated AFP
Hepatoblastoma
196
What are the 3 classic things hepatoblastoma is linked to?
Wilms
AFP
Precocious puberty due to making bHCG
197
What is the following describing?
Cystic mass/multiple cysts
AFP negative
No calcifications
Large portal vein feeding the mass
Mesenchymal hamartoma
198
What age group do the following liver masses typically appear?
HCC
Fibrolamellar subtype
Undifferentiated embryonal sarcoma
Age >5
199
What is the following describing?
Cirrhosis (biliary atresia, fanconi syndrome etc)
AFP elevated
HCC
200
What is the following describing?
No cirrhosis
Normal AFP
Central scar, non enhancing, T2 dark
Tumour is gallium avid
Calcifies
Fibrolamellar HCC
201
What is the following describing?
Cystic
Aggressive mass
Hypodense with septations
Fibrous pseudocapsule
Undifferentiated embryonal sarcoma
202
What primary cancers met to the liver in children?
Wilms or Neuroblastoma
203
What is the following describing?
Smoothly enlarged diffusely echogenic kidneys
Cysts in the kidneys - tubular/spare cortex
Loss of corticomedullary differentiation
Liver fibrosis - inversely proportional to cystic changes)
AR PKD
204
What is the following describing?
Multiple AVMs in the liver and lungs
Cirrhosis
Dilated hepatic artery
Hereditary haemorrhagic telangiectasia
205
What is the following describing?
Newborn jaundice >2 weeks
Normal gallbladder
Neonatal hepatitis
206
What is the following describing?
Newborn jaundice >2 weeks
Absent gallbladder
Associated with polysplenia, trisomy 18
Congenital liver fibrosis
Band of bright tissue near branching CBD
No scintigraphy (HIDA) tracer in bowel by 24 hrs
Biliary atresia
207
What is the following describing: Hereditary cholestasis due to paucity of intrahepatic bile ducts, and peripheral pulmonary stenosis
Alagille syndrome
208
What is the following describing?
Abdominal pain
Splenomegaly
Sickle cell
Splenic sequestration
209
What is the following describing?
Multiple infarcts leading to progressive atrophy
Small calcified spleen
Auto infarcted spleen in patient with sickle cell
210
What is the following describing?
2 x fissures in left lung
Asplenia
Increased cardiac malformations
Reversed aorta/IVC
Right sided heterotaxia
211
What is the following describing?
1 x fissure on right side
Polysplenia
Less cardiac malformations
Azygous continuation of IVC
Left sided heterotaxia
212
What is the following describing?
Gastric bubble on left
Larger part of liver on right
Minor fissure on right
Situs solitus (Normal)
213
What is the following describing?
Gastric bubble on right
Larger part of liver on left
Minor fissure on left
Inverted bronchial pattern
Associated with primary ciliary dyskinesia
Situs inversus
214
What is the following describing?
Absent minor fissures
Interrupted IVC
Polysplenia
Biliary atresia
Visceral heterotaxy with thoracic left isomerism
215
What is the following describing?
Prenatal US - absent renal artery
Oligohydramnios
Unilateral renal agenesis
216
What are the associations with unilateral renal agenesis?
Associated with genital anomalies - Unicornuate uterus or rudimental horn
217
What is the following describing?
One kidney comes across the midline to fuse with the other
Each kidney has its own ureteral drainage
Most common in males
Crossed fused renal ectopia
218
What causes congenital PUJ obstruction?
Due to intrinsic defects in the circular muscle bundle of the renal pelvis - treated with pyeloplasty
219
What is the following describing?
Dilatation of the PUJ
No hydroureter
Congenital PUJ obstruction
220
What is the following describing?
Associated with Maternal diabetes, sepsis, dehydration
Unilateral (Left normally)
Peripheral then progresses to hilum
Renal enlargement (Acute)
Renal atrophy (Chronic)
Neonatal renal vein thrombosis
221
What is the following describing?
Severe HTN
Normal size kidney
Neonatal renal artery thrombosis
222
What is the following describing?
Male
Wide belly
Deficiency of abdominal musculature
Hydroureteronephrosis
Cryptochordism
Prune belly/Eagle Barrett syndrome
223
What is the following describing?
Absence of dilatation of the collecting system
No distal obstruction causing dilatation
Congenital primary megaureter
Due to adynamic segment, reflux at UVJ or idiopathic
224
What is the following describing?
IVC pins the ureter
Asymptomatic
Partial obstruction and recurrent UTI
Reverse J shape of ureter
Retrocaval ureter
225
What is the following describing?
Upper pole inserts into IM (Inferior/Medial)
Lower pole inserts SL (Superior/Lateral)
Duplicated system
226
What happens to the upper and lower pole in a duplicated system?
Upper pole - obstructs
Lower pole - refluxes
227
What is the weigert-meyer rule?
Upper pole inserts into IM (Inferior/Medial)
Lower pole inserts SL (Superior/Lateral)
228
What is the following describing?
Cystic dilatation of the intravesicular ureter
Obstruction at ureteral orifice
Cobra head sign - contrast surrounded by lucent rim, protruding from contrast filled bladder
Ureterocele
229
What is the following describing?
Ureter inserts distal to external sphincter in vestibule
Female predominant
Associated with incontinence
Ectopic ureter
230
What are posterior uretheral valves?
Fold in the posterior urethra leading to outlaw obstruction and renal failure
Most common cause of urethral obstruction in male infants
231
What is the following describing?
VCUG - Abrupt caliber change between dilated posterior urethra and normal caliber anterior urethra
Posterior urethral valves
232
What is the following describing?
MRI - Key hole bladder appearance
Hydroureter in kidney
Posterior urethral valves
233
What do the following pre-natal US findings show:
Hydronephrosis
Bladder dilatation
Oligohydramnios
Posterior urethral valves
234
How is hydronephrosis on routine prenatal screening investigated?
If still present once born
VCUG - Anatomy
MAG3 - function & drainage
MR Urography - Function + Structure
235
The following cause what type of hydronephrosis in baby boys?
Vesico-ureteral reflux (VUR)
Primary megaureter
Prune belly
Non-obstructive causes
236
The following cause what type of hydronephrosis in baby boys?
PUV
UPJ Obstruction
Ureteral ectopia
Obstructive causes
237
What is the following describing?
Normal ureters enter bladder at oblique angle so valve is developed.
If angle of insertion is abnormal (Horizontal) reflux develops.
Vesicoureteric reflux
238
What angle of insertion is abnormal for the ureters?
Horizontal
239
What are the grades for VUR?
Dilatation of the collecting system, calyces blunted
Reflux halfway up the ureter
Reflux into non-dilated collecting system
System very tortuous
System mildly tortuous
G1 = Reflux halfway up the ureter
G2 = Reflux into non-dilated collecting system
G3 = Dilatation of the collecting system, calyces blunted
G4 = System mildly tortuous
G5 = System very tortuous
240
What are the complications of chronic reflux?
Scarring which can lead to HTN and/or chronic renal failure
241
What is the following describing?
Adjacent above the UVJ
Dynamic and seen on voiding phase
Associated with VUR
Hutch diverticula (Congenital muscular defect)
242
What is the most common cancer in urachal abnormalities or bladder exstrophy?
Adenocarcinoma
243
What is the following describing?
Midline bladder structure
Patent sinus tract
Patent Urachus
244
What is the following describing?
Midline bladder structure
Extension of bladder apex with sinus tract
Vesicourachal diverticulum
245
What is the following describing?
Midline bladder structure
Cystic structure within the sinus tract leading to umbilicus
Urachal cyst
246
What is the following describing?
Midline bladder structure
Dilated sinus at the umbilicus
Umbilical urachal sinus
247
What is the following describing?
Herniation of the urinary bladder through a hole in the anterior infra-umbilical abdominal wall
Manta ray sign - unfused pubic bones, wide pubic symphysis on AP pelvis
Bladder exstrophy
248
What is the following describing?
GU + GI both drain into a common opening
Females
Cloacal malformation
249
The following renal abnormalities are seen in which age group?
Nephroblastomatosis
Mesoblastic nephroma
Neonates
250
The following renal abnormalities are seen in which age group?
Wilms tumour
Wilms variants
Lymphoma
Multilocular cystic nephroma
<4 years
251
The following renal abnormalities are seen in which age group?
RCC
Lymphoma
Teenagers
252
What is the following describing?
Solid renal mass
Mesoblastic nephroma (Solid tumour of infancy)
253
What is the following describing?
Persistent nephrogenic rests >36 weeks
No necrosis
homogenous appearance, hypodense rind
Nephroblastomatosis
254
How is nephroblastomatosis monitored?
Why?
US every 3 months
Due to risk of transforming to Wilms
255
What is the following describing?
Benign
Involves the renal sinus
Polyhydramnios on antenatal US
Appears as wilms
Mesoblastic nephroma
256
What is the following describing?
Age 0-3yrs
Macroscopic cysts that do not communicate
No functioning renal tissue
Contralateral renal tract anomalies - PUJ obstruction
Multicystic dysplastic kidney
257
What is the difference between MCDK and Hydronephrosis?
Hydronephrosis = Cystic spaces are seen to communicate
MCDK = Cystic spaces do not communicate
258
What does renal scintigraphy show in MCDK v Hydronephrosis?
MCDK = No excretory function
Hydronephrosis = Excretory function
259
Are the following cystic or sold masses?
Nephroblastomatosis
Mesoblastic nephroma
Wilms
Solid
260
Are the following solid or cystic renal masses?
MCDK
Multilocular cystic nephroma
Cystic
261
What is the following describing?
Age 4yrs
Solid renal mass
Spreads via direct invasion
Wilms tumour
262
The following are associated with which syndrome?
Wilms tumour
Omphalocele
Hepatoblastoma
Beckwith Wiedemann
263
The following are associated with which syndrome?
Wilms
Aniridia
Genital
Growth retardation
WAGR
264
Are the following true or false?
Wilms tumours should be biopsied
Wilms occurs in children <2 months old
Both are false
265
What are the renal tumours that look like wilms?
Clear cell RCC
Rhabdoid renal cancer
266
What is the following describing?
Non-communicating
fluid filled locules surrounded by thick fibrous capsule
No solid component or necrosis
Protrudes into the renal pelvis
Bimodal occurrence 4yrs old boys 40 yr old women
Multilocular cystic nephroma
267
What is the most common type of rcc in children?
Translocation carcinoma RCC
268
What is the following describing?
Solid enhancing + Expansile renal growth
Hx of prior cytotoxic chemotherapy
Denser cortex on non-contrast CT
Translocation carcinoma RCC
269
What is the following describing?
Multiple bilateral round expansile renal masses
Lymphoma
270
What is the following describing?
- Age 2-4yrs and 15-17yrs
- Botryoid appearance - multiple round grouped masses (Bunch of grapes)
- Big nodular ugly inducing mass in the bladder
- History of urinary obstruction
Rhabdomyosarcoma
271
What is the most common malignant tumour of the bladder in children?
Rhabdomyosarcoma
272
What is the most common location of rhabdomyosarcoma?
Head/Neck specifically orbit and nasopharynx
273
What is the following describing?
Extra-testicular mass
Mass in scrotum not in testicle
Paratesticular Rhabdomyosarcoma
274
What is the following describing?
Age <2 yrs
Calcification common
Encases vessels (Doesn't invade)
Poorly marginated
Mets to bones
US - Echogenic + Hypervascular
MR - high T2
Neuroblastoma
275
What is opsomyocolonus?
Paraneoplastic syndrome associated with neuroblastoma
276
How are neuroblastoma mets identified?
MIBG
Bone mets - lucent metaphyseal band
277
What is the following describing?
Age 4yrs
Rarely calcifies
Invades vessels
Well circumscribed
Lung metastases
Wilms tumour
278
What is the following describing?
US - Adrenal gland, anechoic + Avascular
MR - Low T2
Adrenal haemorrhage
279
What is the significance of adrenal haemorrhage
on the right
On the left?
Right = Most common
Left = Renal vein thrombus
280
What is the following describing?
Expanded fluid filled vaginal cavity with associated distension of the uterus
Midline pelvic mass
Hydrometrocolpos
281
What is the most common cause of hydrometrocolpos?
Imperforate hymen
282
The following are causes of what condition?
Imperforate hymen
Vaginal stenosis
Lower vaginal atresia
Cervical stenosis
Hydrometrocolpos
283
What is hydrometrocolpos associated with?
Hydronephrosis (Mass effect from distended uterus)
Uterus Didelphys
284
What is the following describing?
Enlarged ovary
Peripheral follicles
+/- arterial flow
Fluid-debris levels - within displaced follicles
Ovarian torsion
285
What is the most common mass causing ovarian torsion?
Mature cystic teratoma
Large follicular cyst
286
What is the significance of a right sided varicocele?
Abdomen CT
Exclude extrinsic mass, renal vein thrombus, portal HTN causing splenorenal shunt
287
288
What is the following describing?
Age 7-14
Sudden onset pain
Blue dot sign on exam
Enlarged testicular appendage >5 mm
Torsion of testicular appendages
289
What is the following describing?
Absent or asymmetrically decreased flow on doppler US
Asymmetric enlargement of tests
Decreased echogenicity of the involved testicle
Torsion of the testicle
290
What is the following describing?
Heterogenous vascular
Extra-testicular mass
Age 5yrs
Embryonal rhabdomyosarcoma
291
What is the following describing?
Multiple small echogenic foci within the testes
Testicular microlithiasis
292
What are the most common germ cell tumours in under <10s?
Yolk sac tumour
Teratoma
293
What is the following describing?
Normal homogenous echogenic tissue is replaced focally or diffusely with hypoechoic vascular lymphomatous tissue
Testicular lymphoma
294
What are the causes of the following testicular calcifications?
Tiny/Micro = Seminoma
Big = Germ cell tumour
295
What is the following describing?
Solid and/or cystic mass
Large
Mass effect on GI system, hip dislocation, nerve compression leading to incontinence
External to pelvis
Saccrococygeal teratoma
296
What is a physeal bar?
Bony bridge crossing the growth plate
Usually due to previous trauma/infection
297
What does the following describe?
Complete physeal fracture, with or without displacement
Salter Harris I
298
What does the following describe?
Fracture involves the metaphysis, above
Salter Harris II
299
What does the following describe?
Fracture involves the epiphysis, below
Salter Harris III
300
What does the following describe?
Fracture involves the metaphysis and epiphysis, above & below
Salter Harris IV
301
What does the following describe?
Compression of the growth plate
Bony bridge across physis
Salter Harris V
302
What does the following describe?
Oblique fracture of the mid shaft of the tibia in child starting to walk
9 months - 3 yrs
Toddlers fracture
303
What are the most common fractures of the paediatric elbow?
Supracondylar fracture
Lateral condyle
Medial epicondyle
304
What are the elbow ossification centres? What age do these form?
Capitellum - 1
Radius - 3
Internal epidondyle 5
Trochlea 7
Olecranon 9
External epicondyle 11
305
What are the muscle attachments for these areas:
Iliac crest
ASIS
AIIS
Greater trochanter
Lesser trochanter
Ischial tuberosity
Symphysis
Iliac crest - Abdominal muscles
ASIS - Sartorius/Tensor fascia lata
AIIS - Rectus femoris
Greater trochanter - Gluteal muscles
Lesser trochanter - Iliopsoas
Ischial tuberosity - Hamstrings
Symphysis - Adductor group
306
What does the following describe?
Fragment of bone at inferior patella with associated soft tissue swelling
13 yr old boy
Acute
Patellar sleeve avulsion fracture
307
What does the following describe?
Fragment of bone at inferior patella with associated soft tissue swelling
13 yr old boy
chronic
Sindig-Larsen-Johansson
308
What does the following describe?
Microtrauma to the patellar tendon on the insertion of the tibial tuberosity
May be bilateral
Common in boys
Osgood-Schlatter
309
What does the following describe?
Celery stalk appearance
Generalised lucency of the metaphysis
1st weeks of life
Congenital rubella
310
What does the following describe?
After 6 weeks of life
Metaphyseal lucent bands
Periosteal reaction along long bones
Wimberger sign - obstruction of medial portion of proximal tibial metaphysis
Syphillis
311
What does the following describe?
Within first 6 months of life
soft tissue swelling
Periosteal reaction
Really hot mandible on bone scan
Caffey disease
312
What does the following describe?
CXR with midsternotomy wires
Congenital heart disease
periosteal reaction in arm bones
Prostaglandin therapy induced periosteal reaction
313
What does the following describe?
>3 months age, resolves by 6 months
Proximal involvement (Femur) comes before distal involvement (Tibia)
Involves diaphysis
Physiologic growth
314
What does the following describe?
Boys
Beveled egde in skull, destruction of inner/outer tables
Round lucent lesion in skull of child
Multiple lucent lesions with expanded appearance in ribs
Vertebrae plana in spine
Langerhans cell Histiocytosis
315
Where does osteomyelitis begin in the following ages?
Newborns
Kids
Adults
Newborns = Metaphysis to epiphysis via perforator vessels
Kids = Starts in metaphysis and regression and avascular epiphysis stops infection progression
Adults = growth plates fuse, no avascular plate, infection can cross to epiphysis
316
What does the following describe?
Most common
Rhizomelic (Short femur & Humerus)
Large head, trident hand
Narrow interpedicular distance
Tomstone pelvis
Achondroplasia
317
What does the following describe?
Most common lethal dwarfism
Rhizomelic shortening (Humerus/Femurs)
Telephone receiver femurs
Short ribs & Long thorax
Small iliac bones
Flat vertebral bones
Cloverleaf skull
Thanatophoric
318
What does the following describe?
Fatal
Bell shaped thorax + short ribs
Too many fingers (Polydactyly)
Chronic nephritis
Normal vertebral bodies
Asphyxiating thoracic dystrophy (Jeune)
319
What does the following describe?
Dwarf with multiple fingers
Ellis van crevald
320
What does the following describe?
Osteoporosis
Dwarf
Wide angled jaw
Acro-osteolysis
Dystrophic nails + Yellow discoloured teeth
Frontal + Occipital bossing
Pyknodysostosis
321
What does the following describe?
Bifid ribs
Calcifications of the fall
Basal cell cancers
Odotogenic keratocysts (Lytic jaw lesions)
Gorlin syndrome
322
What does the following describe?
Collagen defect = brittle bones
Totally lucent skull
Multiple fractures of hyperplastic callus
Legs with fibula longer than the tibia
Wormian bones
Gracile bones
Flat/beaked vertebral bodies
Osteogenesis Imperfecta
323
What does the following describe?
Disorganised sclerotic weak bone
Alternating bands of sclerosis parallel to growth plate
Bone in bone appearance of vertebral body
Picture frame vertebrae
Diffusely sclerotic skeleton
Osteopetrosis
324
What does the following describe?
Osteoporosis
Wormian bones
Acro-osteolysis
Wide angled mandible
Pyknodysostosis
325
What does the following describe?
Congenital fusion of the spine
Tall skinny cervical vertebral bodies
High riding scapula
Omovertebral bone (Big vertebral body)
Klippel Feil
326
What does the following describe?
Oval shaped vertebral body with anterior beak
Mid beak
Thick clavicles and ribs
Tall flared iliac wings
Wide metacarpal bones with proximal tapering
Morquio
327
What does the following describe?
Oval shaped vertebral body with anterior beak
Inferior beak
Thick clavicles and ribs
Tall flared iliac wings
Wide metacarpal bones with proximal tapering
Hurlers
328
What does the following describe?
Anterior tibial bowing
Pseudoarthrosis at the distal fibula
Scoliosis
Neurofibromatosis 1
329
What does the following describe?
Splenomegaly + Hepatomegaly
AVN of femoral heads
H shaped vertebra
Bone infarcts
Erlenmeyer flask shaped femurs
Gauchers
330
What does the following describe?
Hand/foot swelling in infant with sickle cell
Dactylics
Self resolves
Periostitis 2 weeks post pain resolving
Hand foot syndrome
331
What does the following describe?
Varus angulation at the medial aspect of the proximal tibia
Bilateral
<2yrs old
Blounts
332
What does the following describe?
Continuous C sign
Absent middle facet on lateral view
Talar beak
Talocalcaneal coalition
333
What does the following describe?
At anterior facet
Anteater sign - elongated anterior process of the calcaneus
Calcaneonavicular coalition
334
What does the following describe?
Talus in extreme plantar flexion
Dorsal dislocation of the navicular
Locked talus in plantar flexion
Associated with myelomeningocele
Vertical talus
335
What does the following describe?
Hindfoot varus (Decreased talocalcaneal angle)
Medial deviation and inversion of forefoot
Elevated plantar arch
Club foot
336
What are the risk factors for DDH?
Females
Children born breech
Oligohydramnios
337
What does the following describe?
Alpha angle <60
Acetabular angle >30
Developmental dysplasia of the hip
338
What does the following describe?
Absent proximal femur to hypoplastic proximal femur
Varus deformity
Abnormal femoral leg length
Proximal focal femoral deficiency
339
What does the following describe?
12 yr old boy + Hip pain
Bilateral
Salter Harris proximal femoral physis fracture
Kleins line does not cross the lateral epiphysis
Slipped capital femoral epiphysis
340
What does the following describe?
AVN of proximal femoral epiphysis
Boys > Girls
Age 5 yrs
Subchondral lucency on frog leg
Asymmetric small ossified femoral epiphysis
Flat collapsed femoral head, sterile joint effusions
Legg-Calve-Perthes
341
What is the next step if septic arthritis is suspected?
Joint aspiration
342
What does the following describe?
Systemic illness
Resolves in a few days
Wide joint space from effusion
No fever, normal inflammatory markers
Transient synovitis
343
What is the work up for ?Septic arthritis?
X ray hip - medial joint widening
US - effusion
Clinical decision - increased inflammatory markers required to aspirate the joint
MRI only if no aspiration
344
What does the following describe?
Deficient vitamin D
Fraying, Cupping
Irregularity along physeal margin
Rachitic rosary - expansion of anterior rib ends at costochondral junctions
Rickets
345
Can Rickets or scurvy be seen in newborns?
No due to the maternal vitamin D and vitamin C stores still present
346
What does the following describe?
Frayed metaphases
Bowed long bones
Deficient ALP
Newborn
Hypophosphatasia
347
What does the following describe?
Deficient vitamin C
Subperiosteal haemorrhage - lifts up periosteum
Haemarthrosis
Scorbutic rosary - Expansion of costochondral junctions
Scurvy
348
What does the following describe?
Wide sclerotic metaphyseal line - lead line
Knee
Does not spare the fibula
Lead poisoning
349
What are the differentials for this appearance:
Lucent metaphyseal bands
LINE
Leukemia
Infection (TORCH)
Neuroblastoma Mets
Endocrine (Rickets/Scurvy)
350
The following are suggestive of what?
Posterior medial rib fractures <3 yrs
Metaphyseal corner fractures in non-ambulant child
Red flags for NAI
351
What type of skull fracture is NOT concerning for NAI?
Parietal bone fracture
352
How does the central canal in the spinal cord appear on US?
Echogenic line
353
What does the following describe?
Low conus - below L2
Thickened filum terminale >2mm
Low lying cord/Tethered cord
354
Which posterior dimples need screening?
High dimples above the gluteal crease
355
Why are low dimples below the gluteal crease never screened?
They never extend intra-spinally, might become pilonidal sinuses later
356
What does the following describe?
Failure of the distal cord to properly involute
Cystic structure at the end of the spinal cord
Terminal ventricle
357
What does the following describe?
Oblique radiograph - Collar of scotty dog
AP view - sclerotic pedicle
Pars interarticularis defect (Spondylolysis)
358
What is forward slippage of a pars defect referred as?
Sondylolisthesis
359
What does the following describe?
Failure of closure of the primary neural tube
Dorsal defect in posterior elements
Tethered cord
Open spinal dysraphism
360
What is an open spinal dysraphism?
Neural tissue exposed through defect in bone and skin
361
What is a closed spinal dysraphism?
Defect is covered by skin
362
What is the following describing?
Neural placode is flush with the skin
Myelocele
363
What is the following describing?
More common
Neural placode protrudes above the skin
Myelomeningocele
364
What is the following describing?
Herniation of CSF filled sac through defect in posterior elements
Lumbar/Sacral region
No neural tissue present in sac
Meningocele
365
What is the following describing?
S/C fatty mass above gluteal crease
Dural defect
Tethered cord
Lipomyelocele
366
What is the following describing?
Herniation of terminal syrinx into a posterior meningocele via posterior spinal defect
Terminal myelocystocele
367
What is the following describing?
Linear T1 structure in the filum terminale
Filum not thickened
Conus normally located
Fibrolipoma of the filum terminale
368
What is the following describing?
Thickened filum terminale >2mm
Low lying conus below L2
May have terminal lipoma
Tight filum terminale
369
What is the following describing?
Epithelial lined tract extending from skin to deep soft tissues
T1 low signal
Dermal sinus
370
What is the following describing?
Sagittal split in the spinal cord
T9-S1 location
Normal cord above and below the split
+/- 2 thecal sac
Each card has its own central canal + dorsal/ventral horns
Diastematomyelia
371
What is the following describing?
Ranges from partial agenesis of the coccyx to lumbosacral agenesis
Blunted sharp high terminating cord
Shield sign - opposed iliac bones
Caudal regression
372
What is the following describing?
Anterior sacral meningocele
Anorectal malformation
Sacroccocygeal osseous defect (Scimitar sacrum)
Caudal regression
373
The following are associated with which condition?
Breast cancer
Choroid plexus cysts
Omphalocele
Germ cell tumours
Klienfelters disease
374
What is the most concerning finding on AXR for a neonate presenting with abdominal pain?
Portal venous gas - Branching opacities over the liver
375
At which age can US no longer be used to diagnose DDH?
6 months due to ossification of the pelvis
376
What is the following describing?
Tigroid pattern high signal in centrum semiovale
Spares U fibers
Metachromatic leukodystrophy
377
What is the following describing?
Posterior WM high signal
Cerebellar
Spinal cord
Krabbe disease
378
What is the following describing?
Symmetric peritrigonal WM splenium high signal
X linked adrenoleukodystrophy
379
What is the following describing?
Anterior WM high signal + Centrifugal direction (Peripherally to central)
Alexander disease
380
What is the following describing?
Centripetal (Medial outwards)
White matter high signal
Increased NAA
Canavan disease
381
What is the following describing?
WM swelling
Frontotempotal cysts
Van der Knaap disease
382
What is the following describing?
XR - well defined lytic lesion, no bony sequestrum
MRI - High signal on fluid sensitive sequences, contrast enhancement
Medial clavicle high signal
CRMO (Chronic recurrent osteomyelitis)
383
What type of Osteogenesis imperfecta does this patient have?
Blue sclera
Antenatal fractures
Accordion hips
Poor/no skull ossification
Lethal - Type II OI
384
What type of Osteogenesis imperfecta does this patient have?
Grey sclera
Triangular face
Short stature
Wheelchair bound, kyphoscoliosis
Type III - Severe OI
385
What type of Osteogenesis imperfecta does this patient have?
White sclera
Long bone bowing, vertebral fractures
Walks with brace/crutches
Type IV and V OI
386
What type of Osteogenesis imperfecta does this patient have?
Blue sclera
May have no fractures
Stature may be normal or kyphoscoliosis
Type I OI
387
What is the following describing?
2 Week old baby
Cardiomegaly
perihilar consolidation
Bilateral pleural effusion
Midline tubular hypoechoic structure with prominent vascularity on cranial US
Vein of Galen malformation
388
What is the following describing?
Cystic encephalomalacia filled with CSF which communication with the ventricles
Poroencephalic cyst
389
What are the extra cardiac causes of cardiac failure in an infant?
Vein of Galen Malformation
Hepatic haemangioendothelioma
390
What is the following describing?
Infant
CCF
Large mass in liver
CT - Rim enhancement with gradual variable central contrast enhancement
Hepatic haemangioendothelioma
391
The following are findings of what?
DJ flexure to the left of the L1 pedicle at level of pylorus
Retroperitoneal D2/D3
Duodenum in C shape configuration
Normal contrast study
392
What is the following describing?
DJ flexure low lying and to left of midline
No retroperitoneal D3
Inverted SMA/SMV relationship
High caecum
Malrotation
393
What is the following describing?
Neonate
Hepatosplenomegaly
Extensive bilateral stippled triangular calcification along paravertebral regions
Adrenal glands
Wolman disease
394
What is the most common cause of a neonatal mass lesion?
Hydronephrosis
395
How is UTI investigated in <6 month old children
Responds well to treatment within 48 hrs
US within 6 weeks - If abnormal MCUG
DMSA 4-6 months post infection
396
What is the following describing in <6 month old children
Atypical UTI
US during acute infection
DMSA 4-6 months post infection
MCUG
397
What is the following describing in <6 month old children
Recurrent UTI
US during acute infection
DMSA 4-6 months post infection
MCUG
398
How is suspected heterodoxy investigated?
ECHO
Abdominal US
399
What is the following describing?
Children
Younger patients
Unifocal, multiple lesions
Femur/Humerus or pelvis
Permeative destructive lesion, wide zone of transition and soft tissue extension
Hair on end spiculated appearance
Ewings sarcoma
400
What is the following describing?
Children - Older age group
Eccentrically located metaphyseal lesion, or diaphysis
Knee or distal femur
Aggressive lesion with calcified osteoid matrix and soft tissue mass
Sunburst periosteal reaction
Lung mets
Osteosarcoma
401
What is the following describing?
Male child
Scrotal pain
Hyperaemia on colour doppler
To and fro flow, or reversed diastolic flow
Torsion-Detorsion/Reverse torsion
402
The following CXR views are used for what in paeds?
R + L Oblique & AP
NAI
403
The following CXR views are used for what in paeds?
Horizontal beam lateral + AP
Anterior Pneumothorax
404
The following CXR views are used for what in paeds?
AP & R + L Decubitus
FOB Inhalation
405
The following is describing what?
Lytic lesion in the skull
Diabetes insipidus
Loss of T1 high signal in posterior pituitary
Enhancement and thickening of the infundibulum
Langerhans cell histiocytosis
