Paeds Flashcards
(104 cards)
Cyanotic, decreased pulmonary flow, Normal sized heart/mildly enlarged heart
- ToF
- Pulmonary atresia + VSD (variant of ToF)
Cyanotic, decreased pulmonary flow, Massive cardiomegaly
- Ebsteins
- Pulmonary atresia without VSD
- Non cardiac
- Rhabdomyoma
- Mediastinal mass
- AV fistula
- CDH
Causes of bowel obstruction in children
AIMs
A - Adhesions, Appendicitis
I - Intussusception, Incarcerated Inguinal Hernia
M - Malrotation volvulus, Meckels diverticulum
Most common age and sex for intussusception
3m-1y (almost all <3yrs). - above this age think of pathologic lead point.
Girls, Winter/spring (viral illness time)
Thought to be due to lymphoid hypertrophy in the mesentery.
X-ray findings of intussusception
Paucity of gas ascending colon,
mass within ascending/transverse colon,
SBO
(Can image left decubitus or prone)
Henoch-Schönlein Purpura
Small vessel vasculitis affecting skin, joints, GI tract, GU tract.
Can cause small bowel intussusception
Where do swallowed foreign bodies normally get stuck?
In the upper oesophagus in the thoracic inlet.
Causes of jaundice beyond 4 weeks age
Biliary atresia
- Absent gallbladder
- Normal uptake of radio tracer but doesn’t enter the bowel (should be seen within the bowel within 15min)
Neonatal hepatitis
- Delayed uptake/excretion of radio tracer
Hepatic mass in 3yo with elevated AFP
Hepatoblastoma
Causes of hepatic masses in under 5yo
Hepatoblastoma (+ AFP)
Haemangioendothelioma
Mesechymal hamartoma
Metastatic disease (Wilms or neuroblastoma)
Causes of paediatric hepatic masses in over 5yo
HCC (elevated AFP) Embryonal sarcoma, undifferentiated Hepatic adenoma Haemangioma Metastatic disease
Multiple liver masses
Abscesses
Metastatic disease
Lymphoproliferative disease
Multiple adenomas (in association with gaucher disease or fanconi anaemia)
Haemangioendothelioma (liver mass)
Vascular tumour
May present with high output cardiac failure
Usually involute over weeks to months
Mesenchymal hamartoma (liver mass)
Considered a developmental anomaly rather than neoplasm
Predominantly cystic mass
Rare
Pseudomambranous colitis
Pancolitis.
Yellow plaque-like growths on the bowel wall (pseudomembranes)
Severe wall thickening with mucosal hyper enhancement.
Not much mesenteric or soft tissue involvement.
Neutropenic colitis
Ascending colon and terminal ileum
Adventitial hyperenhancement and pericolonic fluid
Necrosing inflammation with ischaemia and secondary bacterial infection.
Graft vs Host (bowel)
Usually in bone marrow patients
Donor T cells attack the mucosa of the host and may replace it with granulation tissue.
Hyperenhancement of the mucosal layer. May or may not have wall thickening throughout the GI tract.
Lymphoproliferative Disorder
Typically in post-solid organ transplants.
Proliferation of EBV infected cells (host usually not previously infected with EBV).
Lymphoma like growth, though more likely parenchymal masses than lymphadenopathy.
Usually occurs in the vicinity of the transplant.
Vesicoureteric reflux grading
1 - Ureter only 2 - Ureter and calyces (no blunting) 3 - Blunting of the calyces 4 - Tortuous dilation of the collecting system 5 - Very tortuous and dilated ureter.
Duplex kidney. What abnormality typically occurs in the upper and lower moieties
Upper pole - Obstruction secondary to ureterocele (both start with vowels). Ectopic ureter insertion medial and inferior to lower pole ureter.
Lower pole - Reflux. (both start with consonants)
Drooping lily sign
When there is contrast reflux into the lower moiety and the lower moiety is pushed inferiorly secondary to the obstructed upper pole moiety.
Primary megaureter
Hirschprung equivalent in the ureter
Distal aperstaltic part is narrowed and relatively obstructed.
More common on the left and in boys.
Urachal anomalies
Patent urachus
Urachal diverticulum
Urachal cyst
Urachal sinus
Prune belly syndrome
Hypoplasia abdominal walls
Urinary tract abnormality
Cryptorchidism
(females can’t have cryptorchidism so can only have pseudo-prune belly)