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Flashcards in Pediatrics Deck (85)
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1

Ddx long bone lesion in 2-year-old

Toddler's fx, osteomyelitis, LCH, fibrous dysplasia, osteoid osteoma

2

What's Legg-Calve-Perthes disease?

idiopathic AVN of femoral epiphysis
age 4-8 years
10% bilateral
asymmetry then fragmentation of epiphysis

3

Currarino triad:

anorectal malform (imperforate anus)
presacral mass: meningocele, teratoma, lipoma, dermoid, or enteric cyst
partial sacral agenesis

4

VACTERL =

V : vertebral anomalies :
hemivertebrae
congenital scoliosis
caudal regression
spina bifida
A : anorectal anomalies :
anal atresia
C : cardiac anomalies / cleft lip
T : tracheo-
E : oesophageal fisula + / - oesophageal atresia
R : radial ray anomalies / renal anomalies
L : limb anomalies
polydactyly
oligodactyly

5

vessel between trachea and esophagus =

pulmonary sling (left PA arises from R PA and courses posterior to the trachea

6

Age of pyloric stenosis:
Numbers:

Age: 2-8 weeks
Male: female 4:1
Muscle thicker than 3mm
Length of pyloric channel >17mm

7

Ddx for microcolon:

Meconium ileus
distal bowel atresia
Hirshprung's (total colonic)
Microcolon of prematurity
Megacystitis-microcolon hypoperistalsis syndrome

8

What's meconium ileus? What's the difference between meconium ileus and meconium plug?

Meconium ileus is abnormally thick, impacted meconium in the ileum, usually related to CF
Meconium plug is a *functional* colonic obstruction in a newborn due to an obstructing meconium plug. It is usually transient and affects the left colon with meconium plugging the bowel distal to this segment. Small left colon syndrome is a subset of meconium plug syndrome (for most purposes is synonymous)

9

Enema on newborn shows colon small from splenic flexure distally
what's it associated with?

Small left colon
Functional obstruction due to immaturity of myenteric plexus
Assoc. maternal DM, substance abuse
Ddx: hirschprung's

10

ddx Abdominal cyst in a fetus or child

GI duplication cyst
choledochal cyst
ovarian cyst (on pedicle)

11

Ddx for SBO in a new born: ... an infant: ...in a child?

NB: intestinal atresia, Hirschprung's disease, small left colon, meconium plug, meconium ileus, midgut volvulus
Infant-2 year old: Incarcerated hernia, Hirshprung's, malrotation, intussusception
Older child: appendicitis, intussusception, malrotation, adhesions

12

Neuroblastoma - who gets it?

infants and very young children (mean age of presentation being ≈ 22 months) with 95% of cases <10 years. Occasionally identified antenatally or at birth
Beckwith-Wiedemann syndrome
DiGeorge syndrome
Hirschsprung disease
NF1

13

Beckwith-Wiedemann syndrome: what is it? Features?

congenital overgrowth disorder characterised by a unique set features which can consist of :
macroglossia (most common clinical finding)
omphalocoele
localised gigantism / macrosomia
hemihypertrophy
organomegalies (nephromegaly, hepatosplenomegaly)
Assoc. with *Neuroblastoma and *Wilm's, hepatoblastoma

14

DiGeorge syndrome

cleft lip - / + palate
congenital heart disease (particularly conotruncal anomalies): often a major part of this syndrome- tetralogy of Fallot, interrupted aortic arch, truncus arteriosus
charcateristic facies : elongated face

15

Ddx for nasopharyngeal tumor in teenager

JNA
lymphoma
rhabdomyosarcoma
nasopharyngeal carcinoma

16

Newborn with liver mass

Hepatoblastoma or Congenital hemangioma
Hepatoblastoma: fat and osteoid elements, no AV shunting, peak age 18-24 mos. Get chest CT to look for mets
congenital hemangioma (aka Hemangioendothelioma): large endothelial-lined vascular channels (much AV shunting), fetus or neonate

17

What completes the ring in double aortic arch?

Ligamentum arteriosum

18

Sacrococcygeal teratoma - tell me about it

most common congenital tumor
80% in girls
70% benign, rest malignant
classified based on intrapelvic involvement

19

smooth brain with hourglass configuration

Lissencephaly - extreme form of migrational abnormality (do not confuse with normal appearance of preterm brain)
Pts usually present in status epilepticus

20

features of cleidocranial dysostosis

Skull: wormian bones, brachycephaly
Chest: absent/hypoplastic clavicles
Limbs: short / absent fibula, short / absent radius
Widened pubic symphysis

21

What are the common craniosynostoses? Describe each

- dolichocephaly/scaphocephaly (elongated): sagittal suture (most common)
-brachycephaly (round, wide): coronal and/or lamboid sutures
-plagiocephaly (asymmetric): unilateral coronal and lambdoid sutures
-trigonocephaly (pointy forehead, triangular head): metopic suture
(many more)

22

What solution do you use for an enema in an infant?

Cysto Conray, 400 mOsm

23

Congenital heart disease: increased pulmonary blood flow, not cyanotic ddx:

Shunts:
ASD (not enlarged)
heart enlarged: VSD, PDA, (ECD) endocardial cushion defect
Peripheral shunt (vein of Galen, congenital hemangioma of liver)

24

Congenital heart disease: increased pulmonary blood flow, cyanotic ddx:

The "Ts"
Transposition
TAPVR
Truncus arteriosus
Tricuspid Atresia w large VSD
Single ventricle

25

Congenital heart disease: decreased pulmonary flow (cyanotic)

"right heart problems"
TOF (not enlarged)
Enlarged:
Pulmonary atresia
Tricuspid Atresia w small VSD
Ebstein's anomaly (huge heart)

26

What's usually the diagnosis for "snowman heart"

supracardiac TAPVR (dilated SVC and left vertical vein)

27

Pneumomediastinum in a child ddx

Foreign body aspiration
asthma
blunt trauma

28

Most common orbital mass in a child:

hemangioma

29

Ddx for aggressive lesion in retrobulbar space:

mets (neuroblastoma), LCH, rhabdomyosarcoma, lymphoma

30

vascular subcutaneous lesion over the skull that communicates with the dural venous sinuses

Sinus pericranei