X-rays in Children - Lecture Flashcards

(25 cards)

1
Q

Cardiomegaly in x-ray in children

A
  • If over 55% of cardiothoracic space
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2
Q

Size of thymus on x-ray

A
  • Biggest at 2yrs old
  • Can continue to grow ito adolescence
  • If small - screen for DiGeorge
  • Usually occupies R upper lobe - sail sign - if large
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3
Q

What can consolidation be on CXR?

A
  • Could be infection, collapse of lung, effusion
  • If treat with physio and improvement - suggests collapse

Appear very similar in children

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4
Q

When to Xray neonate for resp distress?

A
  • Usually wait 4 hrs if well - can just be TTN
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5
Q

Lower lobe vs middle lobe differentiating in CXR

A
  • If diaphragm obliterated - lower lobe
  • If cardiac border gone - middle lobe

R lung has 3 lobes

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6
Q

What is shown here?

A
  • Congenital lobar emphysema
  • Appears as hyperinflated lung on one side
  • Shifts structures away from inflation
  • Presents with poor feeding and rapid breathing, failure to thrive
  • Requires surgery later on
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7
Q

What is shown here?

A
  • Congenital cystic adenomatoid malformation
  • Non cancerous mass located in 1 part of lung
  • Need surgery if large cyst, failure to thrive or repeated infections
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8
Q

What is this?

A
  • Congenital diaphragmatic hernia
  • Oxygenate poorly
  • Need resus at birth
  • Affects alveolar growth in utero - outcome is poor
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9
Q

What are the tubes shown in image?

A

Umbilical line - arterial and venous

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10
Q

What are the lines shown here?

A

ECMO lines
* Can do venous or venous and arterial
* If just venous - rest for lungs - used for meconium aspiration, quick recovery
* If both - lung and cardiac rest

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11
Q

Two common types of diaphragmatic hernia

A
  • Posterior lateral - most common (foramen of bochdalek) - always causes problem
  • Foramen of morgagni hernia is a lot less severe

If occurs early - causes more harm, impairs more growth. If later causes less harm = different outcomes

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12
Q

Consequences of CDH

A
  • Pulmonary hypoplasia
  • Pulmonary hypertension
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13
Q

What can cause raised hemidiaphragm?

A
  • Diaphragm paresis/paralysis
    Can occur post cardiac surgery
    Would see paradoxical breathing - breathing in causes inward movement of chest

OR
* Eventration - muscle replaced by fibrous tissue

Eventration shown

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14
Q

What is choanal atresia?

A
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15
Q

What is shown here?

A

Oesophageal atresia +/- tracheooesophageal fistula
* Stomach filled with gas if fistula
* Coiling of NG due to atresia
* Need surgery to fix - TPN/PEG in meantime
* Cannot be sent home - need regular suction to remove saliva (otherwise this will pool and aspirate)

Need to put firm tube in instead

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16
Q

Which type is most common of tracheooesophageal fistula?

A

Type C - fistula betweem stomach and trachea

17
Q

How can VSD present in neonates?

A
  • Hepatomegaly - sign of HF on children
  • VSD murmur may not present until 6-8 weeks of life
  • Centile dropping, breathless while feeding but not cyanotic
18
Q

How does bronchiolitis appear on CXR?

A
  • RUL consolidation
  • Probably due to mucus pluggling
  • Should consider pneumonia if fever too
19
Q

What can cause rpt CXR to show consolidation in same place with infection symptoms? In someone with neurological conditions

A
  • Aspiration pneumonia
  • Affects same area each time
  • Persistent
20
Q

When to intervene with ingested foreign bodies - which circumstances?

A

Button batteries
Multiple magnets

21
Q

What do hypotonic children not show when in resp distress?

A

Do not show recessions/tracheal tug
Raised RR is enough to intervene

22
Q
A

Harrington rods for scoliosis

23
Q

Duchenne muscular dystrophy

A
  • Delay in motor milestones
  • Gower - use arms up body to stand from squat position
  • Calf hypertrophy - muscles replaced with fibrous tissue
  • Raised ALT
24
Q

What is this and how does it typically present?

A
  • Trisomy 21
  • Bilious vomitting
  • Polyhydramnios
  • Double bubble sign on x-ray
25
What is triple bubble?
If blockage is further down eg jejunal atresia