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Ped > Cervical region > Flashcards

Cervical region Flashcards

1
Q

Infantile hemangioma

A

benign vascular neoplasm GLUT-1
increased insidence in premature
-Nascent phase: subtile precursor 2-4 weeks
-Proliferative phase: (might be biphasic) bulky compressible, strawberry with cutaneous and deep components. Lobulated mass with contrast enhancement, intralesional flow voids
-Final involution: up to 12 yo, never complete

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2
Q

Congenital emangioma

A

Rare lesion completly developed at birth, without proliferative phase

  • RICH: rapidly involutiong congenital hemangioma (skalp, neck) flow voids, arterial aneurysm, direct AV shunts, calcification: diff fibrosarcoma. High output congestive heart failure. Involution completed at 14 months
  • NICH: non involuting congenital hemangioma. Grows with the child.
  • PICH: partially involution congenital hemangioma
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3
Q

Kaposiform hemangioendothelioma

A

Locally agressive, intermediate malignancy
il defined vascular mass with stranding of subcutaneous infiltration, intralesional calcifications and feeding-draining vessels
Kasabach-Merritt

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4
Q

Tufted angioma

A

Benign vascular tumor, upper back and neck

Kasabach-Merritt

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5
Q

Venolymphatic

A

Low flow vascular malformation

  • fochal nucal transluscency: when more than 3mm
  • cystic hygroma: 60% associated to chromosomme abnormality (turene, T18 and T 21). Non identifiable flow
  • venolymphatic malformation: large trans-spacitial multicystic masse with septa and fluid-fluid level, with some flow possible in septa. Absent calcifications. Small mass effect, considering its size
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6
Q

Venous malformation

A

slow growing lesion or dysplastic venous channels with minor lymphatic component
well defined, ovoid, heterogenous with enhancement and possible flebolites

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7
Q

Systemic lymphatic malformation

A

Lymphoangiomiomatosis:
Gorham-Stout disease: vanishing bone disease
Kaposiform lymphangiomiomatosis

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8
Q

Teratoma

A

teratomas in the neck 5-10% of all teratomas
tree layers
-mature: mostly cystic, can have calcifications and fat
-Immature

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9
Q

Cervical cystic masses

A

epidermoid: unilocular, restricted diffusion
dermoid:
thyroglossal duct cyst
laryngocele: can produce airway obstruction in newborns
Foregut duplication cyst: might or not communicate, look for it
thymic cyst: midline or anterior to SCL

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10
Q

Soft tissue neck mass

A

ectopic thymus: form primoidial thymopharyngeal dut (mandibular angle to thoracic inlet)
Fetal goiter: secondary to maternal (graves, Hashimoto)) or fetal thyroid dysfunction (US guided umbilical blood sampling)

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11
Q

Infantile fibromatosis

A 
12% of pediatric soft-tissue tumors 
Benign: 
-nodular fascitis
-myositis ossificans
-myofibroma
-fibromatosis colli
Intermediate
-inflammatory myofirboblastic tumors
-infantile fibrosarcoma
-low grade myofibroblastic sarcoma
Malignant:
-fibromyxoid sarcoma
-adult fibrosarcoma
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12
Q

Nodular fasciits

A

head and neck followed by extremities, adolescents
more often subcutanous
rapidly developing
broad based fascial contact, and fascial tale
hypoechoic, vascular
IRM: “inverted target” sign discrete high signal centrally and lower peripherally at T2, rim of perilesional edema
can be transcompartmental

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13
Q

cranial fasciitis

A

similar to noular fascitiis in the crane
infants less than 2yo
dff: LCH, epidermoid, dermoid

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14
Q

Myositis Ossificans

A

reparative pseudosarcomatous proliferation characterized by metaplastic bone formation in striated muscle, tendons, and subcutaneous fat
post-traumatic, nontraumatic and progressive
adolescents and young adults
quadriceps femoris and the brachialis
painful soft-tissue mass that is accompanied by skin erythema, systemic findings
characteristic peripheral calcification in intermediate and mature, paraleling the long axe of the bone/muscle. Can have priosteal reaction, nome edema

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15
Q

Myositis ossificans progressiva

A

fibrodysplasia ossificans progressiva
AD
congenital malformations of the great toes nd progressive heterotopic ossification at characteristic extraskeletal sites

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16
Q

Gardner fibroma

A

1st decade
painless plaquelike mass, back and the paraspinal region in 61%
associated to desmoid fibromatosis

17
Q

Infantile Myofibromatosis

A

the most common benign fibrous tumor in infants 90% of cases occur within the first 2 years
solitary 50-80%: firm cutaneous or subcutaneous mass, boys
Multicentric (with or without visceral involvement), more girls
hypovascular mass, can have central necrosis
spontaneous regression of the tumor over a period of 1–2 years in most cases

18
Q

Fibromatosis Colli

A

rotation of the head are toward the side of the lesion
first 4–8 weeks of life, Male babies
fusiform enlargement of the ipsilateral sternocleidomastoid muscle

19
Q

Fibrous Hamartoma of Infancy

A

younger than 2 years (20% at birth)
above the waist
US:heterogeneous, predominantly hyperechoic subcutaneous mass that has intervening hypoechoic regions that give it a serpentine pattern, and ill-defined or lobulated margins, poor vascularity
IRM: nonencapsulated mass with characteristic low-signal-intensity fibrous strands interspersed with high-signal-intensity fat in an organized fashion, again giving it a serpentine pattern

20
Q

Soft tissue mass fat-containing

A

lipofibromatosis
lipoblastoma
lipofromatous hamartoma

21
Q

Desmoid fibromatosis

A 
locally aggressive
recurrence
4-5 yo, second pick 3rd decade
5% of the cases of Gardner syndrome are associated with FAP
often intra-abdominal
22
Q

Inflammatory myofibroblastic tumor

A

(inflammatory pseudotumor)
around 9 yo
lung, mesentery and omentum
associated to inlammatory mediators

23
Q

Grisel syndrome

A

cervical lymphadenitis and retropharyngeal abscess presented as post-intlammatory torticolis: atlanto-axial rotatory subluxation of C1 and C2, autolimited

24
Q

Neck neuroblastoma

A

5% of neuroblastomas occur at neck
associated to Horner syndrome
Restricted diffusion, displastic calcification in 50%

25
Q

Congenital infantile fibrosarcoma

A

more favorable prognosis than adult fibrosarcoma

large solid mass

26
Q

Lemierre syndrome

A 
suppurative thromboflebitis of internal jugular, in previously healty teenagers
complications: septic emboly, osteomyelitis and arterial vasospasm
Fusobacterium necrophorum (anaerobic gram -)
27
Q

Retropharyngeal abscess

A

more than 8 mm at C2

28
Q

Lymphadenitis

A

Viral: hyperplasia
Bacterial
Kawasaki: midium vessel vasculitis
mycobacterual: children 1 to 5 yo, lymphadenitis not responding to treatment, central low density and rim of enhancement. Can have calcifications
Cat scratch disease: painful hypodense and hyperemic regional nodes, with granulomas in liver, spleen, osteomyelitis, encephalitis. Bartonella infection
Mononucleosis: EVB, adenomegaly
HIV: HIV, kaposi, NHL, mets

29
Q

Sialoadnitis

A

Infectious: mups the most common, bilateral
other virus: HIV, influenza, coxackie
obstructive: more in man, submandibular (Wharton duct)

30
Q

NHL

A

malignant neoplasm of B or T
low, intermediate or high grade
Burkutt, large B cell, lymphoblastic B or T, anaplastic large cells
-nodal: bilateral asymetric adenopathy, relatively hypodense
-nor nodal lymphatic (tonsils, adenoids)
-non nodal
treated with chimio

31
Q

Hodking lymphoma

A 
the most common cancer for 15-19yo
nodular lymphocyte predominant
classical:4 types)
marked unilateral painless cervical lymphadenopathy
chimio radio
32
Q

Rhabdomyosarcoma

A

35% head and neck
under 6 yo
Associated to; Noonan, NF1, Beckwith-Wiedemann, Li-Fraumeni
Small blue cells, no calcif
Embryonal, alveolar and undifferenciated anaplastic
-orbit
-parameningeal: risk of intractranil extension 55% :PL and mrain MRI
-pterygopalatine

33
Q

Nasopharyngeal carcinoma

A

EBV related
asymetric adenoid enlargement and mastoid fluid
radiosensible

34
Q

Thyroid carcinoma

A

incidental node 20% risk of cancer,
papillary or papillary-folicular
only surgical treatment
If RET (MEN2a or MEN 2b, medullary carcinoma is prevented with prophylactic thyroidectomy

35
Q

Primary cervical neuroblastoma

A

less that 2 yo
principal cancer that metastatizes to head and neck
calcifies, displaces vessels (instead of encasing them)
soft tissue mass, aggressive periosteal rection

36
Q

Nerve sheat tumor

A

NF1 and NF2

Ped (7 decks)

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