CORE - Peds Flashcards
Telephone receiver femurs
thanatophoric dysplasia
Cloverleaf skull
thanatophoric dysplasia, severe Apert syndrome, severe Crouzon syndrome
Platyspondyly
thanatophoric dysplasia
Anterior beaking of mid vertebral body
Morquio’s
Anterior beaking of inferior vertebral body
Hurler’s
Banana sign
Chiari II - appearance of the cerebellum
Lemon sign
Chiari II - appearance of the skull shape
Luckenschadel skull
associated with Chiari II - dysplasia of the skull with multiple rounded lytic defects; affects inner table
Hair-on-end skull
thalassemia, sickle cell disease
Most common cause of cyanosis in newborn
Transposition of the great arteries
Wimberger sign
Congenital syphilis
Celery stalk metaphyses
Congenital rubella
Floating tooth in the mandible
Eosinophilic granuloma
Wide angled mandible and dwarfism
pycnodysostosis
Osteonecrosis of the mandible (peds)
OI on bisphosphonates
Wimberger ring sign
Circular calcification surrounding the osteoporotic epiphyseal center of ossificatoin in scurvy - may result from bleeding
Subperiosteal hemorrhage
Scurvy
Gingival bleeding
Scurvy
Intralobar sequestration, most common location
LLL
Congenital lobar emphysema, most common location
LUL
Bronchial atresia, most common location
LUL
Elevated endothelial growth factor (EGF)
Hemangioendothelioma; follows peripheral nodular discontinuous enhancement pattern
Elevated AFP DDx
Hepatoblastoma, HCC, gastroschisis, yolk sac tumor (testes), pancreatoblastoma, anencephaly
Subglottic hemangioma
assoc. with PHACES syndrome (P = Dandy-Walker), cutaneous hemangiomas; most commonly left-sided
Cutaneous hemangioma
assoc. with PHACES syndrome (P = Dandy-Walker)
Ropy opacities
Meconium aspiration
Pneumothorax (neonate)
Meconium aspiration
Fluid in the fissures (neonate)
TTN
Granular opacities, premature, low lung volumes
RDS
Granular opacities, normal/increased lung volumes
PNA
Granular opacities, low lung volumes, pleural effusion
B-hemolytic strep PNA
Band-like opacites (neonate)
CLD/BPD
Non-bilious vomiting (3 weeks to 3 months) + NEXT STEP
Hypertrophic pyloric stenosis; next step is ultrasound
Paradoxical aciduria
Hypertrophic pyloric stenosis
Thickness and length hypertrophic pyloric stenosis
4 mm and 14 mm
Posterior mediastinal mass <2 y/o
Neuroblastoma
Absent or hypoplastic GB
Biliary atresia
Triangle cord sign
Biliary atresia - triangular or tubular echogenic cord of fibrous tissue seen in the porta hepatis at ultrasonography
Asplenia
Congenital heart disease
Splenic infarct
SCD
Gallstones
SCD
Fishmouth or H-shaped vertebrae
SCD, Gaucher’s
Hand or foot pain/swelling (infant)
Hand-foot syndrome (dactylitis in SCD)
Short microcolon
Mid to distal colonic atresia, Hirschsprung’s (dependent on length of involvement)
Long microcolon
Meconium ileus, ileal/proximal colonic atresia, total colonic Hirschsprung’s
Calcified abdominal mass in newborn
Meconium peritonitis
Meconium ileus equivalent
DIOS
Abrupt caliber change of aorta below celiac origin
Hepatic hemangioendothelioma (shunt)
Cystic mass in liver of newborn
Mesenchymal hamartoma
Unilateral renal agenesis
Unicornuate uterus (females); absent vas deferens/epididymis, seminal vesicle cysts (males)
Neonatal renal vein thrombosis
Maternal diabetes
Neonatal renal artery thrombosis
Misplaced umbilical artery catheter (should be at T8-10 or L3-5)
Hydronephrosis on fetal MRI
Posterior urethral valve
Urachal anomaly assoc. malignancy
Adenocarcinoma
Solid renal tumor in <3 month old
Mesoblastic nephroma
Solid renal tumor of childhood
Wilms
Midline pelvic mass in female
Hydrometrocolpos
Blue dot sign
Torsion of testicular appendage (>5 mm)
Extratesticular scrotal mass
Rhabdomyosarcoma
Narrowing of interpedicular distance
Achondroplasia
Tombstone iliacs
Achondroplasia
Champagne glass pelvic inlet
Achondroplasia
Trident hands
Achondroplasia; short fingers with a separation between the 3rd and 4th digits
Posterior vertebral scalloping
Achondroplasia, NF1, Marfan’s, Ehlers-Danlos, intraspinal mass, mucopolysaccharidoses
Idiopathic scrotal edema
Henoch-Schonlein purpura
Acute scrotal pain age 7-14
Torsion of testicular appendage (most common), testicular torsion, epididymitis
Physiologic periostitis of the newborn
1-4 months; femur before tibia, always diaphyseal
Acetabular angle should be
<30
Alpha angle should be
> 60
Klein’s line
along lateral femoral neck; for SCFE
Hilgenreiner line
drawn through triradiate cartilage; ‘H’ for horizontal
Perkins line
drawn through lateral acetabulum; ‘P’ for perpendicular to Hilgenreiner line
Most common symptomatic vascular ring
Double aortic arch
Neonatal infection with frontal lobe atrophy
HIV
Dolicocephaly
Sagittal suture fusion
Brachycephaly
Bilateral coronal or lambdoid suture fusion
Plagiocephaly
Unilateral coronal or lambdoid suture fusion
Trigonocephaly
Metopic suture fusion
Turricephaly
Sagittal, coronal, and lambdoid suture fusion
Right-sided heterotaxia
bilateral major/minor fissures, asplenia, more cardiac malformations, aorta on the right side of the spine
Left-sided heterotaxia
bilateral single fissures, polysplenia, fewer cardiac malformations, azygous continuation
Congenital CMV (CNS)
periventricular calcifications, pachygyria-lissencephaly, hydrocephalus
Congenital toxoplasmosis (CNS)
basal ganglia calcifications, hydrocephalus
Congenital HSV (CNS)
hermorrhagic infarction => bad encephalomalacia
Congenital HIV (CNS)
frontal lobe atrophy
Caffey disease
<6 m/o, self-limited; periosteal reaction, soft-tissue swelling, irritability; affects mandible, ulna, and clavicle; hot on bone scan
Wormian bones DDx
Pycnodysostosis, OI, Rickets, Kinky hair syndrome, Cleidocranial dysostosis, Hajdu-Cheney, Syndrome of Downs
Differential for high output cardiac failure in pediatric patient
Hepatic hemagnioendothelioma, vein of Galen malformation, sacrococcygeal teratoma
Grade 1 VUR
reflux into ureter only
Grade 2 VUR
reflux into renal pelvis, no dilation
Grade 3 VUR
mild dilation of ureter and pelvicalyceal system
Grade 4 VUR
tortuous ureter with moderate dilation, pelvicalyceal blunting with preserved papillary impressions
Grade 5 VUR
tortuous ureter with severe dilation of the ureter and pelvicalyceal system, loss of fornices and papillary impressions
VUR treatment
grades 1-3 with antibiotics only, grades 4-5 with antibiotics +/- reimplantation
Rhizomelic
Proximal limb shortening
Mesomelic
Mid limb shortening
Acromelic
Distal limb shortening
Most common congenital heart disease
Bicuspid aortic valve or VSD (depends on wording)
Aortic coarctation associations
assoc. with Turners, bicuspid aortic valve
Extra-cardiac shunts
hepatic hemangioendothelioma, vein of galen malformation, sacrococcygeal teratoma
type 1 TAPVR
Supracardiac (50%) - snowman sign