CTC and Case reviews Flashcards
most common soft tissue mass in trachea of a kid
hemangioma
what percent of meconium aspiration leads to pnx
20-40%
how to differentiate btw beta hemolytic step pna and RDS
beta hemolytic strep pna has pleural effusions
what type of ca can CCAM transform into
pleuropulmo blastoma, rhabdomyosarcoma
where is CLE most common? what is the rx?
LUL, lobectomy
what infection is associated with CDH on the right?
GBS pna
what is pappiloomatosis, what is the imaging appearnace
assoc with perinatal HPV infection, 2 percent risk of sq cell ca, see soft tissue masses/nodules in the airways and lungs
what nuc med tracer has affinity for thymic rebound
FDG
what type of neuroblastoma in a kid has better prognosis
thoracic
what are the imaging features of pleuropulmo blastoma? what extra pulmo association does it have?
no calcs, no rib invasion, can be cystic or solid (looks like CCAM). associated with multilocular cystic nephroma in 10%
most common type of TE fistula? what do u see in the stomach?
N type - blind ending E with distal connection of E and T, see too much air in the stomach
what percent of duodenal atresias have downs? what percent have polyhydramnios and premature?
30 percent have downs, 40 percent have ploy/PT
what are the signs of duod atreasia vs duod obstruction (ex due to malrotation/volvulus)
duod atresia: double bubble with no distal gas
what are the signs of duod obstruction?
double bubble with a small amount of distal gas, causes are web, stenosis, annular panc, ladd bands
what are the measurements for Hypertrophic pyloric stenosis? age range?
4 mm single wall, 14 mm length, age 2-12 weeks (NOT after 3 mo of age)
what are the signs of distal ileal atresia
long microcolon, contrast does NOT reach ileal loops
risk of perforation with intusseception? why is air reduction better than barium?
0.5 percent. air causes less peritonitis (spillage of fecal material)
what are enteric duplication cysts assoc with?
vertebral anomalies, 30 percent of the time
what is the only parameter associated with decreased incidence of NEC?
breast feeding
what part of colon is NEC most common in
right colon
is maternal AFP higher in omphalocele or gastroschisis
gastroschisis
what time frame is physiologic gut herniation seen
6-8 weeks, up to 11 weeks
what liver tumors in kids have high AFP
hepatoblastoma (solid, calcs in 50%) and HCC
what is most common type of choledochal cyst? what is carolis?
type 1 (focal dilation of CBD), carolis is type 5 and intrahepatic bil-dil only see central dot sign
what is carolis associated with
ARPKD and medullary sponge kidney
what do u see in the liver in osler weber?
liver AVMs, massively dilated hepatic a, cirrhosis
what type of peds liver tumor is gallium avid
fibrolamellar HCC
what is the most common extrahepatic sign of biliary atresia
absent GB
what is seen in biliary atresia, what are the associations
no extrahepatic bile ducts, triangle cord sign on US (echogenic structure at porta hep), assoc with trisomy 18 and polysplenia
what is fibrosing colonopathy
thickening of the proximal colon due to enzyme replacement threapy in CF patients
what GU problems are seen with unilateral renal agensis
absent ipsi ureter, absent ipsi hemitrigone, absent ipsi vas def, seminal vesicle cyst on ipsi side
what is the risk of wilms in horseshoe kidney
8 times higher risk of wilms
what cancer can develop in a horseshoe kidney
renal carcinoid
what percent of congenital UPJ obstruction is bilateral
20%
what kind of bladder cancer is assoc with patent urachus
adenoca
what is the mgmt for nephroblastomatosis
US q3 mo until the age of 7 to make sure it doesnt go to wilms
what does mesoblastic nephroma look like
solid mass on infancy, usually involves the renal pelvis
what is unique about clear cell variant of wilms
likes to met to the bones
age presentation diff btw NB and wilms?
NB: usually before 2 years, can be born with it. Wilms: usually around 4 yo, never born with it
what is the next best step if u suspect wilms on imaging?
NEVER biopsy bc u can seed the tract, remove it surgically/chemo first
what is the best test for NB mets?
MIBG scan
what is the paraneoplastic syndrome assoc with NB?
opsomyoclonus (dancing eyes and feet)
what percent of SC teratomas are b9?
eighty percent
what is the most common extratesticular mass in a kid?
embryonal rhabdo from the spermatic cord or epeidydmis
what are the most common testicular germ cell tumors in a kid
yolk sac (v high AFP) and teratoma
how do sertoli cell testicular tumors present
bilateral, burned out tumors, assoc with Peutz Jehgers
in what condition is sindig larsen johansen syndrome seen?
kids with cerebral palsy
what is the most common acquired cause of hypothyroidism in kids
hashimotos
what is amelia?
absent limb
what is rhizomelia?
proximal limbs are short (femur, humerus)
what is acromelia?
distal limbs are short
what is mesomelia?
middle limbs are short (forearm)
what is a risk factor for achondroplasia?
advanced paternal age
what is jaffe campanacci syndrome
multiple NOFs, MR, hypogonadism, cyrptochidism, multiple cafe au lait spots, cardiovasc probs
what is the inheritance pattern for multiple hereditary exostosis? what is the risk of malignant degeneration in HME?
AD, risk of malignant deg: 1-20%
what is the most common mechanism of elbow injury in kids?
hyperextension - usually results in posterior displacement of the fracture fragment
what is the difference in managment for extension vs flexion type injuries in elbow fractures in kids?
flexion requires open reduction, extension usually closed reduction
what are the most common types of elbow injuries in kids (most to least common)
supracondylar fx, lateral condylar fx, medical epicondyle
what type of CCAM is associated with other anomalies?
type 2 (many cysts, uniform size) assoc with skeletal, cardiac, intestinal)
what are the CNS manifestations of LCH?
hypertrophied, Low T1 pituitary stalk, diabetes insipidus
what ribs show notching in coarctation of the aorta? what vessels supply the distal aorta in coarctation? what is the gender predominance?
inferior surface of the 3rd to 5th ribs. mediastinal, intercostal, superior epigastric vessels. male predominance.
what is the most frequently occurring symptomatic vascular ring? iare cardiac anomalies more prevalent in right or left aortic arch with aberrant subclavian artery?
right aortic arch with aberrant left subclavian, cardiac anomalies are more common with a right aortic arch (as opposed to left aortic arch with aberrant right sublavian)
what is denys drash syndome?
meduallary glomerulosclerosis, wilms tumor, ambigious genetalia. almost all have nephroblastomatosis (increased risk of wilms)
what is the abnl relationship btw the SMA and SMV seen in malrotation?
SMA to the right of the SMV = abnormal
are bladder ears seen in a distended or non distended bladder?
non distended
what are bladder ears associated with
it is due to patent process vaginalis - assoc with inguinal hernia
what is the most common cause of a palpable abdominal mass in a neonate?
UPJ obstruction
what is potter SYNDROME
oligohydramnios assoc with pulmonary hypoplasia
