CXR

Question 1

DDx of increased pulmonary blood flow in 1. acyanotic child

and a 2. cyanotic child

Answer 1

1. ASD, VSD, PDA, Endocardial cusion defect, PAPVR
   Or any combination
2. TGA, TAPVR, hypoplastic left heart syndrome, persistent rtuncus arteriosis, single ventricle

Question 2

Signs of decreased pulmonary blood flow and DDx

Answer 2

1. Small Hilum, black lung fields, small and thin vessels

2. Critical stenosis, atresia of pulmonary or tricuspid valves, including TOF. (decreased pulmonary blood flow)

Question 3

Pulmonary venous congestion

1. Characteristics
2. DDx

Answer 3

1. Hazy and indistinct margins of vasculature, and kerley B lines.
2. Caused by pulmonary HTN secondary to LV failure, or obstruction of venous drainage (MS, TAPVR, cor triatriatum).
   Lymphatic congestion

Question 4

CXRs with Normal pulmonary vasculature?

Answer 4

Obstructive lesions- PS, AS

Small left to right shunts.

Question 5

Signs of increased pulmonary blood flow

Answer 5

• Right and left PAs enlarged and extend to lateral 1/3
• increased vascularity to apices
• external diameter of the right PA > internal diameter of trachea