FRCR

Question 1

Ficat classification of AVN

Answer 1

1 - pain, minor radiographic changes e.g. blurred trabeculae, osteopaenia
2 - months of pain, sclerosis or lucency
3 - Crescent sign, flattening
4 - OA superimposed on deformity

Question 2

Perthes diagnosis

Answer 2

Bone scan for early diagnosis
MRI for evaluating extent
Age and extent determine prognosis (better if younger)

Question 3

Orientation of coin on radiograph

Answer 3

If in trachea, more likely sagitally orientated as no cartilage posteriorly
If in oesophagus may be coronally orientated
Proximal foreign body has higher mortality

Question 4

McCune-Albright

Answer 4

Cafe-au-lait spots (Coast of Maine)
Precocious puberty
Polyostotic fibrous dysplasia

Question 5

Mazabraud syndrome

Answer 5

Polyostotic fibrous dysplasia and intramuscular myxomas in middle aged females

Question 6

Fibrous dysplasia

Answer 6

May be associated with endocrine disturbance (separate to McCune-Albright_
e.g. HPT, acromegaly, Cushings

Question 7

Congenital lobar emphysema v Swyer-James

Answer 7

Small lung in Swyer James
Male predominance for CLE
LUL most common, them RML, RUL. Despite LUL being most common lobe, right hemithorax most commonly affected
May be associated with aberrant L pulmonary artery or congenital heart disease

Question 8

High specificity fractures for NAI

Answer 8

Metaphyseal, posteromedial rib, scapula, spinous process, sternum

Question 9

Osteochondritis dissecans

Answer 9

Similar appearance to SONK but younger age group
Grade 1 - cartilage
2 - low signal bony outline signifies fibrous attachment
3 - high signal bony outline
4 - loose body
Medial femoral condyle classic

Question 10

Ependymoma v medulloblastoma (Brain)

Answer 10

Ependymoma calficy
Ependymoma heterogeneous
Medulloblastoma hyperdense (male 2x F, most common amongs 6-11 yr)

Question 11

Ependymoma v astrocytoma (spine)

Answer 11

Astrocytoma more common in children, ependymoma adult
Astro tends to be more extensive
Haemorrahge in ependymoma

Question 12

Drop mets

Answer 12

GBM, medulloblastoma, ependymoma, sPNET, germinoma, choroid plexus carcinoma,

Breast, lung, melanoma, lymphoma, leukaemia

Question 13

Pilocytic astrocytoma association

Answer 13

NF1 - (particularly of optic nerves - optic pathway glioma)

Question 14

Craniosynostosis - type, cause

Answer 14

Sagital suture most common (scaphocephaly), then coronal (brachycephaly)
Metabolic, haematological, MPS, iatrogenic, chromosomal
HPT, rickets, thalasaemia, PCR, sickle cell, shunt, Apert’s, Crouzon’s
Plagiocephaly - unilateral coronal
May lead to deformity and raised ICP

Aperts: Chrom10, AD, mostly sporadic, skull and limb malformations. Brachycephaly, and syndactyly
Crouzons: Chrom10, AD. Clover-leaf skull, expothalmos

Question 15

Lymphoma

Answer 15

Hodgkin more common than NHL in children

Question 16

Mediastinal lymphadenopathy

Answer 16

More commonly malignant in children - lymphoma, neuroblastoma, rhabdomyosarcoma

Question 17

NEC risk factors

Answer 17

Preterm.
Birth asphyxia.
Placental insufficiency.

Question 18

NEC bowel affected, complications

Answer 18

Caecum and terminal ileum most likely

Perforation, stricture, multi-organ failure

Question 19

Madelung deformity

Answer 19

Hurlers, achdondroplasia
Turners
Leri-Weill (mesomelic dwarfism)
Nail patella
Diaphyseal aclasia (multiple hereditary exostoses)
Olliers

Question 20

Diaphragmatic hernia

Answer 20

Bochdalek more common left side
Associated with lung hypoplasia, cardiac defects, neural tube defects, aneuploidy, sequestrations
May also have gut malrotation / volvulus

Question 21

Oesophageal atresia

Answer 21

Associated with VACTERL, and trisomies

Question 22

Complete

Answer 22

.