Last minute essentials Flashcards
CHARGE
Coloboma heart defect retarded growth GU abnorm Ear anomalies
CXR: high volume, ropy perihilar opacities, +/- PTX
Mec aspiration syn
CXR: low volumes and bilateral granular opacities
SSD (arena, no hay fluido), GBSP
Leading cause of death in sickle cell patients
acute chest
Bronchiectasis like CF but lower lung predominance
PCD
Big fucking mass in the chest of a 2 yr old
Pleuropulmonary Blastoma (PPB): normal ribs Askin tumor (Ewing): eats rib
Ideal spot for umbilical v cath
IVC/RA junction
Cathether that goes down first in Neonate
umbilicus, umbilical artery, iliac artery, then aorta.
SHould be posiitoned low or high to avoid renal arteries
UAC.
T8-T10 or L3-L5
Omphalocele is contraindication
Cathether that goes down first in Neonate
umbilicus, umbilical artery, iliac artery, then aorta.
SHould be posiitoned low or high to avoid renal artery thrombosis (presents as HTN)
UAC.
T8-T10 or L3-L5
Omphalocele is contraindication
VACTERL
Vertebral anomalies Anal imperforation Cardiac TE F or Esoph atresia R renal Limb (radial ray)
Dx when 3 or more are present
heart and kidney are the MC affected organs.
Only variant that goes between esophagus and trach
assoc w tracheal stenosis
Pulm sling
Dysphagia Lusoria
left arch w aberrant R subclav
Bilious vomiting is ___ until proven otherwise. Next step?
MGV
upper GI
- Non bilious vomiting?
- nxt step?
HPS
US
Jejunular atresia secondary to
vascular insult
look for additional atretic segments
Triple bubble
dubble bubble but
- very very distended? NO dista air NADA
- not so distended?
- Duodenal Atresia
- MDG
SMA to the right of SMV on US or CT
Malrotation
HPS
- age range
- criteria
- BW?
- 2-12w
- 4mm single wall, 14 mm length
- paradoxycal aciduria
Which gastric volvulus can cause ischemia and needs to be fixed?
Mesenteroaxial, flips over short axis, MC in monsters (kids)
Duodenal web is assoc w
malrotation and Down Syndrome
short microcolon
colonic atresia
short microcolon
colonic atresia (vascular insult)
Colon with caliber change on lower GI
Small left microcolon
Hirschsprung
Rectum smaller than sigmoig (ratio < 1) or saw tooth pattern
Hirschsprung
Spinal asocc with imperforate anus
tethered cord (get US)
always think VACTERL
Hernias Lateral to inf epigastric
Indirect (MC in kids)
Age range of intusscupetion
3 mo - 3yr
If pt perforates while reducing intusscuecption and gets tension pneumoperitoneum. Nxt step?
Needle decompression
Pressure should not exceed 120mmHg
Gastroschisis facts
- no membrane
- R>L
- assoc w anomalies are rare
- high serum AFP
- assoc w intestinal atresias
- liver + stomach
Omphalocele
- midline
- membrane
- many assoc.
MC cause of pancreatitis in kids
trauma
Peds pancreatic mass
at age 1?
age 6?
age 15
- pancreatoblastoma
- adenoCA
- SPEN
Liver massess in tumors nxt thing to look at in question stem ?
< 1 yoa
< 5
> 5
age
- Infantile Hepatic Hemangioma (high EGF, Kasaback Merrit syndrome, HOCF, spont involute)
- Hepatoblastoma (Syndromic assoc, Well circum solid RIGHT sided mass, calcs 50%, high AFP, Precocious puberty)
- > 5: HCC, Fibrolamellar (< 35, NON. enhancing central scar, T2 dark), embryonal sarc
NON enhancing central scar, T2 dark
FIbrolamellar
Type 5 choledocal cyst
intrahepatic only (Caroli)
Intra + extra hep choledochal cysts type?
4
Central dot sign
PV surounded by dilated bile ducts
Central dot sign
PV surrounded by dilated bile ducts
cysts in the kidney + liver fibrosis.
AR-PCKD
The purpose of liver bx in congenital biliary atresia is to exclude
Alagille Syn (hereditary cholestasis)
Kid with gallstones + no spleen, think …
SCD
Isomerism with reverse aorta & IVC
right isomerism
Type of cancer with horseshoe kidney?
Syndorme?
- renal carcinoid, Wilms, TCC
- Turner
Congenital UPJ tx
pyeloplasty (radiologist can look for overlying vessels prior t procedure)
UPJ obstruction vs Extrarenal pelvis
Whitaker test
Smoothly enlarged echogenic kidneys with loss of CM diff. in child.
AR-PCKD**
Neonatal RV thrombosis assoc w
maternal diabetes
Kid shaped like a pear (abd musculature def)
cryptorchid
hydroureteroneph
Prune Belly (Eagle Barret)
Reverse J fishhook appearance of ureter
Retrocaval (circumcalva ureter)
cobra head sign
Ureterocele (secondary to obstruction of ureteral orifice) assoc w duplicated collecting system
Weigert Myer rule
UInfmedUO
LLatR
Midline bladder structure mass
AdenoCA at patent urachus
Manta Ray sign {AM}
bladder extrosphy (inc risk of CA)
Solid organ GU- Neonate diff dx? u born w it
- Nephroblastomatosis
- Mesoblastic Nephroma
Solid organ GU- Neonate diff dx? u born w it
- Nephroblastomatosis (hypodense rind, rests that didnt regress, can turn into Wilms, f/u w US)
- Mesoblastic Nephroma (benign hamartoma, MC renal tumor in infancy, polyhydramnios)
Solid organ GU- Around age 4 diff dx?
- Wilms (solid ball, lung mets)
- Lymphoma
- Multicystic nephroma (young boys, middle age women, herniates into renal sinus, resect)
Solid organ GU- Teenager diff dx?
- RCC (solid tumor of adolesents, assoc VHL, TS)
- Lymphoma
Multiple tiny cyst with no functioning renal tissue
Multicystic Dysplastic Kidney
50% contralateral renal abnorm
Renal scintigraphy w/o excretory function
I say Beckwidth-Widemann you say…
WHO?
- Wilms
- Hepatoblastoma, hemihypertrophy
- Omphalocele
Biopsy for Wilms tumor?
NO! You can seed the tract and upstage.
MC bladder CA in humans < 10 yoa
Rhabdomyosarcoma
BW: {paratesticular mass}
Raccoon Eyes
Orbital Neuroblastoma
Adrenal gland tumor frequantly contrasted with Wilms…
and differences?
Neuroblastoma
< 2yoa, calcifies 90%, mets to bones, MIBG
Nxt step adrenal mass in neonate
F/U Us imaging
Cerebriform adrenal
CAH
MCC idiopathic scrotal edema
HSP
Peutz Jeghers and bilateral scrotal massess
Sertolli cell tmors
Sacroccoccygeal Teratoma resection involves…
cutting out the coccyx if not it reccurs.
Cellery stack
Congenital rubella
Destruction of the medial portion of the prox metaphysis of tibia
Syphilis (Wimberger sign)
Dead. dward with short ribs
Jeune
Telephone receiver + cloverleaf head
Thanatophoric dysplasia
Many bifid ribs
Gorlin Syndrome
Erlenmeyere flask shaped femurs
Gaucheres
The commonly accepted minimum diameter for treating a true aneurysm of the splenic artery is
2.0 to 2.5 cm
Coalescent peripheral hepatic nodules with target-like appearance and capsular retraction
Liver epithelioid hemangioendothelioma
A Segond fracture is an avulsion fracture at the attachment of the lateral collateral band due to internal rotation and varus stress.
assoc w ACL injury
T2 hyperintense late enhancing scar + SC and + HIDA, Barely perceptiple w/o contrat.
FNH.
- Empty thecal sac sign
2. Central nerve root clumping
arachnoiditis
+CE of Nerve roots of cauda equina
facial N is the MC n. affected
GBS
Thickened enhancing onion bulb nerve roots. Dread locks.
Chronic inflammatory demyelinating polyneuropathy (CIDP)
