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Rad video > Paediatric > Flashcards

Paediatric Flashcards

1
Q

Necrotising enterocolitis

RF

A

onset directly proportional to GA
Premature infants

Distension - symmetric, asymmetric with focal distension, persistent loop sign
Pneumatosis
Portal venous air
Pneumoperitoneum

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2
Q

Common associations of intestinal malrotation

5

A 
CDH
Omphalocoele
Gastroschisis
Prune Belly Xd
Heterotaxy
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3
Q

DDH - Demo, RF
4
Ossification is delayed

A 
F>M (5:1)
Bilateral 25%, L>R
Breech
Oligohydramnios
Swaddling
FHx
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4
Q

Perkins line

Hilgenreiner line

A

vertical line tangential to outer margin of acetabulum

Intersects proximal femoral metaphysis in inner third

Horizontal line through tri-radiate cartilage

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5
Q

Acetabular angle
<28 at birth
<22 at 1 year

A

Angle formed by line tangential to bony acetabulum and horizontal line through triradiate cartilage

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6
Q

Perthes disease

Demo

A

5-8 years
M>F 4:1
Caucasians
Bilateral in 15%, asymmetric

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7
Q

SCFE

Demo

A 
12-15yrs
M>F
African Americans
Obese/tall
Bilateral 20-30% asymmetric
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8
Q

Bowing of legs
Genu vara/tibia vara
6 causes

A 
Physiological upto 2 yrs
Blounts
Rickets
Renal osteodystrophy
Osteogenesis imperfecta
Fibrous dysplasia
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9
Q

Prostaglandin periostitis

A

Administration of PG to maintain patency of ductus causing diffuse, symmetrical periosteal reaction in neonates.

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10
Q

Pentalogy of Cantrell

A

Cephalic fold defect

CHD
Ventral hernia
Sternal defect
Absent anterior diaphragm
Pericardial defect
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11
Q

Choledochal cyst types

6

A

type I: most common, accounting for 80-90% 1 (this type can present in utero)
Ia: dilatation of extrahepatic bile duct (entire)
Ib: dilatation of extrahepatic bile duct (focal segment)
Ic: dilatation of the common bile duct portion of extrahepatic bile duct

type II: true diverticulum from extrahepatic bile duct

type III: dilatation of extrahepatic bile duct within the duodenal wall (choledochocoele)

type IV: next most common
IVa: cysts involving both intra and extrahepatic ducts
IVb: multiple dilatations/cysts of extrahepatic ducts only

type V: multiple dilatations/cysts of intrahepatic ducts only (Caroli disease)

type VI: dilatation of cystic duct.

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12
Q

Oesophageal atresia types

5

A

type A: isolated esophageal atresia (8%)
type B: proximal fistula with distal atresia (1%)
type C: proximal atresia with distal fistula (85%)
type D: double fistula with intervening atresia (1%)
type E: isolated fistula (H-N type) (4%)

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13
Q

Duodenal atresia

A

No recanalisation - atresia
Partial recan - stenosis/web
80% distal to ampulla of Vater
Assoc : annular, preduodenal PV, other atresias, CHD, Down(30%), VACTERL

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14
Q

Functional immaturity of the colon

A

Abnormal colonic motility

Infants of diabetic mothers, mothers on Mg SO4

No assoc with CF

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15
Q

Urachal anomalies
4
Complication 1

A 
Patent urachus (50%)
Urachal cyst ( 30%)
Urachal sinus (15%)
Vesicourachal diverticulum (5%)

complication : (mucinous) adenocarcinoma

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16
Q

VUR Grade

5

A

grade 1: reflux limited to the ureter

grade 2: reflux up to the renal pelvis

grade 3: mild dilatation of ureter and pelvicalyceal system

grade 4
tortuous ureter with moderate dilatation
blunting of fornices but preserved papillary impressions

grade 5
tortuous ureter with severe dilatation of ureter and pelvicalyceal system
loss of fornices and papillary impressions

17
Q

Lost face sign in CT kidney

A

Loss of normal renal pelvic fat at hilar level in duplicated systems

18
Q

Weigert Mayer Rule

A

Upper pole ureter inserts ectpically inferomedially with associated ureterocoele

Lower pole ureter inserts normally and is prone to reflux.

Upper pole seen on USS (hydronephrotic)
Lower pole seen on MCUG ( reflux)

19
Q

Most common stone types forming staghorn calculi

A

Struvite

Cystine/uric acid less common

20
Q

Associations of simple renal cysts (HU<20) in paediatrics (<0.5%)
4

A

TS
VHL
Carolis
NF

21
Q

Multicystic dysplastic kidneys

A

Most common cystic renal disease in infants.
Extra renal atresia causing abnormal cystic expansion of tubules

Usually unilateral ( bilateral- lethal)
NON communicating cysts of varying sizes

30-50% contralateral anomalies

Rare - malignancy (wilms/RCC)

DTAP - void. No excretion.

22
Q

ADPKD

A 
50% cysts within 1st decade
Associated cysts ( liver 75%, pancreas 10%, cerebral berry (5-10%)
23
Q

ARPKD

A 
enlarged hyperechoic kidneys
1-2mm cysts
Periportal fibrosis and duct dilatation
Pancreatic fibrosis
Striated nephrogram
24
Q

Von Hippel Lindau

manifestations

A 
AD multisystem
Haemiangioblastomas
Renal cysts/RCC
Adrenal phaeo ( Type II)
Pancreatic cysts
Islet cell cystadenomas
25
Q

Wilms tumour
demo
B/L
Signs

A 
mean age 3 yrs
Bilateral 5% (Beckwith)
Claw sign/pseudocapsula
Calcifications
CE +
Tumour thrombus
26
Q

Paediatric renal malignancy with frequent bone metastases

A

Renal medullary carcinoma

frequent in sickle cell trait, clear cell sarcomas

27
Q

`Frontonasal masses

fonticulus frontalis >frontonasal suture

Prenasal space > foramen caecum

A

Epidermoid/dermoid - anywhere along the tract of patent foramen caecum(prenasal space)

“glioma” - misnomer, brain heterotopia, 15% connection to subarachnoid space.

Encephalocoele - meningo or meningoencephalocoele (naming : roof-floor eg frontonasal

Pott’s puffy tumour - frontal sinusitis > frontal osteomyelitis> subperiosteal abscess

Fibrous dysplasia (leontiasis ossea)

28
Q

2nd Branchial cleft cyst (80-90%) - mandibular angle
Bailey Classification
4

A

Type I : superficial to SCM
Type II : between scm and carotid sheath
Type III : splays ICA/ECA
Type IV : deep to carotid, touches pharyngeal mucosa

29
Q

1st Branchial cleft cyst
Arnot Classification
associated with parotid gland

A

Type 1 - no connection to EAC

Type 2 - tail or communication with floor of EAC

30
Q

Paediatric H&N : Cystic masses

6

A 
Encephalocoele
Branchial cleft cyst
(Dermoid/epidermoid)
Thyroglossal duct cysts
Ranula/diving ranula
Lymphatic malformations
Lemierre Xd : septic jugular v thrombophlebitis
31
Q

Paediatric H&N : Solid masses

A

LCH - EG, handschuller X, Letterer Siwe (systemic)

Rhabdomyosarcoma -sk muscle malignancy, masticator sp. common

Lymphoma : 50/50 HL/NHL

Neuroblastoma mets

Plexiform neurofibroma-NF1

Fibromatosis coli : enlarged SCM without LN - fibrosis/haematoma.

32
Q

Paed H&N : Vascular masses

3

A

Haemangioma (think PHACEs), neoplasm, high flow, involution,

AVM

Venous malformation : phleboliths

33
Q

Modified Graf DDH

A 
Type 1 (mature)
IIA - immature (<3m)
IIB- mild-moderate
IIC - critical zone dys
Type III - severe dysplasia, subluxation
Type IV - dislocation
34
Q

Onion skin appearance of well defined testicular mass

A

Epidermoid

35
Q

USS features of pseudomembranous colitis

4

A

Loss of wall stratification
Accordion sign
Wall thickening with PRESERVATION of folds
Pseudomembranes ( hypoechoic non vascular)

36
Q

HUS - colon features on USS
3
Colitis may be prodromal

A

Loss of stratification
Wall thickening with effacement of folds
No visible vascularisation

37
Q

USS features of neutropenic enterocolitis (typhilitis)

Older children

A

Loss of stratification
Wall thickening with some preservation of folds
HYPERAEMIA

Rad video (10 decks)

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