Paediatric Pathophysiology

Question 1

What structure supplies oxygenated blood to the fetal heart prior to parturition and what does it become in adults?

Answer 1

Ductus venosus

Becomes ligamentum venosum (posterior ligament of the liver)

Question 2

At what level does the neonate spinal cord terminate?

Answer 2

L3

Question 3

What is a Bochdalek hernia?

Answer 3

Common congenital diaphragmatic hernia

• Barrel chest
• Scaphoid abdomen
• Respiratory distress
• Dx by CXR, usually herniation of bowel on the left

Question 4

What structures does the ductus arteriosus connect?

Answer 4

Pulmonary artery AND Proximal descending aorta

Question 5

How does a neuroblastoma present?

Answer 5

Most common extra-cranial malignancy in children (<5yrs)

Usually originates from adrenal glands and causes vague abdominal symptoms (distention, constipation, loss of appetite)

Can metastasise to bone causing LYTIC bone lesions

Rx: surgery +/- chemotherapy

Good prognosis unless advanced disease

Question 6

How does small bowel atresia present?

Answer 6

• Bilious vomiting
• Abdo distention
• Failure to pass stool after passing meconium

AXR: distended bowel loops with fluid levels

Question 7

How does a cystic hygroma present?

Answer 7

Soft, fluctuant, translucent mass

Benign lymphangiomas found in the neck and axilla