Pediatric Flashcards by Alex High

What is the infectious etiology of croup?

parainfluenza

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What is the infectious etiology of epiglottitis?

h. influenza

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What is the infecitous etiology of exudative tracheitis?

Staph Aureus

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What syndrome are subglottic hemangiomas associated with and what does it stand for?

PHACES

Posterior fossa/dandy walker
hemangiomas
arterial anomalies
coarctation
eye abnormalities
subglottic hemangiomas

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What cancer may develop in a thyroglossal duct cyst?

papillary

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What anatomy surrounds a 2nd branchial cleft cyst?

posterior and lateral to submandibular gland, lateral to carotid space, anterior to SCM

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Which type of pediatric hemangioma shows up at 6 months?

infantile

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What two syndromes and congenital abnormality is cystic hygroma associated with?

Turners, Downs, coarc

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What is the most common extra occular orbital malignancy in kids?

rhabdomyosarcoma

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What is the most common pediatric benign orbital mass?

dermoid

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high volumes + perihilar streaky= (2)

meconium aspiration

non GB neonatal pneumonia

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Not high (low or normal) volumes + granular (2)

SSD

group B pneumonia

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What are the lung findings in meconium aspiration? (2)

ropy asymmetric densities, hyperinflation

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What are the lung findings in transient tachypnea of the newborn? (2)

coarse interstitial markings, fluid in fissures

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What is the time course of TTN?

peaks at 1 day, resolved by day 3

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What are the pulmonary findings of surfactant deficiency? (2)

low volumes with bilateral granular opacities

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What excludes SDD?

normal plain film at 6 hours post delivery

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High lung volumes in neonates? (3)

meconium aspiration, transient tachypnea, non BH pneumonia

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Low lung volumes in neonates? (2)

surfactant deficiency (no effusion), beta hemolytic pneumonia (effusion)

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What does chronic lung disease look like in infant?

band like opacities, coarse reticular opacities, hyper aeration

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At what age is PIE seen?

1st week

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At what age is CLD seen?

after 3-4 weeks

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Where is bronchopulmonary sequestration most common and at what age does it present?

LLL, adolescence

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Which lobe is CLE most common in?

LUL

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What part of the lungs are affected in CF?

upper lobe

What part of the lungs are affected in primary cilia dyskinesia?

lower lobe

UAC positioning?

High t8-t10 or low L3-L5

Anterior mediastinal mass that straddles the midline?

seminoma

Pediatric posterior mediastinal mass differential (5)

neuroblastoma, ewing, askin, neuroenteric cyst, extramedullary hematopoiesis

Age in pleuropulmonary blastoma?

Age in Askin Tumor

>10

What is the most common type of esophageal atresia/fistula?

N type

What is VACTERL?

Vertebral anomalies, anal, cardiac, TE, fistula, renal, limb. 3+ of above

What variant goes between esophagus and trachea?

pulmonary sling

What is the most common symptomatic vascular ring anomaly?

double aortic arch

What is the most common aortic arch anomaly?

Left arch with aberrant right subclavian artery

What are the five causes of high neonatal obstruction?

midgut volvulus/malrotation, duodenal atresia, duodenal web, annular pancreas, jejunal atresia

What are the five causes of low neonatal obstruction?

Hirschsprung, meconium plug, ileal atresia, meconium ileus, anal/colonic atresia

What causes jejunal atresia?

vascular insult

corkscrew duodenum=

midgut volvulus

Which type of gastric volvulus occurs in kids and what is it?

mesenteroaxial, antrum flips near GE junction can cause ischemia

Wind sock =

duodenal web in older kids

What is meconium plug syndrome?

small left colon; NOT associated with CF

rectum smaller than sigmoid=

hirschsprung

rectum with sawtooth pattern-

hirschsprung

Looks like microcolon but with involvement of the terminal ileum

total colonic aganglionosis

Age of hypertrophic pyloric stenosis

2-12 weeks

What is the criteria for hypertrophic pyloric stenosis?

4mm, 14mm

What should pressure not exceed in reducing HPS?

120mmHg

What target size needs air enema in HPS?

over 2.5cm

What is distal intestinal obstruction syndrome?

meconium ileus equivalent

Which has surrounding membrane, omphalocele or gastrochisis?

omphalocele

When is physiologic gun herniation seen?

6-8 weeks

Pancreatic tumor in 1 yo

pancreatoblastoma

Pancreatic tumor in 6 yo

adenocarcinoma

Pancreatic tumor in 15 yo

SPEN

Hepatoblastoma is associated with what three things?

Elevated AFP, precocious puberty, Wilms

Large cystic hepatic mass with negative AFP in 0-3 yo

mesenchymal hamartoma

0-3 yo multiseptated hepatic mass with fibrous pseudocapsule

embryonal undifferentiated sarcoma

Type 1 choledochal cyst=

focal dilation of CBD, most common

Type 2 choledochal cyst=

diverticulum of bile duct

Type 3 choledochal cyst=

choledochocele

Type 4 choledochal cyst=

intra and extrahepatic

Type 5 choledochal cyst=

carolis- intrahepatic only

What is Alagille syndrome?

hereditary cholestasis due to absent intrahepatic bile ducts, peripheral pulmonary stenosis

What is the triangular cord sign?

bright hand of tissue near branching of CBD, seen in biliary atresia

Horseshoe kidney is associated with what type of cancer?

renal carcinoid

What are the three characteristics of Prune belly?/Eagle Barrett Syndrome?

bad abs, hydrouteronephrosis, cryptorchidism

What is the weigert meyer rule?

in duplicated renal system- upper pole inserts inferior medially, inferior pole inserts superior laterally. upper gets obstructed, inferior gets reflux

What are the five grades of VUR

1: reflux halfway up ureter 2: reflux into non dilated kidney 3: blunted calyces 4: mildly tortuous 5: very tortuous

Two kidney tumors in neonate

Nephroblastomatosis, mesoblastic nephroma

4 renal tumors around age 4

wilms + variants, lymphoma, multilocular cystic nephroma

2 renal tumors in teenagers

RCC, lymphoma

Which type of Wilms mets to bone?

clear cell

What is the follow up for nephroblastomatosis?

US q 3 months until age 7-8

What is a key feature of mesoblastic nephroma?

involves the renal sinus

What are three things seen in Beckwith Wiedemann?

Wilms, omphalocele, hepatoblastoma

Protrude into renal pelvis=

multilocular cystic nephroma

heterogeneous testicular mass in <2 yo w/ elevated AFP=

yolk sac tumor

highly aggressive highly vascular testicular tumor seen in 2nd decade

choriocarcinoma

bilateral burnt out testicular tumors

sertoli cell tumors

testicular sertoli cell tumors are associated with what syndrome?

Peurtz Jegher

four types of sacrococcygeal teratoma

Type 1: extra pelvic 2: barely pelvic, not abdominal 3: some abdominal 4: inside abdomen---malignant!

What is a characteristic of a Milch II lateral condylar fracture?

passes through capitello trochlear groove and is unstable

iliac avulsion

abdominal muscles

asis avulsion=

sartorius

aiis avulsion=

rectus femoris

greater trochanter avulsion=

gluteal muscles

symphysis avulsion=

adductor group

ischial tuberosity avulsion=

hamstrings

lesser trochanter avulsion=

illiopsoas

celery stalk=

rubella

wimberger sign-

syphyllis

pediatric hot mandible on bone scan=

caffey disease

What is the pattern of physiologic growth of the newborn?

periostitis of diaphysis, femur before tibia at about 3-6mo of age

narrowing of interpedicular distance=

achondroplasia

Three features of thanatophoric dwarf=

flat vertebra, telephone receiver femurs, cloverleaf skull

bell shape thorax with short ribs=

jeune/aspyxiating thoracic dystrophy

dwarf with multiple fingers=

ellis van crevald

What is pyknodysostosis?

osteopetrosis in a dwarf with wide angled jaw

Fibula is longer than the tibia=

Osteogenesis imperfecta

congenital fusion of the cervical spine with sprengel deformity=

klippel feil

mid vertebral body beaking

Morquio

Inferior vertebral body beaking

Hurlers

Wide metcarpal bones with proximal tapering=

hurlers/morquio/hunters

anterior tibial bowing w/ pseudoarthrosis of the fibula

NF 1

Where are the four MSK signs see in Gauchers?

AVN femoral heads, H shaped vertebrae, bone infarcts, erlenmeyer flask shaped femurs

PORK=CHop

wormian bones ``` pyknodysotosis osteogenesis imperfecta rickets kinky hair syndrome cleidocranial dysostosis hajdu cheney ```

What are the kocher criteria?

``` Septic arthritis, need 3/4 positive fever inability to walk elevated ESR/ CRP WBC >12k ```

rachitic rosary, fraying/cupping of physeal margin

rickets

rickets in newborn

hypophosphatasia

scorbutic rosary

scurvy

white sclerotic metaphyseal band

lead poisoning

lucent metaphyseal band 4 ddx

leukemia TORCH neuroblastoma mets rickets/scurvy

Eye ball calc <3yo (3)

retinoblastoma CMV colobomatous

Eye ball calc >3 yo

toxo, retinal astrocytoma

dolichocephaly

sagital

trigonocephaly

metopic

brachycephaly

coronal

plagiocephaly

unilateral lambdoid

bilateral lambdoid

turricephaly