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CORE--Peds > Pediatric Chest > Flashcards

Pediatric Chest Flashcards

1
Q

4 main causes of respiratory distress in newborns

A

TTN, neonatal respiratory distress, meconium aspiration, nenatal pneumonia/sepsis

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2
Q

What is bronchopulmonary dysplasia?

A

chronic lung disease of prematurity, after RDS that persists at 28 days of life or persistent need for O2 at 36 post conceptual weeks

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3
Q

Imaging findings of TTN

A

pulmonary edema, fluid in minor fissure

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4
Q

Imaging findings of RDS/hyaline membrane disease

A

hazy pulmonary opacities with air bronchograms, low lung volumes

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5
Q

Imaging findings of pulmonary interstitial emphysema

A

RDS with barotrauma, small cysts with hyperinflated lungs; look for pneumomediastinum/pneumothorax

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6
Q

Most common cause of chronic respiratory failure in pediatrics

A

bronchopulmonary dysplasia

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7
Q

Imaging findings of BPD

A

coarse interstitial opacities and increased lung volumes

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8
Q

Imaging findings of meconium aspiration

A

ropey, coarse interstitial opacities; pneumothoraces

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9
Q

Congenital diaphgragmatic hernia, common side?

A

Left posterior defect diaphragm (Bochdaleck), pulmonary hypoplasia; right side less common, poorer prognosis, liver hypoplasia

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10
Q

Imaging findings of CDH

A

herniation of bowel into thorax, rightward shift of mediastinum; bowel may initially be solid at birth/no air

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11
Q

Associations of CDH

A

bowel malrotation, neural tube defects, congenital heart disease

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12
Q

Brochopulmonary foregut malformations

A

Anomalous budding of the foregut and tracheobronchial tree (affects vasculature/pulmonary parenchyma); Major types include: congenital lobar emphysema/overinflation, bronchial atresia, bronchogenic cyst, CPAM, sequestration, scimitar syndrome, AVM

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13
Q

Cause of congenital lobar emphysema

A

lobar air trapping most commonly due to bronchomalacia; usually symptomatic in first 4 weeks/6 months when detected

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14
Q

Most common lobe affected with CLE

A

LUL, then RML and RUL

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15
Q

Imaging findings of CLE

A

preinatal: CLE fluid filled –> lucent then with lobar hyperexpansion causes mass effect on structures

Differentiate from pneumothorax as a chest tube will only make it worse

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16
Q

Treatment for CLE

A

lobectomy in symptomatic cases

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17
Q

Patient presentation with CLE

A

neonatal respiratory distress, progressive; decreased breath sounds on affected side; hyperresonant hemithorax; diagnosed in first 6 mo

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18
Q

Bronchial atresia

A

atresia of a subsgemental, segmental, or lobar bronchus; distal mucus impaction and hyperinflation

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19
Q

Imaging findings bronchial atresia

A

ovoid/tubular mucocele and focal pulmonary hyperlucency

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20
Q

Commonly affected region for bronchial atresia

A

LL; usually incidentally found in adults

21
Q

Finger in glove sign

A

tubular branching mass with hyperinflated distal lung; key for bronchial atresia

22
Q

CPAM/CCAM

A

congenital pulmonary airway malformation or congenital cystic adenomatoid malformation; hamartomous proliferation of termile bronchioles that communicate with bronchial tree

23
Q

Imaging findings CPAM

A

multiple cysts of variable size; air fluid levels in cysts and variable cyst wall thickness; fluid filled at birth, gradually aerate; 5 histopathological types

24
Q

Arterial supply of CPAM

A

pulmonary circulation; different than sequestration (systemic circulation)

25
Q

Classification system for CPAM

A

Stocker classification; 5 types; Type 0 (fatal) to Type 4; prognosis depends on size, not classification system

26
Q

CPAM treatment

A

dependent on symptoms, usually surgical resection;

27
Q

Pulmonary sequestration, functionality,d a9IQ65 blood supply and location, most common type

A

aberrant nonfunctional lung tissue with system blood supply from aorta, no connection to bronchial tree; commonly LLL and intralobar > extralobar

28
Q

Intralobar vs extralobar bronchopulmonary sequestration

A

Intralobar more common; inside plura with pulmonary venous drainage
Extralobar: separate pleural investment with systemic venous drainage; can mimic adrenal mass if below the diaphragm

29
Q

Scimitar syndrome, hypogenetic lung syndrome, pulmonary venolobar syndrome

A

partially anomalous pulmonary venous return from RLL pulmonary veins into right atrium/IVC vs TAPVR in which all four pulmonary veins return blood to right atrium

30
Q

Imaging findings of scimitar syndrome

A

Commonly RLL; Scimitar vein on XR, hyperlucent and hypoplastic RLL; partial anomalous pulmonary venous return into infradiaphgragmatic IVC

31
Q

Types of small airway disease

A

bronchiolitis, BOS, BOOP, bronchiectasis

32
Q

Common cause of bronchieolitis

A

RSV; small airway obstruction by inflammation/necrotic debris

33
Q

XR findings of bronchiolitis

A

hyperexexpanded lungs (flattening of diaphragm) and increased peribronchial markings

34
Q

Bronchiolitis obliterans syndrome or constrictive bronchiolitis

A

small airway obstruction with submucosal and peribonchial fibrosis with luminal stenosis/occlusions; may be post-transplant, postinfectious, or due to toxin/drug exposure; associated with IBD, RA, Swyer James syndrome

35
Q

Imaging findings of BOS

A

CXR normal or with hyperinflation

CT: air trapping, mosaic perfusion, bronchiectasis and bronchial wall thickening

36
Q

Swyer James MacLeod Syndrome

A

unilateral small hyperlucent lung with volume loss; postinfectious BOS complication

37
Q

Typical trigger for Swyer James

A

adenovirus –> BOS –> SJ

38
Q

Cryptogenic organizing pneumonia, bronchiolitis (COP), previously Bronchiolitis obliterans organizing pneumonia (BOOP),

A

filling of bronchioles and alveoli with granulation tissue polyps

39
Q

Imaging findings of COP

A

multifocal migratory consolidations, GGO, nodules

40
Q

Atoll or reverse halo sign

A

central lucency surrounded by ground glass; organizing pneumonia finding

41
Q

Bronchiectasis

A

bronchial dilation, inflammatory

42
Q

Causes of bronchiectasis

A

CF, allergic bronchopulmonary aspergillosis, post infectious, tracheobronchomegaly (Mounier-Kuhn), aspiration, intralobar sequestration (recurrent infections)

43
Q

Signt ring sign

A

enlargement of bronchiole, which is larger than adjacent pulmonary artery

44
Q

Poland syndrome

A

AR of congenital absence of pec major. Associated with anomalies of hand, short metacarpals, syndactyl (joined fingers)

45
Q

Spinnaker sign/angelwing sign

A

thymus lifted off mediastinum by ectopic air

46
Q

Pediatric anterior mediastinal masses

A

thymus (rebound), lymphoma, germ cell tumor, thymoma

47
Q

Pediatric middle mediastinal mass

A

foregut duplication cyst, neurenteric cyst (vertebral anomalies), lymphadenopathy

48
Q

Pediatric posterior mediastinal masses

A

neurogeic tumors (neuroblastoma, ganglioneuroblastoma, ganglioneuroma)

CORE--Peds (7 decks)

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