pediatric diseases ch28

Question 1

The most common cause of respiratory distress in the nwborn is…

Answer 1

transient tachypnea

Question 2

imaging findings of transient tachypnea are

Answer 2

the lungs are usually hyper inflated
there mayb be streaky perihilar linear densities
there may be fluid in the fissure and/or laminar pleural effusions

Question 3

list newborn respiratory distress diseases

Answer 3

transient tachypnea of the newborn
neonatal respiratory distress syndrome (hyaline membrane disease)
meconium aspiration syndrome
bronchopulmonary dysplasia

Question 4

list childhood lung diseases

Answer 4

reactive airways disease/bronchiolitis
asthma
pneumonia

Question 5

list soft tissue diseases of the neck

Answer 5

enlarged tonsils and adenoids
epiglottitis
croup (laryngotracheobronchitis)
ingested foreign bodies

Question 6

transient tachypnea of the newborn occurs in ___ infants

Answer 6

full-term, or larger, slightly preterm

Question 7

hyaline membrane disease occurs in ___ infants

Answer 7

premature infants

Question 8

the major cause of hyline membrane disease is

Answer 8

surfactant deficiency

Question 9

imaging findings of RDS

Answer 9

there is typically diffuse ground-glass or finely granular appereance to the lungs in a bilateral and symmetric distribution

the granularity seen in the lungs is the interplay of air-distended bronchioles and ducts against a background of atelectasis of alveoli

air bronchograms are common

hypoareation is seen in nonventilated lungs

hyperinflation excludes RDS

Question 10

what is the most common cause of neonatal respiratory distress in postmature infants

Answer 10

meconium aspiration syndrome

Question 11

imaging findings of meconium aspiration

Answer 11

the lungs are hyperinflated with diffuse “ropey” densities
there may be patchy areas of atelectasis and emphysema from air trapping
spontaneous pneumothorax and pneumomediastinum occur in 25%
there may be an associated pneumonia, usually without air bronchograms
small pleural effusions may be present

Question 12

bronchopulmonary dysplasia is a __ diagnosis

Answer 12

clinical diagnosis and has been defined as oxygen dependence at 28 days of life to maintain arterial oxygen tensions >50 mm Hg accompanied with abnormal chest x rays

Question 13

imaging findings of BPD

Answer 13

it may be impossible to distinguish early stages of bronchopulmonary dysplasia from later stages of RDS
the lungs are usually hyperaerated overall
they may contain coarse, irregular, rope-like linear densities representing atelectasis, or later, fibrosis
there areas of atelectasis may be intermixed with lucent cyst-like foci representing hyperexpanded areas of air trapping
-sponge like appereance

Question 14

complications of assisted ventilation with high peak inspiratory pressure and PEEP

Answer 14

• pulmonary interstitial emphysema
• pneumothorax
• pneumomediastinum
• pneumopericardium

Question 15

Reactive airway disease id a general term for a group of diseases in the pediatric population featuring ___, ___, and ___.

Answer 15

wheezing, shortness of breath, coughing

Question 16

imaging findings of reactive airways disease

Answer 16

peribronchial thickening : visualization of the walls of the bronchi on conventional radiographs

bronchi views on end appear as small doughnut-like densities

peribronchial thickening may also produce tram-track linear densities

• there may be hyperinflation of the lungs

atelectasis from mucus plugging

Question 17

imaging findings of pneumonia

Answer 17

• bacterial pneumonia: lobar consolidation or a round pneumonia, with pleural effusion in 10-30% cases
• viral pneumornia : interstitial infiltrates or patchy areas of consolidation suggestive of bronchopneumonia

Question 18

most common cause of pneumonia in neonates

Answer 18

group B beta hemolytic strep

Question 19

most common cause of pneumonia in older infants

Answer 19

respiratory syncytial virus, respiratory viruses (parainfluenza, adenoviruses) and mycoplasma pneumoniae in children older than 5y

Question 20

Adenoids are visible radiographically only after ….

Answer 20

3-6mo

Question 21

adenoids can grow until about age ___

Answer 21

6 years and then involute through adulthood

Question 22

the key imaging finding for enlarged adenoids is __

Answer 22

marked narrowin or obliteration of the nasopharyngeal airway on a soft-tissue lateral neck radiograph

tonsils and adenoids frequently enlarge together

Question 23

The major complications of foreign body ingestion are

Answer 23

perforation, obstruction, stricture formation

Question 24

Salter-Harris fractures type 1

Answer 24

• epiphyseal plate alone
• heals well
• taller, heavier boys
• difficult to notice

Question 25

S-H fracture type 2

Answer 25

• most common
• involve epiphyseal plate and metaphysis
• heals well
• corner sign

Question 26

S-H fracture type 3

Answer 26

epiphyseal plate, epiphysis

• seen in distal huemru and distal tibiA
• poor prognosis = premature fusion of the growth plate

Question 27

SH fracture type 4

Answer 27

fracture of epiphyseal plate, metaphysis and epiphysis

- poorer prognosis than other

Question 28

SH fracture type 5

Answer 28

• epiphyseal plate
• rare, crusah type
• vascular injury
• growth impairment