pediatric diseases ch28 Flashcards
The most common cause of respiratory distress in the nwborn is…
transient tachypnea
imaging findings of transient tachypnea are
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
list newborn respiratory distress diseases
transient tachypnea of the newborn
neonatal respiratory distress syndrome (hyaline membrane disease)
meconium aspiration syndrome
bronchopulmonary dysplasia
list childhood lung diseases
reactive airways disease/bronchiolitis
asthma
pneumonia
list soft tissue diseases of the neck
enlarged tonsils and adenoids
epiglottitis
croup (laryngotracheobronchitis)
ingested foreign bodies
transient tachypnea of the newborn occurs in ___ infants
full-term, or larger, slightly preterm
hyaline membrane disease occurs in ___ infants
premature infants
the major cause of hyline membrane disease is
surfactant deficiency
imaging findings of RDS
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
what is the most common cause of neonatal respiratory distress in postmature infants
meconium aspiration syndrome
imaging findings of meconium aspiration
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
bronchopulmonary dysplasia is a __ diagnosis
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
imaging findings of BPD
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
complications of assisted ventilation with high peak inspiratory pressure and PEEP
- pulmonary interstitial emphysema
- pneumothorax
- pneumomediastinum
- pneumopericardium
Reactive airway disease id a general term for a group of diseases in the pediatric population featuring ___, ___, and ___.
wheezing, shortness of breath, coughing
imaging findings of reactive airways disease
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
imaging findings of pneumonia
- 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
most common cause of pneumonia in neonates
group B beta hemolytic strep
most common cause of pneumonia in older infants
respiratory syncytial virus, respiratory viruses (parainfluenza, adenoviruses) and mycoplasma pneumoniae in children older than 5y
Adenoids are visible radiographically only after ….
3-6mo
adenoids can grow until about age ___
6 years and then involute through adulthood
the key imaging finding for enlarged adenoids is __
marked narrowin or obliteration of the nasopharyngeal airway on a soft-tissue lateral neck radiograph
tonsils and adenoids frequently enlarge together
The major complications of foreign body ingestion are
perforation, obstruction, stricture formation
Salter-Harris fractures type 1
- epiphyseal plate alone
- heals well
- taller, heavier boys
- difficult to notice
S-H fracture type 2
- most common
- involve epiphyseal plate and metaphysis
- heals well
- corner sign
S-H fracture type 3
epiphyseal plate, epiphysis
- seen in distal huemru and distal tibiA
- poor prognosis = premature fusion of the growth plate
SH fracture type 4
fracture of epiphyseal plate, metaphysis and epiphysis
- poorer prognosis than other
SH fracture type 5
- epiphyseal plate
- rare, crusah type
- vascular injury
- growth impairment
