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RRC Cards > Peds > Flashcards

Peds Flashcards

1
Q

most common location of choroid plexus papilloma

A

lateral ventricle (atrium) 50%

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2
Q

most common brain tumor <1 yo

A

choroid plexus papilloma

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3
Q

genetic mutation associated with ATRT

A

SMARCB1 (22q11.2)

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4
Q

location ATRT (atypical teratoid rhabdoid tumor)

A

47% supra, 41% infra, 12% both

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5
Q

features chiari I

A

peglike cerebellar tonsils ≥ 5 mm below foramen magnum

± syringohydromyelia, scoliosis, hydrocephalus

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6
Q

features chiari II

A
  • small post fossa
  • low lying tentorium/torcula
  • pulled down brainstem w/ long, low 4th vent
  • tectal beaking
  • deficienct falx cerebri
  • brainstem kinking
  • large massa intermedia
  • cerebellar tonsils & vermis displaced down
  • myelomeningocele
  • tethered cord
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7
Q

umbilical arterial line location

A

L3-5 or T8-10

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8
Q

umbilical venous line location

A

tip at cavoatrial junction at level of hemidiaphragm

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9
Q

normal hip alpha angle

A

> 60 degrees

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10
Q

double bubble sign

A

Duodenal atresia, stenosis, web

Annular pancreas

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11
Q

normal ligament of treitz location

A

Left of spine
Same level as or superior to duodenal bulb
Posterior

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12
Q

causes microcolon

A
  • ileal atresia

- meconium ileus

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13
Q

congenital pulmonary airway malformations (CPAM)

A 
Type I: large dominant cyst, 2-10 cm 
Type II: small cysts <2cm  
Type III: microcysts 
Type IV: unlined cyst 
Type 0: lethal, global arrest lung development
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14
Q

ossification centres elbow

A 
capitellum
radial head
medial
trochlea
olecranon
lateral
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15
Q

normal end of conus

A

L2

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16
Q

normal width filum terminale

A

2 mm

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17
Q

most common cause upper intestinal obstruction

A

jejunal atresia

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18
Q

most common benign liver lesion of infancy

A

infantile hepatic hemangioma

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19
Q

second most common benign pediatric liver lesion

A

mesenchymal hamartoma of liver

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20
Q

genetic associations with hepatoblastoma

A
  • Beckwith-Wiedemann syndrome
  • Gardner syndrome
  • familial adenomatous polyposis
  • type 1A glycogen storage disease
  • trisomy 18
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21
Q

liver lesions increasing AFP

A

hepatoblastoma

HCC

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22
Q

most common pediatric hepatic malignancy

A

hepatoblastoma

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23
Q

genetic syndrome associated with duodenal atresia

A

trisomy 21

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24
Q

risk factors functional immaturity of colon

A
  • Infant diabetic mother

- Mag sulfate

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25
Q

most common location hirschprung

A

short segment rectosigmoid (73%)

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26
Q

chiari III

A

Low occipital or high cervical meningoencephalocele containing cerebellum ± brainstem, meninges, vessels, CSF
Midline bone defect within supraoccipital bone, opisthion

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27
Q

Child with cystic cerebellar hemispheric mass + enhancing mural nodule

A

pilocytic astrocytoma

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28
Q

Most common 4th ventricular neoplasm of childhood

A

medulloblastoma

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29
Q

feature to distinguish schwannoma from meningioma

A

T2 hyperintensity (meningioma hypo)

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30
Q

diffuse or hemispheric cerebellar mass

thickened folia w/ striated appearance

A

Dysplastic Cerebellar Gangliocytoma (look for cowden)

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31
Q

most common branchial cleft cyst

A

2nd - angle of mandible

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32
Q

1st branchial cleft cyst location

A

in or near parotid

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33
Q

3rd/4th branchial cleft cyst locations

A

lowest point pyriform sinus, extend to thyroid lobe (4th)

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34
Q

genetic syndrome associated with lymphatic malformation neck

A

turners

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35
Q

most common soft tissue sarcoma of childhood

A

rhabdomyosarcoma

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36
Q

swyer james syndrome

A

Acquired unilateral pulmonary hypoplasia (postinfectious bronchiolitis obliterans)
Small, hyperexpanded lung with relative decrease in vascularity

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37
Q

leptomeningeal cyst

A

aka growing skull fracture in <3 yo

traumatic tear of the dura allows leptomeninges ± brain parenchyma to herniate into skull # or suture

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38
Q

abdominal tumors in Beckwith-Wiedemann

A

Wilms
hepatoblastoma
nephroblastoma
adrenal cortical carcinoma

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39
Q

DiGeorge syndrome

A

22q11. 2 deletion syndrome
- malformation of 3rd/4th pharyngeal pouches: thymic & parathyroid aplasia
- CHD: ToF, TA, interrupted aortic arch
- cleft lip ± palate
- facies: elongated face, short philtrum, facial asymmetry, prominent nose
- decreased immunity
- learning disability

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40
Q

WAGR syndrome

A 
11p13 mutation:
Wilms tumors (greatly incr risk)
aniridia (complete/partial absence of the iris)
genitourinary abN
retardation
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41
Q

TORCH infections

A 
toxoplasmosis
other (syphilis, varicella-zoster, parvovirus B19)
rubella
cytomegalovirus (most common)
herpes simplex virus
42
Q

respiratory distress syndrome

A 
aka hyaline membrane disease
preterm
bilateral, symmetrical
granular, ground glass
*decreased lung volumes
complications: bronchopulmonary dysplasia
43
Q

transient tachypnea of newborn

A 
C-section
bilateral, symmetrical
diffuse airspace
fluid in fissure, pleural effusion
hyperinflation
44
Q

meconium aspiration

A

neonatal distress, meconium
bilateral, symmetrical
coarse, ropey, pleural effusion
hyperinflation

45
Q

neonatal pneumonia

A

O2 requirement, inflam markers
unilateral, asymmetric: airspace opacities, patchy/confluent
perihilar streaky

46
Q

Ebstein anomaly

A
  • at birth
  • cyanotic
  • very large heart
  • right to left shunt (decreased vascularity)
47
Q

hypoplastic left heart

A
  • pulmonary venous congestion (not shunt)
  • neonatal
  • needs correction to live
48
Q

ASD

A
  • enlarged pulm arts (left to right)
  • acyanotic
  • can present late
49
Q

tuncus arteriosus

A
  • enlarged pulm arts (left to right)

- cyanotic (present early)

50
Q

pulmonic stenosis cxr

A
  • post-stenotic dilation of main and left pulm art

- 2/2 direction post-stenotic jet

51
Q

Weigert Myer Law

A

in complete ureteral duplication:

  • upper moiety inserts more medial and caudal
  • lower moiety more lateral and cephalad
52
Q

risk factors for developmental hip dysplasia

A

mechanical factors that reduce in utero space and movement:

  • first-born status
  • large fetal size
  • oligohydramnios
  • breech positioning

also females & infants with FHx of DDH

53
Q

epiphyseal equivalents

A

bones considered similar to epiphyses and have a similar list of diseases:

  • patella
  • calcaneus
  • carpal bones
  • greater and lesser trochanters
  • most apophysis
54
Q

asplenia: lung association

A

bilateral trilobed lungs with bilateral minor fissures

bilateral eparterial bronchi

55
Q

polysplenia: lung association

A

bilateral bilobed lungs with no minor fissures

bilateral hyparterial bronchi

56
Q

achondroplasia: spinal findings

A
  • progressive ↓ in interpedicular distance in L spine
  • posterior vertebral body scalloping
  • gibbus deformity of T-L junction
  • anterior vertebral body beaking or wedging (bullet-shaped)
  • ↑ lumbosacral lordosis
57
Q

hypertrophic pyloric stenosis

A

muscle >3 mm thick
pyloric channel >17 mm long
persistent delayed emptying

58
Q

normal postnatal AP renal pelvic diameter

A

<10mm

(measure after 48h of birth d/t dehydration)

(prenatal at 16-27 weeks: <4mm
prenatal at >28 weeks: <7mm)

59
Q

bilateral urinary tract dilation in male infant

A

posterior urethral valve until proven otherwise

need renal ultrasound and VCUG

60
Q

prune belly syndrome - triad

A

cryptorchidism
urinary tract anomalies
hypoplastic or absent abdominal wall musculature

-almost exclusively males

61
Q

airspace opacities + pneumothorax in a term infant

A

meconium aspiration

AIRP

62
Q

screening interval for Wilms tumour in Beckwith-Wiedemann and WAGR syndromes

A

US every 3 months until age 8-10 years

(NCI 2020)

hypothesis: tumour will be detected at a lower stage

63
Q

bone metastasizing renal tumour of childhood

A

clear cell carcinoma

Wilms doesn’t go to bone

64
Q

most common renal tumour in neonates

A

mesoblastic nephroma

mimics Wilms which presents 6mo-4yr

65
Q

screen which infants for IVH using US?

A

preterm <32 weeks
birth weight <1.5 kg

1st screening US: 4-7 days after birth

66
Q

caudal regression syndrome - 2 groups

A

group 1: more severe caudal dysgenesis with high-lying (above L1), blunt/club-shaped cord terminus
group 2: less severe dysgenesis with low-lying, tapered, distal cord tethered by tight filum, lipoma, lipomyelomeningocele, or terminal myelocystocele

67
Q

associations with chiari II

A
  • neural tube defect (myelomeningocele)
  • dysgenesis corpus callosum
  • grey matter heterotopia
  • absent septum pellucidum
  • syringohydromyelia
  • vertebral anomalies
68
Q

pediatric moyamoya presentation (vs adults)

A
  • stroke
  • adults = bleed
  • early childhood and 5th decade bimodal peak
  • east asians
  • vasculopathy (radiation, trisomy 21, NF1, sickle)
69
Q

copper beaten skull association

A

increased ICP

  • craniosynostosis
  • obstructive hydrocephalus
70
Q

luckenschadel skull associations

A

chiari II malformation/neural tube defects

71
Q

Ddx wormian bones skull

A 
PORK CHOP
Pyknodysostosis
Osteogenesis imperfecta
Rickets
Kinky hair syndrome

Cleidocranial dysostosis
Hypothyroidism/Hypophosphatemia
One too many 21 chromosome
Primary acro-osteolysis (Hajdu Cheney)

72
Q

piriform aperture stenosis associations

A
  • choanal atresia
  • mega incisor
  • midline brain defects –> face predicts brain (CC genesis, holoprosencephaly)
  • hypothalamic-pituitary-adrenal axis dysfunction
73
Q

timeline pulmonary interstitial emphysema & chronic lung disease of prematurity

A

PIE: first week of life
CLD: after 3-4 weeks postnatal

74
Q

congenital diaphragmatic hernia associations

A
  • congenital heart disease
  • malrotation

MC is bochdalek, but right side associated w/ GBS pan

75
Q

associations of intralobar and extra lobar sequestration

A

intralobar: recurrent infections (older kids)
extra lobar: congenital anomalies (younger kids)
CPAM, diaphragm hernia, vertebral anomalies, congenital heart disease, pulmonary hypoplasia

76
Q

classic predilection of RSV pneumonia

A

segmental or lobar atelectasis, particularly RUL

77
Q

1 & 2 GI duplication cysts

A 
#1 distal ileum
#2 esophageal
78
Q

more common in kids? Hodgkins or NHL

A

Hodgkins 4x

involves thymus 90% of time

79
Q

klinefelters at risk for which cancers?

A

300x risk germ cell tumor

male breast cancer

80
Q

VACTERL

A 
Vertebral anomalies 37%
Anal, imperforate 63%
Cardiac 77%
TE fistula or esophageal atresia 40%
Renal 72%
Limb 58%
81
Q

associations of malrotation

A

heterotaxy syndromes

omphaloceles

82
Q

max pressure reducing intussusception

A

120 mm Hg

83
Q

contraindications to reducing intussusception

A

free air

peritonitis

84
Q

associations with omphalocele

A 
trisomy 18 (MC)
cardiac (50%)
GI, CNS, GU
Turners
Klinefelters
Beckwith-Wiedenmann
Pentalogy of Cantrell
Umbilical cord cysts (allantoic cysts)
85
Q

Pentalogy of Cantrell

A
  1. omphalocele
  2. ectopia cordis (abN location heart)
  3. diaphragmatic defect
  4. pericardial defect or sternal cleft
  5. cardiovascular malf’ns
86
Q

Associations with biliary atresia

A

polysplenia

trisomy 18

87
Q

Right sided heterotaxy

A
  • two fissures left lung
  • asplenia
  • increased cardiac malformations
  • reversed aorta/IVC
88
Q

Left sided heterotaxy

A
  • one fissure right lung
  • polysplenia
  • less cardiac malformations
  • azygos continuation of IVC
  • 10% biliary atresia
89
Q

age pancreatic mass

A

1 yo - pancreatoblastoma
6 yo - adenocarcinoma
15 - SPEN

90
Q

management of nephroblastomatosis

A

USS screening for Wilm’s q3month until 7-8 yo

91
Q

wilms

A

never biopsy
never before age 2 months
5-10% bilateral

92
Q

locations % neuroblastoma

A

adrenal 35%
retroperitoneum 30%
posterior mediastinum 20% (better outcome than abdominal)
neck 5%

93
Q

stage 4S neuroblastoma

A

<1 yo
distal mets to skin, liver, bone marrow
excellent prognosis

NOT cortical bone

94
Q

wimberger sign - syphilis

A

destruction medial portion proximal metaphysis of tibia

95
Q

normal alpha angle hip

normal acetabular angle hip

A

> 60 degrees

<30 degrees

96
Q

Kocher criteria

A

septic arthritis vs transient synovitis

  1. fever
  2. inability to walk
  3. elevated ESR/CRP
  4. WBC >12K
    - 3/4 = septic
    - -ve CRP and weightbear ≠ septic
    - CRP strongest indicator septic
97
Q

Bugs:
Epiglottitis
Croup
Exudative tracheitis

A

H flu
Parainfluenza
Staph A

98
Q

Normal pre vertebral soft tissues

A

< 6 mm C2

>22 mm at C6

99
Q

% contra lateral abnormalities in px with MCDK

A

40%

100
Q

vein of galen malformation types

A

choroidal (worse): complex networks of AV connections, ++ shunting, high output heart failure, hydrocephalus, present at birth

mural: fewer connections, less shunting, present in infancy/childhood, hydro or developmental delay

101
Q

canavan’s disease

A

NAA peak

  • deficiency of aspartoacylase
  • NAA accumulates in mitochondria, impairing myelin synthesis

RRC Cards (17 decks)

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