Peds Chest Flashcards
neonatal –> medical resp distress –> ddx? (4)
- resp distress synd
- transient tachypnea of the newborn
- meconium aspiration
- neonatal PNA/sepsis
neonatal resp distress –> MCC?
transient tachypnea of the newborn
risk factor for TTN? (3)
- C-section
- maternal DM
- maternal sedation
TTN –> imaging appearance?
pulm edema
neonatal resp distress –> CXR demonstrates pulm edema –> ddx? (2)
- TTN
- neonatal PNA
resp distress synd –> imaging appearance?
- hazy opacities
- decreased lung vol
RDS –> intubation –> possible complication?
pulm interstitial emphysema
pulm interstitial emphysema –> imaging appearance
- hyperinflation
- many small cysts
pulm interstitial emphysema –> MOA?
barotrauma –> immature alveoli rupture –> air into interstitial space
resp distress synd –> how long does it last?
few days - 1 wk
resp distress synd –> >1wk –> what condition?
bronchopulm dysplasia (chronic lung dz of prematurity)
bronchopulm dysplasia –> definition?
36 post-conceptual wks or 28 days of life:
- abnormal CXR
- persistent O2 need
bronchopulm dysplasia –> imaging appearance?
- hyperinflate
- coarse opacities
- round lucencies
neonatal –> meconium aspiration –> pre-term or full term?
full/post term
meconium aspiration –> imaging appearance?
- hyperinflate
- ropy coarse interstitial opacities
meconium aspiration –> increased risk for? (2)
- barotrauma
- PTX
when present with resp distress?
- resp distress synd
- transient tachypnea of the newborn
- meconium aspiration
- neonatal PNA/sepsis
- resp distress synd: immed
- transient tachypnea of the newborn: immed
- meconium aspiration: immed
- neonatal PNA/sepsis: hrs-days
neonatal PNA/sepsis –> possible complication?
pneumatocele
congenital diaphragmatic hernia –> complication?
pulm hypoplasia
congenital diaphragmatic hernia –> MC location?
L Bochdalek
congenital diaphragmatic hernia –> key imaging finding?
thoracic mass –> mediastinal shift
congenital diaphragmatic hernia –> assoc condition? (3)
- malrotation
- neural tube defect
- congenital heart dz
congenital diaphragmatic hernia –> what % assoc w bowel malrotation?
95%
what are the 7 types of bronchopulm foregut malformation?
- congenital lobar emphysema
- bronchial atresia
- bronchogenic cyst
- congenital pulm airway malformation (CPAM)
- sequestration
- scimitar synd
- pulm AVM
congenital lobar emphysema –> MCC?
bronchomalacia –> airway collapse w expiration –> hyperinflate
congenital lobar emphysema –> MC lobe affected?
upper or middle
bronchial atresia –> when does it present?
adult
bronchial atresia –> pathophys?
focal obliteration of proximal bronchus –> distal bronchus filled w mucus –> hyperinfalte
bronchial atresia –> MC lobe?
LUL
bronchial atresia –> imaging appearance?
- proximal focal tubular-shaped opacity radiating from the hilum
- distal hyperlucent lung
what is congenital pulm airway malformation (CPAM)?
hamartomatous multicystic masses of segmental lung tissue with abnormal bronchial proliferation
congenital pulm airway malformation (CPAM) –> possible complicaiton?
infection
what is pulm sequestration?
aberrant lung tissue w systemic blood supply
pulm sequestration –> key imaging finding?
systemic arterial vessel
pulm sequestration –> MC lobe?
LLL
pulm sequestration –> types?
- extralobar
- intralobar
pulm sequestration –> extralobar vs intralobar –> venous drainage?
- extralobar: systemic venous drainage
- intralobar: pulm
what is scimitar synd?
partial anomalous pulm venous return: RLL pulm veins –> R atrium or IVC
scimitar synd –> assoc w what other lung finding?
R lung –> hypoplasia & hyperlucent
bronchiolitis –> imaging findings?
- hyperinflate –> flattened diaphragms
- increased peribronchial markings
what is bronchiolitis obliterans synd?
final common pathway of small ariway obstruction –> bronchiolar inflamm & peribronchial fibrosis –> luminal stenosis and occlusions
bronchiolitis obliterans synd –> assoc w what? (1)
pediatric lung & BM transplant (allogeneic)
bronchiolitis obliterans synd –> CXR appearance?
normal
bronchiolitis obliterans synd –> CT appearance? (3)
- mosaic perfusion
- peribronchial cuffing & bronchiectasis
- air trapping on expiration
bronchiolitis obliterans synd –> complication?
Swyer-James-MacLeod synd
what is Swyer-James-MacLeod synd
bronchiolitis obliterans synd –> abnormal pulm developmt –> unilat lung vol loss & hyperlucent
Swyer-James-MacLeod synd –> key imaging finding?
unilat small hyperlucent lung
Swyer-James-MacLeod synd –> MC organism etiology?
adenovirus
what is organizing pneumonia?
granulation tissue –> fill bronchioles & alveoli
what is cryptogenic organizing pneumonia?
organizing PNA of unknown cause/idiopathic
organizing pneumonia –> etiology? (3)
- infx
- drug rxn
- inhalation
organizing pneumonia –> imaging appearance?
- multifocal GGO/consolidation –> migratory
- nodules
organizing pneumonia –> multifocal consolidation –> distribution?
peripheral, peribronchovascular
what is reverse halo (atoll) sign? indicates what condition?
central lucency –> surrounding GGO
organizing PNA
unilat hyperlucent lung –> ddx? (6)
- endobronchial FB
- PTX
- Swyer-James-McLedo
- congenital lobar emphysema
- CPAM
- Poland synd
Poland synd –> synd? (2)
- unilat partial/complete absence of pect major
- hand/arm anomaly (ie short metacarpal, syndactyly)
pediatric –> ant med mass –> ddx? (3)
- normal thymus
- lymphoma
- germ cell tumor
pediatric –> middle med mass –> ddx? (3)
- duplication cyst
- neurenteric cyst
- LAD
pediatric –> post med mass –> ddx? (3)
neurogenic tumor:
- neuroblastoma
- ganglioneuroblastoma
- ganglioneuroma
what is spinnaker sail sign?
pneumomediastinum –> thymus lift off mediastinum
normal large thymus –> what age?
<5yo
scimitar synd –> synd? (3)
- partial anomalous pulm venous return
- hypoplastic R lung
- RLL systemic arterial supply
recent pharyngitis –> SOB –> CT –> mult scattered nodules –> dx?
septic emboli
recent pharyngitis –> septic emboli –> next step? why?
US neck vein –> eval for jug V thrombus (septic thrombophlebitis)
septic thrombophlebitis –> RF? (2)
- recent pharyngeal infx
- recent ENT procedure
recent pharyngitis –> septic thrombophlebitis –> next step?
CT chest –> eval for septic emboli
what is Lemierre synd?
recent pharyngeal infx –> septic thrombophlebitis + septic emboli
Lemierre synd –> septic emboli –> org?
fusobacterium necrophorum
unilat dilated jug V –> dx?
phlebectasia
phlebectasia –> MOA? stenosis? change size w Valsalva?
- idiopathic
- no stenosis
- enlrg w Valsalva
vasc malformation –> low flow –> ddx? (2)
- venous malformation
- lymphatic malformation
differentiate: venous vs lymphatic malformation –>
- imaging appearance?
- enhancemt?
- fluid level?
- phlebolith?
venous malformation:
- lrg transpatial multicystic mass
- cystic spaces –> enhance
- can fluid levels
- phlebolith
lymphatic malformation:
- lrg transpatial multicystic mass
- septa –> enhance
- can fluid levels
- no phlebolith
lungs –> hyperinflate –> #ribs?
8 post
high vol + perihilar streaky –> ddx? (2)
MNoP:
- Meconium aspiration
- Non GB neonatal Pneumonia
not high vol + granular –> ddx? (2)
- RDS
- grp B PNA
TTN –> natural course?
onset 6hr –> peak 1day –> resolved 3 day old
TTN –> lung vol?
- normal
- inc
differentiate: RDS vs B-hemolytic PNA –> CXR findings
RDS:
- low lung vol
- granular opacity
- no pleural eff
B-hemolytic PNA:
- low lung vol
- granular opacity
- pleural eff
RDS –> surfactant replacement tx –> potential complication? (2)
- pulm hemorrhage
- PDA
neonatal PNA –> non GBS –> imaging findings?
- lung vol
- opacity
- eff?
- hyperinflat
- perihilar –> patchy –> asymm
- eff
persistent pulm HTN –> MOA?
in utero high pulm pressure –> NOT decrease after birth
persistent pulm HTN –> etiology? (2)
- 1ary
- 2ary: meconium aspiration, PNA, etc
bronchopulm dysplasia –> permanent or can resolve?
can resolve