peds MA Flashcards
nonrotation
RT: SB. LT: LB b( similar to post ladd band)
180 degree rotation only.
Rx; Sx IF S&S
Intussuption
adult: 90% mechanical
Intussuption
both air & water reduction can be used. air: cleaner, safer, less rad. try 3-5 times/3-5 min each.
malrotation
volvulus/ 1st mo.
short mesentry RF for intermittant/partial vol and early ppt
1ry mega ureter
aperistlatic segment of the ut. RX: proph ABX. if recurrant UTI: SX
Muconium plug
premature. DX. MG sulfate. contrast enema is Dx and RX
HPS measurement
outer to the inner edges of the muscular layer. ONLY MS
bowel rotation
90 clockwise, then 270 counterclockwise
SG teratoma
- arise from the coccyx. CALC ++.
- RARELY invade the spinal canal or cause bony destruction.
- < 2YO: 10% malg. >2yo: 90% malg.
windsock deformity
- DU diverticulum
- DU web
look up pic
Imperforated anus fistula with
- all imp. anus has fistula
- all low ones > w/ perineum
- high ones: M: Bl/ urethra. F: vagina/vestibule
mcc of non adenxal tumor in female kids
Rhabdomyosarcoma
HP diz ass w/
Tri21.
Esoph dysmotility
NB.
Carneys complex
myxoma endocrine ab. skin pig shawanoma calc testicular mass
carney traid
Pul. chondroma
GIST
extradrenal parag
enteric duplication study nuke study
Tc=99 per ( mekle scan) +ve gastric mucosa
hepatoblastoma ass w/
Beckwith weidman GSD Gardner FAP Tri18
NEC acute MX
free air: Sx
no free air: rest, ABX, AXR
NEC long term MX
enema to eval for stricture
Chonal atresia
90% bony.
DiGoerge. CHARGE. Fetal Etoh syn.
piriform aperture stenosis ASS W/
chonal atresia mega incisor small triangular hard palate/ defect CC agnesis, holoproscnchepahly H-P-A ab
Ca in TGD cyst
PTC.
the cyst is ANT. to hyiod bone. can be paramedine. mass effect on thyriold lobe .
neck mass dil with valsalva
phlebectasia
MMC H&N CONG mass in infancy
Hemang ( start 6 mo ) involute 6-10 yr
NO RX.
B-blocker if needed
MMC H&N mass in infancy
FC of SCM.
4 wk.
no calc
MMC mass in the masticator space.
MMC malg in extra ocular space in kids
RM sarc
MMC B9 orbital lesion in kids
dermoid. PIC plz
MMC mass in the tarcch
SG hemang. LT > RT
MMC of death in premature
SSD.
CLD vs PIE
TIME
PIE: 1 wk
CLD= BPD = 3 wk. low vol.
IL seq vs EL
IL: adult, mmc one, LLL. PNA.
EL: infancy. less common. RS compromise. ass w/ anomalies.
they look cystic, high on T2. hetro. could be Sub diagh or RP
Rx of CPAM and CLE
Sx
Neonatal atypical peripheral atelectasis
periphral, upper lobe.
PBL ass w/
MLCN
brain, bone mets
1-2 YO
< 1 YO»_space;> cystic
MMC ant, med mass in kids
1st lymph HL.
2nd teratoma
MMC mass in the post. med < 10
NB
TEF mmc one
type 1: N type
2nd: type 2: atresia only
H type is type 3
HPS
paradoxical aciduria.
look for GB as a landmark
meonium ileus
low T2 fluid
mottled app in AXR
calc in US
muconium filled pseudocyst ( calc )
appy
outer diamter
gastroschesis
oilgo. high AFP.
gd outcome.
omphalocele ass w/
TRI 18 is the mmc one.
shawshman diamond syndrome
diarrhea panc insuff eczema short fatty panc
FL HCC on nuke
Ga-67 avid
calc > HCC
Biliary atresia ass w/
Tri18. polysplenia
only extrahepatic atresia. prolif of the intra ones.
Kasai procedure then LTX.
Allegile synd
fatty liver. PA stenosis. no atresia
RT hetrotaxy
2 fissures
asplenia
IVC > LT.
CVS anomalies
LT hetrotaxy
one fissure. poly SP. azygous. less CVS
horseshow kid ass w/
TCC
carcniod
Wilms
MCC prenatal hydro.
MCC Cong anomaly of GU in neanonate
UPJ obs.
neonatal RVT
maternal DM
Kid is big
neonatal RAT
UAC»_space; sever HTN
NB orders
Ad > RP > P. med
MMC of Idiopathic scrotal edema
HSP
PJS + testicular mass
Sertoli.
can present with burned out tumor. calc
AML ass w/
NF
TS
VHL
F:M: 4:1
both renal agensis and CF ectopia
M>F
spinning top urethra
bladder contraction > increse Ur sphincter tone > voiding dysfun.
look up pic
Clear cell sarcoma
2 YO. male.
hilum.
mmc mets to ipsilat hilum. bone > lung.
CTX SX.
Most relaible predictor factor in CDH
liver heniation.
worse Px: RT, liver heniation, lung volume
MMC of Round PNA
S. pneumonia
5-12 YO.
FU CXR. not CT.
Hallar index
MAX TRV diam/ AP dima of the chest. WNL 2.5. > 3.5 > Sz
assess severity of pectus excavatum.
Sx; Nuss procedure: retro sternal
Poland Syn mc ass w/
Syndactyl
Intracranial lipoma ass w/
ACC.
ACC > CC hypoplasia
When Pineal G. ca
> 7 YO > WNL
< 7 YO Ca ??
MMC pineal mass in children
tectal plate glioma
MMC pineal masses in adult
glioma
meningoma
MMC S&S of TS
CNS
2nd GU
ass w/ ADPKD. RCC
MX of V of galen AVM
Rx CHF. and Emblization.
MCL of EG in kids
Skull
Adult: ribs
MMC of B9 H&N ca
JNA
MML of TGD cyst
INFRAHYOID
Caudal regression syndrome ass w
maternal DM
polyhydro
anal atresia
OM < 4 YO pathogen
Kingella Kingae»_space; attack cartilage
little BM edema
ALL Lat Condyler fracture type
SH IV..
MMC 5-10 YO
Chronic recurrant multifocal OM CRMO
children.
Long bones, metaphysis. clavicle. BM edema. lytic lesions on XRAY.
CRMO ass diz
WG. IBD. Takaysu Pyderma gangrnosa Psorasis Majeed SAPHO syndrome
OSD of the Capitllaum
seen in the throwers. Radial head subluxation.
MC fracture = Bucket handle #
shearing forces
NAT protocol
AP of UL. LL AP, lat, Obl of chest AP Abd AP and lat: skull LAt Lumber
Anomalies associated with extralobar sequestration
Congenital diaphragmatic hernia Diaphragm eventration Congenital cystic adenomatoid malformation Bronchogenic cyst Foregut duplication cysts Pectus excavatum
the most common cause of acute testicular pain in children younger than 12
Test apge torsion. located btw Epi and sup testicle
Conservative management includes bed rest, scrotal elevation, ice, nonsteroidal anti-inflammatory drugs, and analgesics. The inflammation and pain usually resolve within one week.
A first branchial cleft cyst occurs where ?
adjacent to the parotid gland or near the external auditory canal,
MMC SH fracture
type II
type III, IV and V»_space; poor Px. needs Sx.
Sinding Larson Johnoson injury
Ch. traction injury of the Pattela tendon at the patella insertion.
In active kids and CP pt .
MC avulsion injury of the elbow
Medial epicondyle fractures
but mmc fractures Supracondyler > lat condyle > medial EPI.
MC disorder of the hip of growing children
transient synovitis.
small effusion. C+
Strongest independent Px factor for septic arthritis
CPR.
If Kocher triad > 2»_space;> tap it. no MRI
CPR. WBC>12. fever. no wt bear
Celeray stralk DDx
CMV.
Rubella
Syphlilis
Osteopathia straita
Wimberger sign
Cong Syphliis. passage mark
destruction of the medial prox tibia metaphysis.
Caffey diz = infantile cortical hyperostosis
rare. self limited
STx swellwing. Periost reaction. irritabilioty.
Hot mandible on bone scan
physiologic periostitis of the new born
3 mo - 6 mo
femus then tibia
only diaphysis
renal mass > 8 YO
RCC
supracondyler humerus fracture with hyperfelxtion
ulnar nerve injury > FCU injury > poor wrist adduction and felxion
Guasher
HSM AVN of femoral head H-shaped VB. bone infarcts Erlenmeyer flask deformity o fth efemur
NF1 in MSK
ant bowing of the tibia or radius.
Pseudo-arhtreosis of the ulnar or Fiblua
Type II PA sling ass w/
Trach stenosis
low lying carina T5-T6
T shaped Trachea
bridging broncus
type I Cong Extrahepatic Portosys shunt
absent PV poly Sp CHD mal rotation high in F
type II Cong Extrahepatic Portosys shunt
PV is present. less anomalies M = F
Circum aorta
cross CL side. post to TR and ESOP
A vascular ring > ligamentum arteriosum connects the descending aorta to the pulmonary artery.
MCC of distal VP shunt obstruction
CSF pseudocyst
Most SN and SP signs of raised ICH
flat post. globe
MCC CNS manifestation of LCH
D.I
supratentorial ependymoma
frontal lobe
paranchymal
very bright on T2. Cystic component
Semi lobar Holoprosencphaly
tempral lobe cleavage.
Lobar Holoprosencphaly
fusion of the frontal lobe. sepration of the T.L. presence
of the splenium of CC
Mega Cisterna Magna
> 10 mm on prenatal US. look for the cerebeulm falx to differ from arachniod cyst
small left colon syndrome
a long filling defect extending from the descending to rectosigmoid colon, consistent with a meconium cast.
DM mom
premature infants.
Alexander disease.
extensive T2-hyperintense signal in the bifrontal white matter. The frontal involvement
macrocephaly
Canavan disease
diffuse involvement of the white matter.
macrocephaly
elevated NAA
X-linked adrenoleukodystrophy
involvement of the parieto-occipital white matter.
M>F
Krabbe disease
periventricular white matter with sparing the subcortical U-fibers
metachromatic leukodystrophy
a tigroid pattern of involvement of the periventricular and deep white matter.
most common hereditary leukodystrophy.
rhomboencephalosynapsis.
absence of the vermis with fusion of the cerebellar hemispheres.
Aqueductal stenosis and ventriculomegaly, necessitating ventriculoperitoneal (VP) shunt placement.
Gastroschisis Dx when ?
cannot be diagnosed before 12 to 13 weeks gestational age, as physiologic gut herniation occurs from 8 weeks to approximately 10 to 11 weeks
- young maternal age.
Blount diz:
medial meniscus hypertrophy
medial tibial epiphyseal cartilage hypertrophy
FN brain death study
skull fracture
VP shunt
open fontanel
touniquent > FP study
Sturge-Weber
sporadic
make sure it is calc not vessels on NECT
Mueller-Weiss syndrome.
Osteonecrosis of the navicular in adults
Peds: Kohler
Cerebral arteriovenous malformations
most commonly seen as solitary lesions.
There is no gender predilection.
Hemorrhage is the most common presentation.
most commonly supratentorial, not infratentorial.
They may cause vascular steal and cerebral ischemia.
osteogenesis imperfecta on prenatal ultrasound include
long bone fractures, polyhydramnios, and the ability to compress the calvarium when pressure is applied.
Type II osteogenesis imperfecta is the most severe form of the disease and is often lethal in utero. The severe hypomineralization of the calvarium is compatible with type II
Rx induced Cavernoma
15%
A duplicated collecting»_space; incontinence in ?
ncontinence in females. not male
common cong anomaly
bladder exstrophy.
Bladder exstrophy is associated with an increased risk of bladder malignancy, which is usually adenocarcinoma. Bladder exstrophy is more common in males and is associated with elevated alpha-fetoprotein (AFP) on the maternal quad screen. It may be suspected on fetal ultrasound when there is nonvisualization of the fetal bladder or a low-lying cord insertion; however, as low as 25% of patients with bladder exstrophy are diagnosed antenatally. Amniotic fluid volumes are typically normal in bladder exstrophy.
choroid plexus cyst.
trisomy 18.
The majority of choroid plexus cysts are benign and seen in isolation; however, they are often seen in tri18. Visualization of choroid plexus cysts in utero should prompt further evaluation for other abnormalities.
The perchlorate test
If iodine is not organified, giving perchlorate after I-123 serves as a competitive inhibitor and I-123 will “wash out.” If organification is normal, there will not be substantial washout of I-123 from the thyroid after perchlorate is given.
Hepatoblastoma
associated with low birth weight.
Stage I disease typically has an excellent prognosis.
AFP is elevated in approximately 90%, not 50%, of cases.
Low AFP levels are associated with anaplastic histology and poor outcome.
Hepatoblastoma has a slight male predominance.
PHACE syndrome
posterior fossa malformations, hemangiomas, arterial anomalies, coarctation of the aorta, eye abnormalities.
The most common locations affected by rickets are
the distal femur, proximal tibia, distal radius and ulna, and anterior ribs.
nerve injury ass w/ flexion type supracondyler fracture
ulnar nerve»_space; FCU
week felxion & adduction
this injury happened from falling on elbow.
but FOOSH»_space; extension type supracondyler frcature»_space; brachial a injury
lissenchephaly RF
CMV, toxin, genetic
only 4 layers.
schiznecephaly have similar RF. ass w/ others
how to tell lissenchephaly from cortical band hetrotopia
lissenchephaly > male if double very close to each others
cortical band heterotopia > Female. the inner layer thicker than the cortical layer
what is Blake pouch cyst ?
inferior cyst results in upward and post rotation of the vermis\
normal vermis
normal torcula ( normal in mega CM and arachniud cyst)
falx cerebelli seen with mega CM not Arach cyst
central neurocytoma on MRI
bubbly
cystic
hge
calc
scurvey
subperiosteal hge
periosteal reaction
ab metaphdeal BM SI that resolves post Rx. low T1 high T2. bcz it is prone to tru 2/2 to collagen type I def
BG cyst loc
Mid or post med.
no communication
V of galien malform consist of what
cholliodal a
median prosenchepahlic v
what is b/l focal femoral deficiency ?
b/l short femur
abscent femoral epiph
suprolat disloc
double arotic arch ass w/
Rt dominance. low CHD
antismooth muscle antibody positive in ?
primary sclerosing cholangitis
least Sp typeof hge ass w/ NAI?
EDH
dominat interaction in CXR, AXR?
CS
mesoblastic nephroma paraneaplastic syn ?
High Ca and HTN
