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Year 4 Child Health > Radiology > Flashcards

Radiology Flashcards

1
Q

why are babies and children poor subjects for CXR

A

inadequate inspiration and rotation may falsely simulate disease

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2
Q

what must you be aware of in CXR of babies and children

A

thymus

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3
Q

features of the thymus on CXR of children

A

visible on CXR up to 2 years
often massive in neonates - particularly if unwell
can simulate mediastinal mass or lung opacity
has angel wing morphology
sometimes nodular

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4
Q

common causes of neonatal respiratory distress

A

transient tachypnoea of the newborn
surfactant deficiency
pneumonia
meconium aspiration

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5
Q

after which gestation is surfactant deficiency rare

A

> 36/40

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6
Q

CXR features of surfactant deficiency/respiratory distress syndrome/hyaline membrane disease

A 
onset within a few hours 
small volume lungs (bell shaped thorax)
diffuse granular opacification 
bronchograms 
ventilation related air leaks
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7
Q

what is TTN

A

slow clearing of pulmonary fluid

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8
Q

onset and duration of TTN

A

onset within 24 hours of birth

clears in 1-2 days

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9
Q

CXR findings of TTN

A

normal/overinflated lungs
interstitial lines and pleural effusions
fluid in fissures
air space opacification
looks like pulmonary oedema you would see in adults

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10
Q

onset of meconium aspiration

A

onset at birth- must ask if there was meconium at birth in the history

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11
Q

CXR findings of meconium aspiration

A

patchy opacities
overinflated lungs
air leaks
atelectasis

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12
Q

onset of neonatal pneumonia

A

from birth to several weeks

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13
Q

CXR findings of neonatal pneumonia

A

patchy opacities
overinflation
atelectasis

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14
Q

what is the correct tip position for an ET tube in a neonate

A

2cm above the carina at about T2-3

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15
Q

what happens if you put an ET tube too far down

A

it can end up in one main bronchus resulting in the non ventilated lung collapsing

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16
Q

neonatal CXR are obtained supine/erect

A

supine

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17
Q

where does air accumulate in neonatal pneumothorax

A

anteriorly rather than superiorly, in lateral costophrenic sulci
not over lung apices

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18
Q

features of pneumomediastinum

A

air may outline the heart, thymus and mediastinal vessels

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19
Q

what is the correct position for the tip of a neonatal NG tube

A

stomach

20
Q

where should the tip of an umbilical vein catheter be

A

at or just above the right hemidiaphragm

21
Q

where should the tip of an umbilical artery catheter be

A

lower lumbar in the aorta (L3-4) or above the central branches of the aorta

22
Q

what are common causes of respiratory symptoms in infants (1-4yr)

A

viral - bronchiolitis
bacterial pneumonia
inhaled foreign body

23
Q

CXR signs of bronchiolitis

A

overinflated lungs / normal
perihilar haze
scattered atelectasis
rarely - diffuse opacifications

24
Q

CXR signs of bacterial pneumonia

A

fluffy consolidation with air bronchograms
rounded, lobar or multifocal patterns
effusion
pneumatocele / pneumothorax

25
Q

is radio opaque seen easily on CXR

A

no

radiolucent objects are

26
Q

a coin in the trachea would orientate in the sagittal/coronal plane

A

sagittal

27
Q

how can you tell which lung has the inhaled foreign body

A

the affected lung would be lucent due to air trapping

28
Q

Role of imaging for childhood UTI

A

identify structural abnormalities that could predispose to UTI
exclude vesico ureteric reflux
quantify renal scarring from previous UTI

29
Q

all children under which age should get an USS for UTI

A

<6 months

4 months later they get a VCUG and renogram if US abnormal

30
Q

what should be done in the case of suspected NAI

A

skeletal survey

31
Q

what would an isotope bone scan show in the case of NAI

A

increased osteoblastic activity due to healing fractures

32
Q

skeletal injuries that are suspicious of NAI

A

metaphyseal corner # (as a result of twisting)
posterior / lateral rib #
multiple # in different healing stages
sternal, scapular and spinous process #
spinal injuries with no clear history
any fracture in a baby who is too young to walk or crawl

33
Q

fracture patterns specific to children

A

buckle #
greenstick #
plastic bowing
growth plate injury

34
Q

childrens bones are soft/hard in comparison to adults

A

soft therefore bend or bow instead of snapping

35
Q

in children the physis is lucent and so may mimic a #, true or false

A

true

36
Q

what classification is used for growth plate fractures

A

salter harris 1-5

37
Q

what is a risk of growth plate injury

A

growth deformity

38
Q

difficulties when imaging children

A 
difficulty following instructions 
high dose ionising studies 
irritable 
anatomy varies 
contrast agents 
specific disease processes affecting kids
39
Q

TORCH infections - neonatal pneumonia

A 
toxoplasmosis 
other (syphilis, VZV, parovirus B19)
rubella 
CMV
HSV
40
Q

which lines are specific to neonates

A

umbilical vein and artery catheters

41
Q

path of umbilical artery catheter

A

umbilicus
R/L internal iliac artery
common iliac artery
aorta

42
Q

how can you tell between an umbilical artery or venous catheter in a neonate

A

artery will dip down in pelvis before coming up

43
Q

how can you tell between an umbilical artery or venous catheter in a neonate

A

artery will dip down in pelvis before coming up

44
Q

conditions associated with urine stasis or reflux that could predispose to UTI

A 
ureteral duplication
posterior urethral valve 
spina bifida 
ureteric calculus 
horseshoe kidney
45
Q

conditions associated with urine stasis or reflux that could predispose to UTI

A 
ureteral duplication
posterior urethral valve 
spina bifida 
ureteric calculus 
horseshoe kidney
46
Q

order of ossification centres of the elbow

A 
CRITOL
capitellum 
radial head 
trochlea 
olecranon 
internal epicondyle 
lateral epicondyle

Year 4 Child Health (22 decks)

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