Pediatrics

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anaraya1
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191799
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Pediatrics
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2015-05-12 11:49:17
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Pediatrics review
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Pediatrics Review
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  1. What is the most common renal mass in children?
    Wilms tumor (Nephroblastoma)
  2. What are features that can help to distinguish between neuroblastoma and Wilms tumor?
    Neuroblastoma - much more often calcified

    Can extend behind aorta
  3. How can one distinguish between Wilms tumor and multilocular cystic nephroma?
    Predominantly cystic Wilms tumor is rare
  4. What are pulmonary complications of HPV?
    Papillomatosis - solid and cystic lung nodules
    • Pulmonary sling - 
    • Left pulmonary artery originates from right pulmonary artery
    • Courses posterior to trachea and anterior to esophagus
  5. How does the pathophysiology of duodenal atresia differ from other small intestine or colonic atresias?
    • Lumen of the duodenum is obliterated in development and then recanalizes around the 8th or 10th week. Failure of these leads to duodenal atresia.
    • Other atresias - vascular ischemia
  6. What are the most common locations for enteric duplication cysts?
    Distal ileum

    Esophagus
  7. What is the difference between rhizo and acromelic?
    Acromelic > shortening of distal bones

    Rhizomelic > shortening of proximal bones
  8. Grade 1 Germinal Matrix hemorrhage - confined to caudothalamic groove
  9. What side is cleft palate typically located on?
    Left side
  10. What is the normal course of the umbilical vein to the inferior vena cava?
    Umbilical vein > left portal vein > ductus venosus > inferior vena cava
  11. What is the normal course of an umbilical arterial catheter?
    Umbilical artery > dips down to iliac artery > aorta
  12. Where should the tip of the umbilical artery catheter be?
    T5 to T8

    T4 - level of great vessels

    L1 - L2 - level of renal arteries
  13. What is the difference between an apophysis and an epiphysis?
    Both are growth centers

    Epiphysis - contributes to longitudinal growth
  14. What are characteristic ultrasound findings of Turner's syndrome in the second trimester?
    Cystic hygroma

    Hydrops
  15. Which insertion is typically normal a duplicated collecting system?
    Lower pole
  16. Which collecting system is more prone to reflux in a duplicated collecting system?
    Lower pole
  17. Where does the upper pole in a duplicated collecting system typically insert?
    Distally

    Medially
  18. Which insertion is more prone to developing ureteroceles in a completely duplicated collecting system?
    Upper pole insertion
  19. What are the most common types of benign liver tumors of infancy?
    Hepatic hemangioendothelioma (most common)

    Mesenchymal hamartoma
  20. What is the most common hepatic malignancy in children?
    Hepatoblastoma
  21. What is the pathophysiology of Rickets?
    Failure to mineralize cartilage/osteoid in physes
  22. What type of tumor can produce a paraneoplastic syndrome that reduces phosphate levels and causes rickets?
    Hemangiopericytoma
  23. What is the most common pathogen causing neonatal pneumonia?
    Group B strep
  24. What are risk factors for neonatal pneumonia?
    • Maternal vaginal infection
    • Prolonged labor
    • Premature rupture of membranes
  25. What is the pathophysiology of transient tachypnea of the newborn?
    Retained fetal lung fluid
  26. How does fetal lung fluid normally get resorbed?
    Trachea

    Interstitial lymphatics
  27. What are radiographic findings associated with transient tachypnea of the new born?
    Linear densities radiating from hila

    Pleural effusions
  28. What are the most common imaging findings in neonatal pneumonia?
    Bilateral alveolar opacities

    Hyperinflation

    Pleural effusions
  29. How can one distinguish RDS from neonatal pneumonia?
    Pleural effusions seen in neonatal pneumonia, not RDS
  30. What is the pathophysiology of meconium aspiration?
    Expelled intestinal contents of neonate into amniotic fluid, neonate inhales contaminated fluid

    Typically occurs in mature/postmaure infants
  31. What are classic findings associated with Beckwith Wiedemann syndrome?
    Overgrowth syndrome

    • Macroglossia
    • Macrosomia (overall large size)
    • Abdominal wall defects (omphalocele, hernia)
    • Hypoglycemia (neonatal)
    • Ear creases or pits
    • Wilms tumor
  32. What is the genetic defect in osteogenesis imperfecta?
    Disturbance in type I collagen synthesis
  33. What is the difference between meningocele and myelomeningocele?
    Meningocele - contains meninges but no neural tissue

    Myelomeningocele - contains portions of the spinal cord
  34. What congenital neural abnormality is almost always associated with myelomeningocele (herniated spinal cord/nerves)?
    Chiari II malformation
  35. What is the difference between a hemangioma and a vascular malformation?
    Hemangioma - benign vascular tumor, hyperplasia and cellular proliferation

    Vascular malformation - high flow vs low flow, dysplastic vascular channels, normal endothelial turnover
  36. What are the forms of Langerhans cell histiocytosis?
    • 1. Acute disseminated langerhans cell histiocytosis
    • 2. Unifocal disease
    • 3. Multifocal disease
  37. What anomaly is this and what are the two major forms of this disorder?
    • Right sided aortic arch
    •  - Mirror image type (associated with tetralogy of fallot)
    •  - Aberrant left subclavian artery (posterior impression of trachea)
  38. Corkscrew configuration of duodenum

    Midgut volvulus
  39. Rickets  - metaphyseal fraying/splaying out
  40. What are the two most common forms of inherited pancreatic insufficiency?
    • 1. Cystic fibrosis
    • 2. Shwachman-Diamond Syndrome (pancreatic insufficiency + short stature)
  41. What are the two main causes of hydrops fetalis?
    • Prenatal cardiac failure
    • - Immune (Rh)
    • - Nonimmune
  42. What is the most common soft tissue malignancy in children?
    Rhabdomyosarcoma
  43. Differential diagnosis?
    • Blount's disease - lack of growth of medial tibial physis
    • Physiologic Bowing
    • Rickets
  44. Fever, soft tissue swelling, irritability
    Infantile cortical hyperostosis (Caffey disease)

    Self limiting disease

    • Locations (typical) - 
    • Mandible
    • Clavicle
    • Ribs
  45. What the Risser index?
    Index of skeletal maturity based on the percentage ossification of the iliac crest


  46. What branchial cleft anomaly is this associated with?
    Second branchial cleft cyst

    Associated with angle of the mandible

  47. What branchial cleft anomaly is this associated with?
    First branchial cleft anomaly

    Associated with parotid
  48. What is the peak incidence of Wilms Tumor compared with Congenital Mesoblastic Nephroma?
    Congenital mesoblastic nephroma - presents within first 3 MONTHS of life

    Wilms tumor - peak incidence 3-4 YEARS of age
  49. When are humeral heads typically seen in newborns?
    Humeral head ossification is essentially never seen before 38 weeks
  50. What syndrome is associated with multiple non-ossifying fibromas with additional extraskeletal congenital anomalies?
    Jaffe-Campanacci Syndrome

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