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What is the most common renal mass in children?
Wilms tumor (Nephroblastoma)
What are features that can help to distinguish between neuroblastoma and Wilms tumor?
Neuroblastoma - much more often calcified
Can extend behind aorta
How can one distinguish between Wilms tumor and multilocular cystic nephroma?
Predominantly cystic Wilms tumor is rare
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
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
What are the most common locations for enteric duplication cysts?
What is the difference between rhizo and acromelic?
Acromelic > shortening of distal bones
Rhizomelic > shortening of proximal bones
Grade 1 Germinal Matrix hemorrhage - confined to caudothalamic groove
What side is cleft palate typically located on?
What is the normal course of the umbilical vein to the inferior vena cava?
Umbilical vein > left portal vein > ductus venosus > inferior vena cava
What is the normal course of an umbilical arterial catheter?
Umbilical artery > dips down to iliac artery > aorta
Where should the tip of the umbilical artery catheter be?
T5 to T8
T4 - level of great vessels
L1 - L2 - level of renal arteries
What is the difference between an apophysis and an epiphysis?
Both are growth centers
Epiphysis - contributes to longitudinal growth
What are characteristic ultrasound findings of Turner's syndrome in the second trimester?
Which insertion is typically normal a duplicated collecting system?
Which collecting system is more prone to reflux in a duplicated collecting system?
Where does the upper pole in a duplicated collecting system typically insert?
Which insertion is more prone to developing ureteroceles in a completely duplicated collecting system?
Upper pole insertion
What are the most common types of benign liver tumors of infancy?
Hepatic hemangioendothelioma (most common)
What is the most common hepatic malignancy in children?
What is the pathophysiology of Rickets?
Failure to mineralize cartilage/osteoid in physes
What type of tumor can produce a paraneoplastic syndrome that reduces phosphate levels and causes rickets?
What is the most common pathogen causing neonatal pneumonia?
Group B strep
What are risk factors for neonatal pneumonia?
- Maternal vaginal infection
- Prolonged labor
- Premature rupture of membranes
What is the pathophysiology of transient tachypnea of the newborn?
Retained fetal lung fluid
How does fetal lung fluid normally get resorbed?
What are radiographic findings associated with transient tachypnea of the new born?
Linear densities radiating from hila
What are the most common imaging findings in neonatal pneumonia?
Bilateral alveolar opacities
How can one distinguish RDS from neonatal pneumonia?
Pleural effusions seen in neonatal pneumonia, not RDS
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
What are classic findings associated with Beckwith Wiedemann syndrome?
- Macrosomia (overall large size)
- Abdominal wall defects (omphalocele, hernia)
- Hypoglycemia (neonatal)
- Ear creases or pits
- Wilms tumor
What is the genetic defect in osteogenesis imperfecta?
Disturbance in type I collagen synthesis
What is the difference between meningocele and myelomeningocele?
Meningocele - contains meninges but no neural tissue
Myelomeningocele - contains portions of the spinal cord
What congenital neural abnormality is almost always associated with myelomeningocele (herniated spinal cord/nerves)?
Chiari II malformation
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
What are the forms of Langerhans cell histiocytosis?
- 1. Acute disseminated langerhans cell histiocytosis
- 2. Unifocal disease
- 3. Multifocal disease
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)
Corkscrew configuration of duodenum
Rickets - metaphyseal fraying/splaying out
What are the two most common forms of inherited pancreatic insufficiency?
- 1. Cystic fibrosis
- 2. Shwachman-Diamond Syndrome (pancreatic insufficiency + short stature)
What are the two main causes of hydrops fetalis?
- Prenatal cardiac failure
- - Immune (Rh)
- - Nonimmune
What is the most common soft tissue malignancy in children?
- Blount's disease - lack of growth of medial tibial physis
- Physiologic Bowing
Fever, soft tissue swelling, irritability
Infantile cortical hyperostosis (Caffey disease)
Self limiting disease
- Locations (typical) -
What the Risser index?
Index of skeletal maturity based on the percentage ossification of the iliac crest
What branchial cleft anomaly is this associated with?
Second branchial cleft cyst
Associated with angle of the mandible
What branchial cleft anomaly is this associated with?
First branchial cleft anomaly
Associated with parotid
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
When are humeral heads typically seen in newborns?
Humeral head ossification is essentially never seen before 38 weeks
What syndrome is associated with multiple non-ossifying fibromas with additional extraskeletal congenital anomalies?
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