Pediatric Pathology

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Pediatric Pathology
2013-03-20 03:14:49

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  1. hyaline membrane disease or immature lung disease
    Respiratory distress syndrome (RDS)
  2. Leading cause of infant morality especially premature infants (approximately 90% of all cases)

    1st 72 hours after birth is the most critical

    Causative agent: • lacks surfactant (a chemical detergent/lubricant) needed to keep the lungs from total collapse (atelectasis) during expiration
    Respiratory distress syndrome (RDS)
  3. clinical signs 
    distressed breathing -
    acid base blood imbalance (acidosis)  nasotracheal tube and umbilical catheter are used to monitor the progression of the disease-
    Respiratory distress syndrome (RDS)
  4. AP chest( most important view) demonstrates-
    -ground glass
    air-bronchogram sign
    Respiratory distress syndrome (RDS)
  5. treatment requires vigorous respiratory support with follow-up chest films to “chart” the disease
    Respiratory distress syndrome (RDS)
  6. also know as crib death
    • unknown cause, although occurs more frequently in winter months and underweight
    babies (more males and non-Caucasian)

    • occurs generally between 3 weeks and 4 months of age

    • no specific radiographic signs on post mortem films
    Sudden infant death syndrome (SIDS)
  7. hereditary disease characterized by excessive viscous mucus serections 

    cause – defective gene middle chromosome 7
    cystic fibrosis
  8. most common genetic disorder among Caucasian children with up to a 90% mortality rate due to respiratory involvement
    cystic fibrosis
  9. generalized irregular thickening of lung markings coupled with lung hyperinflation similar to adult severe chronic lung disease
    cystic fibrosis
  10. inflammatory condition characterized by laryngitis with laryngeal spasm that can cause upper airway obstruction 

    infant will have a bark-like cough

    causative agent: virus
  11. AP and lateral soft tissue neck (key films)

    Narrowing (hourglass shape) of subglottic portion of trachea
  12. If chest ordered, must include entire upper airway (include bottom of earlobe and down)
  13. acute inflammation of the bowel mucosa with formation of pseudomembraneous plaques covering areas of bowel ulceration
    Necrotizing enterocolitis (NEC)
  14. abdominal disorder of premature infants that can be fatal( can occur to other patient populations)
    Necrotizing enterocolitis (NEC)
  15. clinical signs -
    bloody diarrhea
    abdominal distention
    metabolic acidosis (blood)
    Necrotizing enterocolitis (NEC)
  16. radiographic signs 
    AP abdomen demonstrates: 

    gaseous small bowel distention – 1st sign pneumatosis coli – air in the wall of small bowel

    Left lateral decub demonstrates: 
    Location of gas pattern
    Necrotizing enterocolitis (NEC)
  17. Necrotizing enterocolitis (NEC)
    • no oral feeding
    • IV antibiotics 
    • possible surgery – colostomy
  18. telescoping or invagination of part of the large bowel into a distal portion

    95% of cases are children – 87% before age 2, 70% between ages 4 and 11 months  possible complication – bowel becomes gangrenous,
    life threatening
  19. severe, intermittent abdominal pain 

    vomiting of stomach contents, later mixed with bile
    bnormal currant jelly-like stools

    sausage-like palpable mass in abdomen
  20. barium enema demonstrates:
    • major filling defect with ileum telescopes into the ileum – coiled spring sign
  21. Intussusception treament
    special type of barium enema
  22. known as congenital aganglionic megacolon •familial congenital defect more common in Caucasian males
    Hirschsprung’s Disease
  23. lacks ganglion cells in the rectosigmoid area causing difficulty in stool evacuation (large amount of feces retained in the colon)
    Hirschsprung’s Disease
  24. sings
    gaseous distention of the large bowel, constipation with repeated bowel obstructions
    Hirschsprung’s Disease
  25. radiographic signs:

    barium enema without usual prep demonstrates:
    grossly dilated sigmoid colon containing feces with a narrowed segment below the dilatation
    Hirschsprung’s Disease
  26. treament

    surgical resection or temporary colostomy
    Hirschsprung’s Disease