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50 Cards in this Set

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ddx: sclerotic metaphyseal bands
LIFe LINeS

lead
infection
fluorosis
leukemia/lymphoma
illness
never forget rickets
scurvy
ddx: stippled/fragmented epiphyses
coumadin toxicity (fetal warfarin syndrome)
cretinism
chrondrodysplasia punctata
trisomy 18
multiple epiphyseal dysplasia
ddx: small colon in an infant
AIM twice

aganglionosis
immature left colon
meconium ileus
atresia (colonic)
ileal atresia
megacystis-microcolon-hypoperistalsis
ddx: sacrococcygeal mass in a neonate
teratoma
chordoma
neurogenic tumor
myelomeningocele
rhabdomyosarcoma
lipoma
melanoma
meconium pseudocyst
how do you differentiate causes of a pulmonary edema pattern in the newborn
big heart, gets better: infant of DM mom, hypoglycemia, asphyxia
big heart, gets worse: cardiomyopathy, aortic stenosis, coarctation, hypoplastic left heart
normal heart, gets better: meconium aspiration, TTN, cord stripping
normal heart, gets worse: TAPVR, hypoplastic left heart, mitral stenosis, cor triatriatum
ddx: neonatal adrenal mass
adrenal hemorrhage
neuroblastoma
wolman's disease

*pearl* always recommend urinary markers and f/u in 2 weeks if uncertain
ddx: diffuse periostial reaction
SCALP

syphilis, sickle cell
caffey's
abuse, hypervitaminosis A
leukemia
physiologic, prostaglandins, pachydermoperiostosis
good prognosis in neuroblastoma is associated with what features
low stage, young age
few n-myc oncogenes
ddx: unilateral opaque hemithorax in the neonate
pleural effusion
chylothorax
atelectasis
pulmonary agenesis
hypoplastic lung
CCAM
diaphragmatic hernia
what are the common causes of pleural effusion in a neonate
birth trauma
CHF
hypervolemia
erythroblastosis fetalis
turner's syndrome
ddx: lobar opacity in a neonate
I HEAR

infection (group B strep, E coli)
hemorrhage
edema
aspiration
RDS
what are lung volumes in:
- RDS
- TTN
- mec asp
RDS: small
TTN: N
mec asp: large
ddx: air and fluid filled hemithorax in the neonate
BPD
CCAM
lobar emphysema
diaphragmatic hernia
PIE
what are the 3 Ws of RSV infection
wheezing
winter
neWborn
which lobe is most commonly affected by RSV infection
RUL
ddx: recurrent pneumonia in a child
CF
asthma
reflux
TE fistula
immune deficiency
BPD
bronchiectasis
foreign body
sequestration
compare croup and epiglottitis
croup:
- self limited
- 6 mo-6 years
- steeple sign of subglottic edema
- viral

epiglottitis:
- acute
- 3-6 years
- thumb sign of glottic and epiglottic edema
- bacterial
name 3 ways to radiographically evaluate a child for airway foreign body
inspiration/expiration flims: air trapping on foreign body side
fluro: mediastinum shifts away from foreign body side on expiration
decubitus film: foreign body side air traps when dependent
ddx: anterior mediastinal mass
4Ts and C

thymic tumor
thyroid
teratoma
terrible lymphoma
cystic hygroma
ddx: middle mediastinal mass in child
bronchogenic cyst
lymphadenopathy
- TB
- lymphoma
vascular anomaly
ddx: posterior mediastinal mass
neurogenic tumor
neurenteric cyst
extramedullary hematopoesis
sequestration
what distinguishes the common mediastinal neurogenic tumors
age:
neuroblastoma: <= 2 years
ganglioneuroblastoma: < 10 years
ganglioneuroma: 6-15 years
nerve sheath tumor: >= second decade
ddx: acyanotic, big heart, increased pulmonary blood flow
ASD
VSD
PDA
ddx: cyanotic, big heart, incrased blood flow
5Ts CHD

truncus arteriosus
transposition
tricuspid atresia (10-15%)
tetralogy (with absent valve)
TAPVR
coarctation (severe)
hypoplastic left heart
double outlet right heart
ddx: cyanotic, decreased blood flow
tricuspid atresia
pulmonary atresia/stenosis
tetralogy
what lesion is most likely to have a right aortic arch
truncus arteriosus
if you see a right arch what lesion is most likely
tetralogy of fallot
what surgical procedures are used to treat TOF
blalock-tussig shunt (subclavian artery to pulmonary artery)
fontan procedure (RA to PA)
what is the most common cardiac cause of cyanosis in the newborn
transposition
what procedures are used to treat tricuspid atresia
fontan procedure (RA to PA)
glenn procedure (SVC to PA)
ddx: double bubble
duodenal atresia
web
midgut vovulus
jejunal atresia
choledochal cyst
annular pancreas
what are manifestations of down's syndrome
duodenal obstruction
immature colon
endocardial cushion defect
hypersegmented manubrium
extra ribs
compare omphalocele and gastrochisis
omphalocele:
- midline defect
- covered by peritoneum
- abnormal rotation
- high association with anomalies elsewhere

gastroschisis:
- off-midline
- uncovered
- +/- malroation
- low association with anomalies elsewhere
rule of 2s in meckel's diverticulum
2% of population
2 ft from ileocecal valve
presents at age 2
2 inches in size
20% contain gastric mucosa
5 polyposis syndromes seen in children
isolated juvenile polyp
familial polyposis
juvenile polyposis
gardener's syndrome
peutz-jegher syndrome
ddx: abdominal mass in a child
wilm's tumor
hydronephrosis
mesoblastic nephroma
neuroblastoma
appendiceal abscess
hepatic mass
enteric or mesenteric mass
ovarian cyst
hydrometrocolpos
dermoid cyst
most common cause of an abdominal mass in a neonate
hydronephrosis
most common cuase of a solid renal mass in a neonate
mesoblastic nephroma
ddx: hydronephrosis
PURE P

posterior urethral valves
ureteropelvic junction obstruction
reflux
ectopic uerterocele
prune belly syndrome
how often is UPJ bilateral
20%
what are 5 complications of horseshoe kidney
WRIST

wilm's tumor
reflux
infection
stone formation
trauma
what are the radiographic findings in prune belly syndrome
hydronephrosis
reflux
urethral obstruction
bladder enlargement
bulging flanks
flaring of the lower ribs
renal agenesis
ureteral atresia
compare wilm's tumor and neuroblastoma
wilm's:
- large kidney
- calcs unusual
- lung mets
- invasion of vessels
- no uptake on nucs studies

neuroblastoma:
- kidney displaced
- calcs common
- bone mets
- encasement of vessels
- uptake on bone scan and MIBG
ddx: adrenal calcs
adrenal hemorrhage
neuroblastoma
pheochromocytoma
adrenal cyst
addison's disease
granulomatous disease
wolman's disease
what is the order of ossification sequence of epiphyses in the elbow
CRITOE

capitellum 2
radium 4
internal (medial) epicondyle 6
trochlea 8
olecranon
external (lateral) epicondyle 10
what are the signs of child abuse
healing fractures of different ages
multiple fractures
fractures in unusual locations
metaphyseal fractures
what are the common ages for:
- developmental dysplasia of the hip
- legg-calve-perthes
- slipped capital femoral ephiphyses
DDH: neonate, infant, toddler
LCP: child
SCFE: teenager
DDH is bilateral in how many patients
5%
when SCFE is bilateral, what diagnosis should be entertained
renal failure
what are the radiographic signs of DDH
shallow acetabulum
increased acetabular angle
small capital femoral epiphyses
delayed ossification of the femoral head
acetabular/femoral head sclerosis