Pediatric pathology

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Pathology : 

Pathology Chapter 20

Pediatric Chest Pathology : 

Pediatric Chest Pathology Aspiration (mechanical obstruction)- RT bronchi due to size and angle. AP/Lat CXR or AP/Lat upper airway Asthma- airways are narrowed by stimuli, caused by anxiety or allergies. PA/Lat CXR Atelectasis- partial or complete collapse of the lung. PA/Lat CXR (slight+) Bronchiectasis- irreversable widening of bronchi, acute infection or congenital. PA/Lat CXR (slight +) Croup- ages 1-3, caused by viral infection. Labored breathing, harsh dry cough, sometimes fever. PA/Lat CXR and AP/Lat upper airway

Pediatric Chest Pathology : 

Pediatric Chest Pathology Cystic fibrosis- inherited disease. Secretions of heavy mucus. Can cause meconium ileus. PA/Lat CXR (slight + if severe) Epiglottitis (supraglottitis)- bacterial infection. Can become fatal within hours of onset. AP/Lat CXR and Lat upper airway

Pediatric Chest Pathology : 

Pediatric Chest Pathology Hyaline membrane disease (HMD) or RDS - primarily in premature infants. Alveoli and the capillaries are injured or infected resulting in leakage of fluid and blood into the spaces between alveoli or into the alveoili themselves (granular appearance) PA/Lat CXR (slight +)

Pediatric Chest Pathology : 

Pediatric Chest Pathology Meconium aspiration syndrome – newborns inhale fecal material containing meconium. AP/Lat CXR (possible pneumothorax) Neoplasia – tumor or abnormal growth in the lung (hemoptysis). PA/Lat CXR Pneumonia- Can occur in newborns by a rupture of membrane allowing inhalation of amniotic fluid. PA/Lat erect or decub CXR (mederate +)

Pediatric Chest Pathology : 

Pediatric Chest Pathology Pneumothorax – can occur with infants on ventilators. PA/Lat erect or decub CXR (slight -) Pneumomediastinum – air will leak from the air sacs into the soft tissue between the lung and heart (slight - )

Thyroid disordersPA/Lat CXR, AP and Lat upper airway, and long bone survey : 

Thyroid disordersPA/Lat CXR, AP and Lat upper airway, and long bone survey Congenital goiter – enlarged thyroid at birth caused by hypo/hyper thyroidism Cretinism – neonate form of hypothyroidism resulting in jaundice, slow bone growth and possible dwarfism Neonatal Graves’ Disease – occurs in infants whose mothers have hx of Graves’ (form of hyperthyroidism) enlarged thyroid can close airway.

Pediatric Skeletal Pathology : 

Pediatric Skeletal Pathology Craniosteosis – deformity of the skull cause by premature closing of sutures. PA/Lat skull Developmental dysplasia of hip (DDH) or Congenital dislocation of hip (CDH) -femoral head separated from the acetabulum in the newborn. US or AP hip Hydrocephalus – CSF in ventricles cannot drain Pre birth US, AP/Lat skull (+ based on size)

Pediatric Skeletal Pathology : 

Pediatric Skeletal Pathology Idiopathic juvenile osteoporosis – loss of bone density. Bone survey (slight - ) Osteochondrodysplasia – abnoramal bone growth, dwarfism, short stature. Achondroplasia most common form. Short limbed dwarfism. Long bone survey for possible dwarfism

OsteochondrosisAP/Lat effected parts : 

OsteochondrosisAP/Lat effected parts Kohler’s bone disease – navicular bone of the foot Legg-calve-perthes disease – head and neck of the femur Osgood-Schlatter disease – tibial tuberosity Scheuermann’s disease - kyphosis

Pediatric Skeletal Pathology : 

Pediatric Skeletal Pathology Osteogenesis imperfecta – abnormally soft and fragile bones. Deformities, dwarfism, and abnormally large sutures w/wormism bones. AP/Lat skull and bone survey (- up to 50%) Osteomalacia (Rickets-infantile osteomalacia) – bones do not calcify, bowed legs .AP lower limbs (moderate - )

Pediatric Skeletal Pathology : 

Pediatric Skeletal Pathology Osteomyelitis – bone or bone marrow infection, long bones. Patchy moth eaten appearance. AP/Lat of affected limbs, Nuc med bone scan (early), CT, or MRI Osteopetrosis (marble bone) – increased bone density. Can be severe, starting in infancy and often becoming fatal. Bone survey to include skull (moderate +)

Spina BifidaPrenatal US, PA/Lat spine, CT or MRI of affected area : 

Spina BifidaPrenatal US, PA/Lat spine, CT or MRI of affected area Meningocele – CSF fluid filled bulge under the skin. Common and severe form involving the meninges Myelocele – most severe type involving actual spinal cord Spina bifida occulta – mild form characterized by defect or splitting of the posterior arch of L5-S1 without protrusion

Talipes (club foot)AP/Lat foot (Kite method) : 

Talipes (club foot)AP/Lat foot (Kite method) Talipes calcaneus – foot dorsiflexed (walk on heel) Talipes equinus – foot planterflexed (walk on toes) Talipes Valgus – outward turning of the foot (walk on inside) Talipes Varus – inward turning of foot (walk on outside)

Pediatric Skeletal Pathology : 

Pediatric Skeletal Pathology Tumors – malignant tumors less common in children Benign bone tumors may be found in adolescents and young adults but less common in infant and young children. AP/Lat affected area Retinoblastoma – cancer of the retina of the eye. May spread through optic nerve to the brain. Hereditary. AP/Lat skull

Pediatric Abdomen pathology : 

Pediatric Abdomen pathology Atresias – opening to an organ is absent. Ap abdomen and/or GI series Celiac Disease – hereditary, gluten causes an allergic reaction of the intestinal lining. Erect or decub abdomen and/or GI series Hematuria – blood in urine. IV urogram Hepatitis – infection of the liver with the Hepatitis B virus. Usually passed by mother at birth. AP abdomen

Pediatric Abdomen pathology : 

Pediatric Abdomen pathology Hepatomegaly – enlargement of the liver indicating acute hepatitis, cirrhosis, or bile duct obstruction. AP abdomen Hirshsprung’s disease (congenital megacolon)nerves controlling contractions are missing (colostomy) AP abdomen and/or GI series

Pediatric Abdomen pathology : 

Pediatric Abdomen pathology Horseshoe kidney – congenital condition, two kidneys are joined at the lower kidney pelves. Kidneys are malrotated and facing anteriorly. IVU and/or US Hydronephrosis – enlarged kidney distended with urine caused by an obstruction. IVU and/or US

Pediatric Abdomen pathology : 

Pediatric Abdomen pathology Hypospadias – congenital condition of infant male where the opening of the urethra is on the underside of the penis Epispadias – Urethra lies open as a channel in the penis rather than a closed tube Both diagnosed clinically or possible urethrogram

Pediatric Abdomen pathology : 

Pediatric Abdomen pathology Inflammatory bowel disease (IBD) – chronic disorders of inflammation of the intestines: Crohn’s disease and ulcerative colitis Crohn’s – infection of the intestinal wall (small or large) Ulcerative colitis – only the large and usually starts in the rectum or sigmoid Acute abdomen and/or GI series CT/MRI can detect early sign

Intestinal obstructions : 

Intestinal obstructions Ileus – (non mechanical)intestinal obstruction caused by a lack of contractile movements Intussusception – (mechanical)caused by telescoping Meconium ileus – (mechanical) intestinal contents become hardened Volvulus – (mechanical) caused by twisting of bowel itself AAS and small bowel series or BE (moderate – depending on severity of distension)

Pediatric Abdomen pathology : 

Pediatric Abdomen pathology Meckel’s divertculum – congenital. saclike outpouchings in the wall of the small intestine (ileum) best seen on radionuclide scan or SBS Necrotizing enterocolitis (NEC) – inflammation of the inner lining of the intestine, most often in premies and may lead to tissue death. AAS Peptic Ulcer – erosion of the lining of the stomach or duodenum. Believed to be hereditary. UGI

Pediatric Abdomen pathology : 

Pediatric Abdomen pathology Polycystic kidney disease (infantile or childhood) – hereditary condition that causes many cysts to form in the kidneys causing enlarged kidneys in infants and children. Generally fatal if it affects both kidneys without transplant or dialysis. IVU, US, CT, or MRI Pyelonephritis – bacterial infection caused by reflux of urine from bladder to kidneys IVU and/or US

Pediatric Abdomen pathology : 

Pediatric Abdomen pathology Pyloric stenosis – narrowing of the pylorus frequently resulting in forceful vomiting. UGI series and/or US Neuroblastoma – associated with childhood CA (under age 5) occur in parts of the nervous system, most frequently the adrenal glands. Second most common type of cancer in children. Wilms’ tumor – indicates a cancer of the kidneys of embryonal origin (under age 5) most common abdominal CA in children. Usually affects only one kidney. X-rays of affected body part, IVU, CT, US

Pediatric Abdomen pathology : 

Pediatric Abdomen pathology Urinary tract infection (UTI) caused by bacteria, fungi,or some type of parasite. Most common cause is reflux. IVU and/or VCUG Vesicoureteral reflux – backward flow of urine from bladder. IVU, VCUG, or nuc med

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