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BrieMuthKimball
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what is the current term for suspected child abuse?
Nonaccidental trauma (SNAT)
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At what age can a child be talked through an exam without immobilization or parental aid?
2-3 years
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What are three possible roles of the parent?
- Observer in the room, lending support and comfort
- Assisting in immobilization
- Remains in waiting area
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Who should the technologist report suspected abuse to?
The ER
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What are some immobilization devices?
- Tam-em board
- plexiglass hold down paddle
- Pigg-O-Stat
- Tape
- Sheets
- Sandbags
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What does Diaphysis mean?
Shaft or body of a long bone
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The secondary center for occification in long bones is?
the epiphysis
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What is the primary site of ossification in long bones?
The diaphysis
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At what age is skeletal growth complete
25
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What is the epiphyseal plate made up of?
cartilage
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This is most common in children when foreign objects are swallowed into air passages of the bronchial tree
Aspiration (mechanical obstruction)
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This condition (primarily seen in children from ages 1-3) is caused by a a viral infection. It is made evident by labored breathing and a harsh dry cough.
Croup
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_________ is treated most commonly with antibiotics, but AP and lateral radiographs of the neck and upper airway demonstrate smooth but tapered narrowing of upper airway
Croup
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A hereditary disease with secretions of heavy mucus that cause clogging of bronchi and bronchioles
Cystic fibrosis
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A frequently associated condition with cystic fibrosis is of an intestinal obstruction
Meconium ileus
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A bacterial infection of the epiglottis most common in children from ages 2-5 but may also affect adults. It is a serious condition that can become fatal resulting from blockage of airway that causes swelling
Epiglottitis
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One of the most common indications for chest radiographs in premature infants.
Hyaline Membrane Disease
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In this emergency type condition, the alveoli and capillaries of the lung are injured and infected, resulting in leakage of fluid and blood into spaces between alveoli. Granular appearance
Hyaline membrane disease
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An enlarged thyroid at birth is caused by an underactive thyroid (hypothyroidism) or an overactive thyroid (hyperthyroidism)
Congenital goiter
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A deformity of the skull caused by premature closure of skull sutures.
Craniostenosis
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In this condition the femoral head is separated by the acetabulum in the newborn. Unknown cause. More common in girls, babies born breech or hereditary
Developmental displasia of the hip
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A group of diseases that mainly affect the epiphyseal plates of long bones, resulting in pain, deformities, and abnormal bone growth
Osteochondrosis
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This condition leads to abnormal bone growth at the hip. If affects children ages 5-10 (head of femur first appears flattened, then later fragmented)
Legg-Calve-Perthes disease
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This condition causes inflammation of the tibial tuberosity. It is most common in 5-10 year old males and usually affects one leg
Osgood-Schlatter disease
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In this hereditary disorder, the bones are abnormally soft and fragile. Infants with this condition may be born with fractures.
Osteogenesis imperfecta
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In this condition, developing bones do not harden or calcify, causing skeletal deformities. Commonly bowed legs
Osteomalacia (rickets)
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When the posterior aspects of the vertebrae fail to develop, exposing part of the spinal cord
Spina bifida
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_________ is a mild form that is characterized by some defect or splitting of the posterior arch of the L5-S1 vertebrae without protrusion of the spinal chord or meninges
Spina Bifida Occulta
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A congenital deformity of the foot that can be diagnosed prenatally with the use of real time ultrasound.
Talipes (clubfoot)
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A congenital condition that requires surgery because an opening to an organ is absent.
Atresia (or clausura)
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In this congenital condition of the large intestine, nerves that control rhythmic contractions are missing. Results in constipation and vomiting
Hirschsprung's disease (congenital megacolon)
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This narrowing or blockage at the pylorus or stomach outlet occurs in infants, frequently resulting in repeated, forceful vomiting
Pyloric stenosis
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_________ are associated with childhood cancer (generally younger than age 5). Occur in parts of the nervouse system, most frequently the adrenal glands.
Neuroblastomas
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The second most common type of childhood cancer
Neuroblastoma
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______ indicates a cancer of the kidneys of embryonal origin, Usually occurs in children younger than 5. One of the most common abdominal cancers in children
Wilms' tumor
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__________ frequently occurs in both adults and children and is caused by bacteria, viruses, fungi, or some type of parasite.
Urinary tract infection
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What is a common cause of UTI in children?
Vesicoureteral reflux
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Lower extremities
AP: Lateral and medial epicondyles of distal femur should appear ______________
Lateral: Medial and lateral condyles and epicondyles of distal femur should be ______
- Symmetric and in profile
- Superimposed
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What is the Kite method used for?
Talipes (congenital clubfoot)
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What are the positions for a pediatric skull exam?
- AP: CR parallel to OML
- Reverse Caldwell: 15* CR cephalad
- Towne: CR 30* to OML
- Lateral
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Where should the petrous ridges lie with a 15* cephalic angle
Petrous pyramids and auditory canals are projected into lower one half to one third of orbits
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Where will the petrous ridges lie in an AP 0* skull?
Superimposing superior orbital margins
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Where will the petrous pyramids lie with a 30* town projection?
Projected below orbital rim, allowing visualization of the entire orbital margin
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Where do you center for a lateral pedi skull?
Midway between glabella and occipital protuberance or inion
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What are the pediatric NPO protocols?
- Younger than 3 mo: NPO 3 hrs
- 3 mo - 5 yrs: NPO 4 hrs
- 5 yrs and older: NPO 6 hours
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For barium enemas on children do we use single or double contrast usually?
Single
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What are the contraindications for giving laxatives prior to a lower GI study?
Hirchsprung's disease, extensive diarrhea, appendicitis, obstruction and conditions where patient can not withstand fluid loss
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What are the prep's for pedi lower GI studies?
- Newborn to 2 yr: none
- 2-10 yrs: Low meal evening before, laxative, water, maybe enema if no BM
- 10+: small meal evening before, 2 laxatives with water, maybe enema if no BM by morning
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What is the prep for an IVU?
No solid food for 4 hours before exam to diminish the risk of aspiration from vomiting. Plenty of clear liquids until one hour prior to exam
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Where is the centering point for a pedi abdomen?
1 inch above umbilicus
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What is the preferred method for positioning an upright pedi abdomen?
Pig-O-Stat
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What are two indications for pedi upright abdomen?
Intussusception and constipation
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What amounts of barium are given for what age?
- Newborn to 1 yr: 2-4 oz
- 1-3 yrs: 4-6 oz
- 3-10 yrs: 6-12 oz
- older than 10 yrs: 12-16 oz
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How is a pedi patient positioned for a contrast study?
Laying down
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what is the positioning sequence for a UGI?
- Starting with the patient supine
- Left lateral
- LPO, RPO
- Right lateral
- Prone
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In what position does the stomach empty quickly and it is important to check the location of the duodenaljejunal junction to rule out malrotation
Right lateral
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For a small bowel follow through, AP or PA films are taken at _________ intervals
20-30 minute
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How long on children does it take for barium to reach the ileocecal valve for a small bowel series?
1 hour
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what size enema tip do you use on neonates and infants?
#10 French flexible silicon catheter and 60ml syringe
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Barium enemas are often used in children to reduce _______
intussusception
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How high should the enema bag be placed from the table top?
3 feet
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What are two indications for pedi VCUG's?
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What is the prep for a VCUG?
None unless it is followed by an IVU
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What size tube should be used for a VCUG?
#8 French feeding tube?
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An air enema is performed under fluoroscopy for the
pnuematic reduction of an intussusception
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What proves that an intussusseption has been reduced?
An AP supine abdomen film showing that air or barium has passed through the ileocecal region into the ileum
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