Group C batch 35
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P.
- Boat shaped heart ( coeur en sabot )
- Cardiophrenic angle is more prominent
- Uplifted apex
- Increase waist of the heart
- Oligemic lung
D.
Most probably fallot tetralogy
P.
- Egg on side appearance of the heart
- Plethoric lung
D.
Most probably TGA
P.
1. Cardiomegaly
2. Flask shaped heart
D.
Most probably pericardial effusion
N.B
Most important vital sign is pulsus paradoxus
P.
Hypertranslucency around the heart
D.
Most probably pneumopericardium
Causes:
1. Penetrating trauma
2. Thoracic surgery
3. Positive pressure ventilation
P.
Miliary shadow in both lungs (bilateral)
DD:
1. Pulmonary TB
2. Interstitial pneumonia (viral, bacterial or fungal infection)
3. Pulmonary hemosidrosis
4. Histocytosis
5. Sarciodosis
مرتبه على ال most common
P. Homogeneous opacity in Rt upper and middle lobes of the lung with centralized mediastinum
D. Most probably lobar pneumonia in upper and middle lobes of the right lung
P.
- Homogeneous opacity in the lower lobe of the right lung with obliteration of right costophrenic angle and rising to axilla
- Trachea is shifted to the left side
D. Most probably pleural effusion in right lower lobe
P. Hypertransleucency around the mediastinum and around the heart
D. Most probably pneumomediastinun
Cause:
Rupture of cyst
P.
- Homogeneous opacity in the lower lobe of the right lung with hypertranslucency of the middle lobe of Rt lung and fluid level inbetween
- Shifting of mediastinum to the left side
D. Most probably Rt side hydroneumothorax
P.
- Cystic like lesions in the left lung extending from the abdomen
- Left copula of diaphragm is obliterated
- Mediastinum pushed to the right side
D. Most probably diaphragmatic hernia
P.
1. Recoil of nasogastric tube
2. Air inside the stomach
D. Most probably esophageal atresia with tracheoesophageal fistula
Types of TEF:
1. Type B ( proximal TEF and blind distal esophagus)
2. Type C ( distal TEF and blind proximal pouch of esophagus) > most common
3. Type D ( proximal and distal TEF ) > 2nd most common
Types of esophageal atresia:
1. Type A ( blind proximal and distal pouches of esophagus)
2. Type B ( proximal TEF and a blind distal esophagus)
3. Type C ( distal TEF and a blind proximal pouch of the esophagus)
4. Type D ( proximal and distal TEF)
P.
1. Ground glass appearance of the lungs
2. Air bronchogram
D. Most probably first stage of respiratory distress (hyaline membrane disease)
P.
Opacity of both sides of the lungs with no demarcation of the heart
D.
Most probably sever respiratory distress
Chest x-ray 👆
P.
Air under the diaphragm and all around the abdomen pushes the viscus centrally
D.
Most probably pneumoperitonium ( stage 2 )
Cause:
Necrotizing enterocolitis
N.B
Mechanism of NE
Inflammation of intestine > its distension > thining of the wall > decrease vascularity > gangrene > rupture
P.
Hypertranslucent inside the colon which become more distended
D. Most probably pneumointestinalis
Causes:
1. Necrotizing enterocolitis
2. Imperforated anus
3. Hirschsprung disease
4. Intussusception
5. Rectal stenosis
6. Volvulus
7. Short bowel
8. Megacolon

N.B:
. Necrotizing enterocolitis ( bloody diarrhea, abdominal distension, vomiting)
. Imperforated anus (vomiting of meconium, abdominal distension)
. Hirschsprung disease ( constipation) > we do barium enema and biopsy.
. Intussusception ( jelly stool , abdominal distension, vomiting )
P.
1. Dilated stomach
2. Elongation of pyloric canan ( string sign )
3. The duodenal cap is umbrella shape
D.
Most probably congenital pyloric stenosis
Start:
Between 2nd to 3rd weeks
Symptoms:
1. Excessive regurgitation
2. Projectile vomiting
3. Weight loss
4. Abdominal mass
P.
Two air fluid level in upper part of the abdomen with no gases in the lower part of the abdomen
D.
Most probably duodenal atresia
Abdominal x-ray 👆
P.
1. Severe dilatation of both ureters
2. Tortuosity of both ureters with change of calyces
D.
Most probably vesicouretheral reflux ( grade 5 )