Lists (numbered lists indicate frequency, bulleted lists are in no specific order)

Abdominal masses, malignant

1. most common abdominal malignancy: Neuroblastoma
2. Wilms tumor
3. Hepatoblastoma
4. (Most common abdominal tumors in teens: NHL, Rhabdo, germ cell tumors)

The most common renal mass is

• congenital hydronephrosis
• Multicystic-Dysplastic Kidney also is frequent.

Other causes of abdominal masses

• Choledochal cysts
• bezoars
• gastrointestinal duplications
• polyps

Causes of pancreatic insufficiency in children

1. Cystic fibrosis
2. Schwachman-Diamond

Disorders are associated with skeletal anomalies and hematologic disease.

• Fanconi's Anemia (no thumb or radius)
• Schwachman-Diamond Syndrome (pancreas)
• Dyskeratosis Congenita (skin and nail changes)
• TAR syndrome (thrombocytopenia, absent radius, thumbs present)
• Diamond-Blackfan Anemia (RBC hypoplasia)
• Bloom syndrome (predisp to leukemia, malignancies)
• Other rare disorders associated with both skeletal anomalies and hematologic disorders include
  • familial aplastic anemia syndromes
  • cartilage-hair hypoplasia
  • Dubowitz syndrome
  • Seckel syndrome
  • Poland anomaly
• Acquired disorders also may be associated with both hematologic and skeletal abnormalities. Children who have newly diagnosed acute lymphoblastic leukemia often present with bone pain and generalized radiologic signs, but they do not have congenital abnormalities.

Phagocyte dysfunction, general

• Hyper IgE Syndrome
• Leukocyte Adhesion Deficiency
• Chediak-Higashi syndrome
• Chronic granulomatous disease

B-cell defects (Mnemonic: Breasts can make a girl too X-rated: B-cell defects

T-cell defects (WASH'D'M): T-cell defects

Most common form of pure red blood cell aplasia in children

1. Transient erythroblastopenia of childhood (TEC)
2. Diamond-Blackfan anemia
3. other forms of pure red cell aplasia are rare
   • The anemia of chronic disease usually is associated with an obvious underlying disorder and rarely is profound.
   • Fanconi anemia seldom presents with anemia in the first year, and usually physical anomalies, pancytopenia, and macrocytosis are evident.
   • Severe iron deficiency would be expected to be microcytic.

Causes of direct (conjugated) hyperbilirubinemia: A yellow MAOIST. (oops, politically incorrect) or a more loving one: SI Te AMO: Differential for Cong Hyperbili

GI Bleeding

Osteogenesis Imperfecta

• Several variants
  • best is type 1 and also the most common
  • worst is type 2
  • worse to best: 2341
  • blue sclera only in types 1,2
  • subtype a: no dentinogenesis imperfecta

Most common surgical condition in newborn period (1/700) : Pyloric stenosis

most common cause of chronic diarrhea in childhood: Diarrhea of Infancy, Chronic nonspecific aka Toddler's diarrhea

Vaginal Bleed - Prepubescent
Top 3 causes:
•  vulvovaginitis
•  scratching because of pinworm
•  vaginal foreign body

Most common inheritable cause of thrombophilia (3-8% caucasians; 1% African American): Factor V Leiden deficiency, defect R506Q

Most common coagulopathy (1% population): von Willebrand disease

Hemoptysis

• single most common cause is acute lower respiratory tract infection.
• Another  common cause is foreign body aspiration, particularly in children younger than 4 years of age.
• Chest trauma that involves a contusion also can cause hemoptysis.
• Much less common causes include neoplasms, vascular diseases, and arteriovenous malformation.
• consider CF

Bone pain

• 3 classic nonosseous tumors that we must consider in evaluation of bone pain: Histiocytosis, Neuroblastoma and Leukemia

3 types of histiocytosis

1. LCH (EHL) Dave 'Birbeck' on CD1a: bone pain, rash, draining ear, draining pee, bumps, pallor/bleed, pulmonary infiltrates
2. HLH-APC-FEP-IAHS
3. malignant

Type I Histiocytosis: Langerhans cell histiocytosis

• 3 types (alphabetic - the later, the more spread)
  • Eosinophilic granuloma - localized
  • Hans-Schuller-Christian - limited spread
  • Letterer Siwe- disseminated

Most common pediatric malignancy (1/3 of all malignancies in children): Leukemia

What other diseases/syndromes have increased risk of ALL?

• WAS, AT, Down, congenital hypogammaglobulinemia

Sites of leukemia relapse

• most common site: bone marrow
• CNS
• testes

The leading cause of death from disease in children and adolescents: Leukemia

Platelet disorders

#1 clinical manifestation of early congenital syphilis: Periostitis, Usually affects long bones; Usually asymptomatic; May be painful

bone most often fractured during birth

1. clavicle
2. humerus

4 entities assoc with absent or hypoplastic radius

• congenital thrombocytopenia-absent radius (TAR) syndrome
• VACTERL (formerly VATER): vertebral, anus (imperforate), cardiac origin, TE fistula, radii (absent), renal origin, limbs.
• Fanconi anemia
• Holt-Oran Syndrome (assoc w/ secumdum atrioseptal defect)

Most common cause of decreased active motion of the upper extremity in a newborn: clavicle fracture

Two most common causes of intrauterine growth retardation:

• placental insufficiency
• intrauterine viral infection (the TORCH complex: toxoplasmosis, rubella, cytomegalic virus and herpes).

#1 cause of non-communicating hydrocephalus: aqueductal stenosis

Most common serious malformation of the posterior fossa: Arnold Chiari II malformation

Arnold Chiari Malformation

1. ACM I: tonsil herniation only
2. ACM II: tonsils and brainstem herniation + usually myelomeningocele
3. ACM III: herniation of cerebellum
4. ACM IV: severe hypoplasia of cerebellum without herniation

Most common hereditary neuromuscular disease (1/3600): Duchenne Muscular Dystrophy

Most common epilepsy syndrome in childhood: Benign Rolandic Epilepsy (10% of childhood seizure disorders)

Most common seizure disorder of childhood: febrile seizures

Most common seizure type in childhood: Generalized tonic clonic

Muscular dystrophies

• Duchenee Muscular Dystrophy

• Becker Muscular Dystrophy

• fascioscapulohumeral syndrome (mnemonic: 'face and scapula' -> face and proximal arm weakness)

• limb-girdle dystrophy

• myotonic dystrophy.

Type

1. von-Gierke: G6Pase deficiency: severe fasting hypoglycemia, gout at puberty
2. Pompe: alpha-glucosidase (acid maltase, lysosomal enzyme) deficiency: hypotonia, then heart failure
3. Cori: glycogen debranching deficiency: presents like type 1
4. Anderson: glycogen-branching enzyme deficiency: progressive liver cirrhosis
5. McArdle: muscle phosphorylase deficiency: exercise intolerance

Most common malignancy in children: leukemia
Mostt common solid malignancy in children: Brain tumor, 20% of all tumors

5 most common brain tumors in children: ABCPE

• Astrocytoma 40%

• brainstem glioma 10%

• craniopharyngioma 10%

• PNET (medulloblastoma) 20%

• Ependymoma 10%

Most common posterior fossa tumors:

1. cerebellar astrocytoma

2. medulloblastoma

3. brainstem glioma

Most common brain tumor in children < age 7

• medulloblastoma

Mnemonic for PNET

• Little blue worm wearing a diaper but is very strong and crawls around the brain
• Starts in the cerebellar vermis (vermis = worm)
• Crawls around the brain (mets to the brain and spinal cord).
• The worm is very strong (requires surgery, radiation, and chemo to treat) and spreads the sutures of the skull (sutural diastasis).
• The worm is blue because there are small blue cells.
• The worm is wearing a diaper b/c there is a younger age of onset

Causes of congenital stridor

1. laryngomalacia
2. vocal cord paralysis
3. congenital subglottic stenosis/web

Most common cause of chronic glomerulonephritis in older children and adults

• Membranoproliferative GN: most common in the 2nd decade of life

Most common obstructive lesion, most common cause of hydronephrosis in childhood: UPJ obstruction

Ureteroceles are the most common cause of urinary retention in females

Vaginal Bleed - Prepubescent
Top 3 causes:
•  vulvovaginitis
•  scratching because of pinworm
•  vaginal foreign body
 

The most common primary orbital malignancy in childhood. this tumor should be a consideration in any child between the ages of  7 and 8 who has a rapidly progressing unilateral proptosis.: Rhabdomyosarcoma

The most common metastatic lesion to the orbit in childhood: neuroblastoma

The most common organic acidemias: propionic acidemia, methylmalonic aciduria, isovaleric acidemia