CHILD WITH GI SYMPTOMS

Question 1

Pyloric stenosis DDx:

6

Answer 1

1. Partial duodenal atresia.
2. GERD.
3. Gastroenteritis.
4. Hepatitis.
5. UTI.
6. Otitis media.

Question 2

Pyloric stenosis workup:

10

Answer 2

1. Physical exam.
2. CBC.
3. Electrolytes.
4. US abdo.
5. Barium swallow.
6. PH probe.
7. Endoscopy.
8. AST/ALT/bil/ALP.
9. UA, urine culture.
10. Tympanocentesis culture.

Question 3

Hirschprung’s disease DDx:

4

Answer 3

1. Low-fiber diet.
2. Anal stenosis.
3. Hypothyroidism.
4. Lead poisoning.

Question 4

Hirschprung’s disease workup:

10

Answer 4

1. Physical exam.
2. Rectal exam.
3. Stool exam and culture.
4. Barium enema.
5. Suction rectal biopsy.
6. Anorectal manometry.
7. TSH, FT4.
8. CBC.
9. Electrolytes.
10. Serum lead level.

Question 5

Intussusception DDx:

6

Answer 5

1. Appendicitis.
2. Meckel.
3. Vovlulus.
4. Gastroenteritis.
5. Enterocolitis.
6. Blunt abdo trauma.

Question 6

Intussusception workup:

7

Answer 6

1. Physical exam.
2. Rectal exam, stool for occult blood.
3. CBC.
4. Electrolytes.
5. Contrast enema.
6. US abdo.
7. CT abdo.

Question 7

Somatoform disorder DDx:

4

Answer 7

1. Malingering.
2. IBS.
3. Lactose intolerance.
4. Child abuse.

Question 8

Somatoform disorder workup:

7

Answer 8

1. Physical exam.
2. CBC.
3. Electrolytes.
4. US abdo.
5. CT abdo.
6. Amylase, lipase.
7. Stool exam.

Question 9

Colic DDx:

6

Answer 9

1. Formula allergy.
2. GERD.
3. Lactose intolerance.
4. Strangulated hernia.
5. Testicular torsion.
6. Gastroenteritis.

Question 10

Colic DDx:

6

Answer 10

1. Formula allergy.
2. GERD.
3. Lactose intolerance.
4. Strangulated hernia.
5. Testicular torsion.
6. Gastroenteritis.

Question 11

Colic workup:

4

Answer 11

1. Physical exam.
2. Rectal exam, stool for occult blood.
3. US abdo.
4. US testicular.