EM GI

Question 1

, as the infant has presented with bilious vomiting and abdominal distension on the day 1 of life and has not passed meconium yet. The diagnosis is also suggested by the history of polyhydramnios in the mother and the fact that the affected infant is a preterm, low birth weight baby. Maternal history of polyhydramnios is present in 25% of cases.

Answer 1

ileal atresia

Question 2

operative cholangiography, as the clinical features of the infant like jaundice, passage of high, dark yellow colored urine, pale stools, hepatosplenomegaly, and conjugated hyperbilirubinemia are highly suggestive of biliary obstruction. This can be intrahepatic, commonly due to neonatal hepatitis, or extrahepatic, due to extra hepatic biliary atresia.

Answer 2

Cholangiography is direct visualization of the intrahepatic and extrahepatic bilary tract to evaluate the cause, location, and extent of biliary obstruction. It provides definitive information to guide the decision of whether operation is indicated or not.

Question 3

_____ combination is the most effective and safe for the treatment of amebic liver abscess.

Answer 3

metronidazole and chloroquin phosphate

Question 4

While the above scenario is highly suggestive of infantile hypertrophic pyloric stenosis (IHPS) (age 6 weeks, male, projectile vomiting with each feeding, hypochloremia with metabolic alkalosis), the need for surgery is not emergent. The child should be

Answer 4

placed NPO, and dehydration and electrolyte abnormalities should be corrected, after which a pyloromyotomy can be performed.

Question 5

The patient presents with a picture of cholestasis (jaundice, dark urine, clay colored stools). On biopsy, inflammation, intrahepatic bile duct proliferation, and fibrosis are seen.

Answer 5

Extrahepatic biliary atresia, in which various degrees and types of obliteration of the extraheptic biliary tree occur, usually presents in the first month of life with largely direct hyperbilirubinemia (often after physiologic jaundice has subsided), dark urine, and acholic stools.

Question 6

____ is the most sensitive study that can confirm the presence of Meckel diverticulum.

Answer 6

Radionuclide scan - intravenous infusion of technitium-99m pertechnetate

Question 7

_____ are colonoscopy findings associated with ulcerative colitis. A colectomy can be a relative cure since the disease is limited to the colon.

Answer 7

Crypt abscesses and superficial mucosal involvement

Question 8

______ are all associated with colonoscopy findings in Crohn’s disease.

Answer 8

Skip lesions, transmural involvement, fistulas, and fissures