Gastroenterology

Question 1

Duodenal atresia mechanism

Answer 1

failure of recanalization during the 8th-10th week of gestation after obliteration of the lumen by epithelial proliferation

Question 2

apple peel deformity

Answer 2

jejunal / ileal atresia

Question 3

jejunal / ileal atresia mechanism

Answer 3

In utero mesenteric vascular occlusion

Question 4

Highest incidence of atresias

Answer 4

Jejunal / ileal higher than duodenal or colonic

Question 5

MC location of jejunal / ileals atresias

Answer 5

Distal ileum

Question 6

MC location of SIP

Answer 6

terminal ileum

Question 7

Meconium ileus mechanism

Answer 7

obstruction of terminal ileum by hyperviscous secretions

Question 8

Do patients with CF have meconium ileum or other way around?

Answer 8

90% of patients with MI have CF
10% patient with CF have MI
* If have MI, look for CF!!

Question 9

MC association with microcolon (+ others)

Answer 9

Maternal diabetes

hypothyroidism; toxemia ie. magnesium

Question 10

Hirschsprung disease male or female predominant?

Answer 10

male

Question 11

Immaturity of the ganglion cells of the colon leading to transient impairment

Answer 11

Meconium plug

Question 12

Rocker bottom perineum suggests

Answer 12

Sacral agenesis (ass with IDM)
--> poor prognosis for fetal continence

Question 13

Gastroschisis mechanism

Answer 13

Involution of RIGHT umbilical vein causing weakness in umbilical ring

Question 14

Meds associated with gastroschisis

Answer 14

Vasoconstrictive meds ie. ibuprofen ,pseudoephedrine, cocaine

Question 15

Association of malrotation with omphalocele and gastroschisis?

Answer 15

ALL infants with gastro and omphalocele have malrotation

Question 16

Omphalocele male or female predominant?

Answer 16

Male

Question 17

Omphalocele mechanism

Answer 17

Failure of intestinal loops to return to abdominal cavity at 11 weeks or somatic folds fail to complete formation at 18 weeks

Question 18

Ass syndromes with omphalocele

Answer 18

OEIS, BWS, pentalogy of Cantrell ;

also all trisomies; heart defects, GU, etc

Question 19

Paucity of intrahepatic bile ducts, unusual facies, vertebral anomalies

Answer 19

Alagile syndorme

JAG 1 mutation

Question 20

JAG 1 mutation

Answer 20

Alagile syndrome

Question 21

Extrahepatic cholestasis

Answer 21

Biliary atresia
Scherlosing cholangitis
 Bile duct stenosis
Choledochal cyst
Bile plug syndrome

Question 22

Multinucleated giant cells + cholestasis

Answer 22

Idiopathic neonatal hepatitis

Question 23

MC location of NEC

Answer 23

terminal ileum and proximal colon

Question 24

Which has higher association with GI anomalies- gastro vs omphalocele?

Answer 24

Gastro
ALL infants with both have malrotation
16% gastro have other anomalies such as volvulus, atresia, stenosis or perforation