Gastrointestinal Disorders

Question 1

Frothing and bubbling at the mouth and nose, cough, cyanosis, respiratory distress
Feeding exacerbates the symptoms
Inability to pass an NGT or OGT in a newborn is suggestive of the dx

Answer 1

Tracheoesophageal atresia

Type A-most common

Question 2

Gold standard in diagnosing GERD

Answer 2

Esophageal pH monitoring

Question 3

Indications for Endoscopy in FB ingestion

Answer 3

Sharp objects, disc button batteries, or FBs with respiratory symptoms

Failure to visualize the object+symptoms

Question 4

Most common cause of nonbillous vomiting

Answer 4

Pyloric stenosis

Question 5

Firm, movable, olive shaped mass on the abdomen; visible peristaltic wave after feeding

Answer 5

Pyloric stenosis

Question 6

Confirmatory test for Pyloric stenosis

Answer 6

Ultrasound: pyloric thickness >4mm or length >14mm

Question 7

Shoulder sign

Answer 7

Pyloric stenosis

Question 8

Double tract sign

Answer 8

Pyloric stenosis

Question 9

Triad:
Sudden onset of severe epigastric pain
Inability to pass a tube into the stomach
Retching with emesis

Answer 9

Volvulus

Question 10

Seen in barium enema as it encounters the volvulated loop

Answer 10

Bird’s beak sign

Question 11

X-Ray finding showing distended sigmoid loop

Answer 11

Inverted U sign

Question 12

X-ray finding showing a midline crease corresponding to messenteric root in greatly distended sigmoid

Answer 12

Coffee bean sign

Question 13

Bilous vomiting without abdominal distention

Answer 13

Duodenal atresia

Question 14

X-Ray: double-bubble sign

Answer 14

Duodenal atresia

Question 15

Corkscrew sign

Answer 15

Malrotation

Question 16

Meckel diverticulum’s rule of 2

Answer 16

2% of the population
2 inches long
2 feet from the ileocecal valve
2/3 have ectopic mucosa 
2% become symptomatic

Question 17

Presents with painless rectal bleeding and brick colored stool

Answer 17

Meckel diverticulum

Question 18

Remnant of the omphalomesenteric duct

Answer 18

Mickel diverticulum

Question 19

Presents with chronic constipation wither rum usually empty of feces on exam and with normal anal sphincter tone

Answer 19

Hirschprung disease

Question 20

Hirschsprung disease

Answer 20

Absence of Meissner and Aurbach plexus

Aganglionic segment limited to rectosigmoid (80%)

Question 21

Pellet-like or ribbon like stool

Answer 21

Hirschsprung disease

Question 22

Currarino triad

Answer 22

Anorectal malformation
Sacral bone anomalies
Presacral masses

Question 23

Gold standard for the diagnosis of Hirschsprung disease

Answer 23

Rectal suction biopsy

Question 24

Management of Hirschsprung disease

Answer 24

Temporary colostomy and wait until infant is 6-12 months old to perform definitive procedure.

(Swenson, Duhamel, Boley)

Question 25

Presents with severe paroxysmal colicky pain at frequent intervals with straining efforts. Currant jelly stools. Slightly tender sausage shaped mass in the RUQ

Answer 25

Intussusception

Question 26

Barium enema: coiled-spring sign

Answer 26

Intussusception

Question 27

Treatment of PUD

Answer 27

PPI + Clarithromycin + Amoxicillin or Metronidazole

Question 28

Chronic or persistent diarrhea is

Answer 28

>14 days duration

Question 29

Lactose intolerance is what type of diarrhea

Answer 29

Osmotic diarrhea

Question 30

Classic ex. Cholera which increase cAMP and cGMP

Answer 30

Secretory diarrhea

Question 31

Wt loss in Some Dehydration

Answer 31

5-10%

Question 32

Composition of Reduced osmolarity ORS (mEq/L)

Answer 32

``` Glucose 75 Sodium 75 Chloride 65 Potassium 20 Citrate 10 Osmolarity 245 ```

Question 33

Vomiting/diarrhea occurring in

Answer 33

Food poisoning

Question 34

Vomiting/diarrhea occurring in 1-6hrs

Answer 34

Staphylococcus aureus

Question 35

Watery diarrhea, abd cramps in 8-72hrs

Answer 35

Salmonella

Question 36

Bloody diarrhea >15hrs

Answer 36

Shigella

Question 37

superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus

Answer 37

Cullen's sign

Question 38

Bluish bruising of the flanks and is a sign of retroperitoneal hemorrhage

Answer 38

Grey Turner sign

Question 39

Active viral replication, increased risk of transmitting HBV

Answer 39

HBeAg

Question 40

First serologic marker to appear & it's rise coincides with the onset of symptoms. Antigen used in hep B vaccine

Answer 40

HBsAg

Question 41

Iden of people who have resolved infections with HBV; determination of immunity after immunization

Answer 41

Anti-HBs

Question 42

Idem of infected people with lower risk of transmitting HBV

Answer 42

Anti-HBe

Question 43

Rises in level during the core window period

Answer 43

IgM anti-HBc