Gastrointestinal/Surgery

Question 1

9yo, drawing up knees and screaming, red current jelly stools

Answer 1

Intussusception

Question 2

Intussusception

Investigations

Answer 2

Vitals - temp, BP, HR, RR
X-ray - target sign, free air with perforation
Enema - diagnostic and therapeutic

Question 3

Intussusception

Complications

Answer 3

Haemorrhage
Incarceration
Necrosis
Peritonitis
Lifetime recurrence rate of 5-13%

Question 4

Intussusception

Management

Answer 4

IV fluids
Barium air enema
May need surgery if irreducible

Question 5

Projectile vomiting, palpable abdominal mass

Answer 5

Pyloric stenosis

Question 6

Duodenal atresia

Answer 6

Bilious vomiting at 1 day of age

Xray shows double bubble

Question 7

GOR

Answer 7

Non-bilious vomiting after every meal

Otherwise well, happy with good weight gain

Question 8

GBS Sepsis

Answer 8

Non-billious vomiting in a premature baby

Irritability and temperature

Question 9

Coeliac

Clinical Presentation

Answer 9

Poor weight gain, abdominal distension, chronic loose bowel motions, muscle wasting

Question 10

Crohn’s

Answer 10

Weight loss, abdominal pain, diarrhoea, lumps on shins

Question 11

Lactose intolerance

Answer 11

Diarrhoea following acute episode of gastroenteritis, following resolution of infection

Question 12

Mesenteric adenitis

Answer 12

Pain following viral URTI
Low grade fever
FBE and CRP normal

Question 13

Recurrent abdominal pain of childhood

Answer 13

Episodic pain that is better over the weekend

Investigations all normal

Question 14

Inguinal lymphadenopathy

Answer 14

Unilateral loin lump, tender and erythematous with no cough impulse

Question 15

Inguinal hernia

Answer 15

Premmie

Unilateral groin lump, more prominent on crying

Question 16

Hydrocele

Answer 16

Unilateral enlarged scrotum, transluminate mass