GI/GU disorders Flashcards
The pediatric primary care nurse practitioner examines a two-year-old patient with a tender, edematous, and erythematous knee. The parent reports that, two weeks ago, the patient experienced a five-day episode of fever and bloody diarrhea. Which organism is the likely cause of the patient’s current symptoms?
a. E. Coli
b. Shigella f.
c. Salmonella e.
d. G. lambia
c. Salmonella e.
A 9-year-old girl has been losing hair for about 2 years and now presents with a large mass in her epigastrum. Her parents separated about 3 years ago. The patient and her siblings have been spending part of each week at each parent’s home. A plain film of the abdomen reveals a large mass in the stomach. Endoscopy reveals a trichobezoar. What do you now recommend to the family?
a. surgical consultation for removal of bezoar
b. endoscopic removal of bezoar under anesthesia
c. reassurance that the bezoar will pass
d. abdominal CT scan to rule out gastric tumor
a. surgical consultation for removal of bezoar
Common routes of the spread of hepatitis A virus include all of the following except:
a. infants in daycare centers
b. transfusion of packed red blood cells
c. close personal contact
d. consumption of contaminated water or food
b. transfusion of packed red blood cells
All of the following statements about hepatitis E are true, except:
a. infection with hepatitis E virus (HEV) in pregnancy is associated with high mortality rate
b. cases of hepatitis E in the United States are rare
c. outbreaks of hepatitis E tend to be very large because of the high rate of secondary (case-to-case) spread
d. anti-HEV appears to be protective, and prospects for developing a vaccine are good
c. outbreaks of hepatitis E tend to be very large because of the high rate of secondary (case-to-case) spread
The emergency room calls about a 2 year old who swallowed some toilet bowl cleaner. Mom says she was cleaning the bathroom and thought the toddler was in another room. She turned around and saw her son with the bottle at his lips. He did some coughing, crying, and spitting. 2 hours later, physicians in the ED say that the lips look red and perhaps there is a burn on the posterior oropharynx. The child appears well. The next appropriate step would be:
a. admit NPO on steroids and antibiotics with EGD the next morning
b. observe in ED for 6 hours and if no symptoms send home
c. send home with UGI in 1 month and follow up as needed
d. admit NPO with EGD the next morning
d. admit NPO with EGD the next morning
A 5-month-old infant has been fed only goat milk. Laboratory studies reveal: Hgb 9.5 g/dL; MCV, 98 fL; WBC 4200/mm3; and reticulocyte count, 0.2%. For initial treatment, it would be MOST appropriate to recommend dietary supplementation with
a. iron
b. folic acid
c. ascorbic acid
d. pyridoxine
b. folic acid
Of the antibodies found in human colostrum and milk, the immunoglobulin (Ig) that is MOST likely to prevent organisms from adhering to the infant’s intestinal mucosa is:
a. IgA
b. IgE
c. IgG
d. IgD
a. IgA
A 3-year-old boy, who has sustained second- and third-degree burns of the esophagus from ingesting a lye solution, requires placement of a gastrostomy tube for nutritional support. The parents are counseled about the risks and benefits of tube feedings. In your discussion, you tell them that the MOST frequent complication of enteral feeding is:
a. electrolyte disturbances
b. gastric irritation
c. diarrhea
d. clogging of the feeding tube
c. diarrhea
An 8-month-old girl recently recovered from a gastrointestinal illness. When the mother reintroduced the formula, cereal, and baby foods the child had been eating before the illness, the girl developed persistent, watery diarrhea; abdominal distention; flatulence; and recurrent abdominal pain. Of the following, the MOST likely cause of this patient’s problem is
a. lactose intolerance
b. gluten sensitivity
c. cow milk allergy
d. new-onset infectious enteritis
a. lactose intolerance
An 8-year-old boy recently was diagnosed as having severe ulcerative colitis. Of the following, the best INITIAL management is:
a. oral azathioprine
b. bowel resection
c. continuous nasogastric feedings
d. intravenous corticosteroids
d. intravenous corticosteroids
