GIN

Question 1

Definition of diarrhea

Answer 1

Infant: >10 mL/kg/d
Children: >200 g/24h
Lasting <14 days

Question 2

Hereditary conditions that manifest as enamel defects

Teeth are covered by only a thin layer of abnormally formed enamel

Answer 2

Amelogenesis imperfecta

Question 3

Hereditary opalescent dentin

Odontoblasts fail to differentiate normally, resulting in poorly calcified dentin

Answer 3

Dentinogenesis imperfecta

Question 4

Age of eruption of first primary tooth

Which tooth erupts first?

Answer 4

6.5 mo

Mandibular central incisor

Question 5

Age of eruption of first permanent tooth

Which tooth erupts first?

Answer 5

6-7 yr

Mandibular central incisor

Question 6

Surgical closure of cleft lip is performed by __ of age

Answer 6

3 months

Question 7

Closure of cleft palate is done before __

Answer 7

1 year of age

Question 8

Loss of LES relaxation and loss of esophageal peristalsis

Answer 8

achalasia

Question 9

Achalasia, alacrima and adrenal insufficiency

Answer 9

Allgrove syndrome

Question 10

Barium fluoroscopy reveals smooth tapering of the lower esophagus leading to the closed LES, resembling a bird’s beak. Diagnosis?

Answer 10

Achalasia

Question 11

Most sensitive diagnostic test for achalasia

Answer 11

Manometry

Question 12

Surgical procedure of choice for hypertrophic pyloric stenosis

Answer 12

pyloromyotomy

Ramstedt procedure

Question 13

Pharmacologic therapy fo hypertrophic pyloric stenosis

Answer 13

atropine sulfate

Question 14

In erect abdominal films, double fluid level with a characteristic beak near the lower esophageal junction. The stomach tends to lie in a vertical plane

Answer 14

Mesenteroaxial gastric volvulus

Question 15

In erect abdominal films, a single-air fluid level is seen without the characteristic beak. The stomach lies in a horizontal plane

Answer 15

Organoaxial gastric volvulus

Question 16

Treatment of gastric volvulus

Answer 16

laparoscopic gastropexy

Question 17

Plan abdominal radiograph finding in duodenal atresia

Answer 17

double-bubble sign

Question 18

Hallmark of duodenal obstruction

Answer 18

bilious vomiting without abdominal distention, noted on the 1st day of life

Question 19

Gold standard in the evaluation and diagnosis of malrotation and volvulus

Answer 19

UGIS

Question 20

UGIS: corkscrew appearance of the small bowel with or without bird’s beak appearance. Diagnosis?

Answer 20

malrotation

Question 21

Most common congenital anomaly of the GI tract caused by the incomplete obliteration of the omphalomesenteric duct during the 7th week of gestation

Answer 21

Meckel diverticulum

Question 22

Hernia containing a Meckel’s diverticulum

Answer 22

Littre hernia

Question 23

Delay or difficulty in defecation present for 2 wk or longer and significant enough to cause distress to the patient

Answer 23

constipation

Question 24

Triad of anorectal malformations, sacral bone anomalies and presacral anomaly

Answer 24

Currarino triad

Question 25

Gold standard for diagnosing Hirschsprung disease

Answer 25

Rectal suction biopsy

Question 26

Treatment of choice for Hirschsprung disease

Answer 26

endorectal pull-through

Question 27

Treatment of H. pylori-related PUD

Answer 27

``` Triple therapy: 2 antibiotics + PPI amoxicillin 50 mkday BID x 14 days clarithromycin 15 mkday BID x 14 days metronidazole 20 mkday BID x 14 days PPI 1 mkday BID x 1 mo ```

Question 28

Medical treatment for ulcerative colitis

Answer 28

``` Aminosalicylate -sulfasalazine 50-75 mkday BID-QID max 2-4 g Corticosteroid -prednisone 1-2 mkday OD max 40-60 mg Immunomodulators - azathioprine 2-2.5 mkday - 6-MP 1-1.5 mkday ```

Question 29

Management of pouchitis

Answer 29

oral metronidazole or ciprofloxacin | probiotics

Question 30

Test for reducing substances, stool pH, breath hydrogen test, are tests for?

Answer 30

Carbohydrate malabsorption

Question 31

Stool a1-antitrypsin is a screening tool for?

Answer 31

Protein-losing enteropathy

Question 32

Fecal elastase-1 estimation tests for?

Answer 32

Exocrine pancreatic insufficiency

Question 33

Presence of acanthocytes in the PBS, extremely low plasma levels of cholesterol and triglycerides Autosomal recessie disorder Neuro symptoms Diagnosis?

Answer 33

Abetalipoproteinemia

Question 34

Chylomicron retention disease

Answer 34

Anderson disease

Question 35

Deficiency of lysosomal acid lipase

Answer 35

Wolman disease

Question 36

Small bowel biopsy showing villous flattening, crypt hyperplasia, chronic inflammatory cell infiltrate of the lamina propria with adjacent lipid accumulation in the surface epithelium. Diagnosis?

Answer 36

Tropical sprue

Question 37

Treatment of tropical sprue

Answer 37

supplementation of folate and vitamin B12 for 6 mo | tetracycline or sulfonamides

Question 38

Treatment of Whipple disease

Answer 38

2 weeks of IV ceftriaxone or meropenem, followed by cotrimoxazole for 1 yr

Question 39

Malabsorption of neutral amino acids Manifests with aminoaciduria, photosensitive pellagra-like rash, headaches, cerebellar ataxia, delayed intellectual development, diarrhea

Answer 39

Hartnup disease

Question 40

Rapid onset of nausea and vomiting within 6 hr; fever, abdominal cramps and diarrhea within 8-72 hr, most likely etiology?

Answer 40

S. aureus (preformed toxins)

Question 41

Watery diarrhea and abdominal cramps after an 8-16 hr incubation period, likely etiology?

Answer 41

C. perfringens, B. cereus (enterotoxin-producing)

Question 42

Abdominal cramps and watery diarrhea after a 16-48 hr incubation period, likely etiology?

Answer 42

Enterotoxin-producing bacteria, Crystosporidium, Cyclospora, noroviruses, H1N1 influenza virus

Question 43

Bloody diarrhea and abdominal cramps after 72-120 hr incubation, likely etiology?

Answer 43

Shigella, Shigatoxin-producing E. coli

Question 44

Familial intrahepatic cholestasis associated with lymphedema of the lower extremities Episodic cholestasis

Answer 44

Aagenaes syndrome

Question 45

Cerebrohepatorenal syndrome Fatal in 6-12 mo Intrahepatic cholestasis

Answer 45

Zellweger syndrome

Question 46

Arteriohepatic dysplasia - Broad forehead; deep-set, widely spaced eyes; long, straight nose; underdeveloped mandible - ocular abnormalities - cardiovascular abnormalities (PS) - vertebral defects - tubulointerstitial nephropathy

Answer 46

Alagille syndrome

Question 47

Medical management of persistent cholestasis

Answer 47

1. Diet containing medium chain triglycerides 2. Vit A 10,000-15,000 IU/day 3. Vit E 50-400 IU/day as oral a-tocopherol 4. Vit D 5,000-8,000 IU/day of D2 or 3-5 mcg/k/d of 25-hydroxycholecalciferol 5. Vit K 2.5-5 mg every other day as water-soluble derivative of menadione 6. Calcium, phosphate, zinc supplementation 7. UDCA 15-30 mkday

Question 48

Four features of appropriate complementary feeding

Answer 48

1. Timely 2. Adequate 3. Safe 4. Properly fed

Question 49

Energy needs of infants from complementary foods per age: 6-8 mo 9-11 mo 12-23 mo

Answer 49

6-8 mo: 200 kcal/d 9-11 mo: 300 kcal/d 12-23 mo: 550 kcal/d

Question 50

Critical window for introduction of lumpy food

Answer 50

10 mo

Question 51

``` Children with a family history of allergy should avoid Cow’s milk until __ Egg Peanuts Fish ```

Answer 51

Cow’s milk 1 yr Egg 2 yr Peanuts and fish 3 yr