GIT

Question 1

Cholelithiasis in children is usually due to

Answer 1

Hemolytic dyscrasia

Question 2

Gold standard for diagnosis of biliary atresia

Answer 2

Direct cholangiography

Question 3

Most common form of biliary atresia

Answer 3

Obliteration of the entire extra hepatic biliary tree at or above the porta hepatis

Question 4

Seen in biliary atresia upon ultrasound where there is a cone shaped fibrotic mass cranial to the bifurcation of the portal vein

Answer 4

Triangular cord sign

Question 5

Biliary atresia vs neonatal hepatitis

Persistent acholic stool

Answer 5

Biliary atresia

Question 6

Most common cause of viral gastroenteritis in infants

Answer 6

Rotavirus

Question 7

Duration of acute diarrhea must not be more than how many days?

Answer 7

14

Question 8

Child presents with watery diarrhea and vomiting:

Day care center
Infants and toddlers

Answer 8

Rotavirus

ETEC

Question 9

Child presents with watery diarrhea and vomiting:

Profuse diarrhea and vomiting
Flecks of mucous on voluminous diarrhea

Answer 9

Cholera

Question 10

Child presents with watery diarrhea and vomiting:

Profuse diarrhea after eating raw oysters or undercooked shellfish

Answer 10

Vibrio parahemolyticus

Question 11

Child presents with watery diarrhea and vomiting:

Person to person
Winter

Answer 11

Norwalk

Question 12

Child presents with watery diarrhea and vomiting:

Greasy stool after camping

Answer 12

Giardia

Question 13

Child presents with watery diarrhea and vomiting:

After history if travel

Answer 13

ETEC

Question 14

In cholera, binding of the enterotoxin B to the ganglioside receptor activates what 2nd messenger?

Answer 14

Adenylate cyclase

Question 15

Increased levels of cAMP in cholera blocks reabsorption of?

Answer 15

NaCl reabsorption

Question 16

Drug treatment for cholera

Answer 16

Tetracycline or Doxycycline

Question 17

Invasion of intestinal epithelium is the basis for the bleeding diarrhea in what infection?

Answer 17

Shigella

Question 18

Enteric fever is caused by this organism

Answer 18

Salmonella typhi

Question 19

Empiric treatment for typhoid fever

Answer 19

Ceftriaxone

Question 20

Bloody diarrhea, pus and WBC in stools:

Trophozoite with ingested RBC

Answer 20

Amoebiasis

Question 21

Bloody diarrhea, pus and WBC in stools:

Abdominal cramps, systemic toxicity after antibiotic used

Answer 21

Clostridium difficile

Question 22

Usual antibiotics implicated in clostridium difficile infection

Answer 22

Clinda
Ampi
2nd gen Ceph

Question 23

Treatment for clostridium difficile

Answer 23

Metro

Vanco

Question 24

Bloody diarrhea, pus and WBC in stools:

Abdominal cramps, tenesmus

Answer 24

Shigella

Question 25

Bloody diarrhea, pus and WBC in stools: High fever, headache, drowsiness, confusion, meningismus, seizures, abdominal distention

Answer 25

Salmonella

Question 26

Bloody diarrhea, pus and WBC in stools: Diarrhea after eating hamburger

Answer 26

EHEC

Question 27

This serotype of Shigella produces Shiga toxin that is implicated in HUS

Answer 27

Shigella dysenteriae

Question 28

Clue in the Symptoms that is most likely due to shigella

Answer 28

Painful defecation

Question 29

Differentials for shigella

Answer 29

SECCSY ``` Salmonella EIEC Entamoeba histolytica Campylobacter Clostridium difficile Yersinia enterolitica ```

Question 30

Empiric treatment for shigella

Answer 30

Cipro

Question 31

Most common cause of intestinal obstruction between 3 months and 6 years old

Answer 31

Intussuception

Question 32

Currant jelly stool Sausage shaped mass Coiled spring sign in barium enema Donut or target sign in UTZ

Answer 32

Intussuception

Question 33

Noted to have vomiting every after feeding Clear breath sounds, firm movable mass on abdomen

Answer 33

Pyloric stenosis

Question 34

Vomit greenish material after every feeding on 1st day of life Nondistended abdomen with hyperactive bowel sounds

Answer 34

Duodenal atresia

Question 35

Double bubble sign on xray

Answer 35

Duodenal atresia

Question 36

Most common segment affected in Hirschprung

Answer 36

Rectosigmoid

Question 37

Most common cause of intestinal obstruction in neonates

Answer 37

Hirschprung

Question 38

Gold standard for diagnosis of Hirschprung

Answer 38

Rectal suction biopsy

Question 39

Definitive repair for Hirschprung occurs when the infant is

Answer 39

6-12 months

Question 40

Abdominal pain, vomiting Cant pass NGT Omega sign/coffee bean sign

Answer 40

Volvulus

Question 41

Abdominal pain, vomiting Postprandial vomiting, nonbilious, abdominal distention, Down's Olive shaped mass Barium- shoulder sign, double tract sign

Answer 41

Pyloric stenosis

Question 42

Painless rectal bleeding Intermittent pain Normal history or recurrent obstruction Scintigraphy scan to detect gastric tissue

Answer 42

Meckel's diverticulum

Question 43

Where is Meckel's usually found?

Answer 43

2ft from the ileocecal valve

Question 44

How many criteria must be met to diagnose functional constipation?

Answer 44

2

Question 45

In foreign body ingestion, symptoms of cervical swelling, erythema and subcutaneous crepitations may indicate

Answer 45

Perforation of oropharynx or proximal esophagus

Question 46

What test must be done if the foreign object cannot be visualized and the child is symptomatic?

Answer 46

Endoscopy

Question 47

Alkali agents cause this type of necrosis

Answer 47

Liquefactive

Question 48

Acidic agents can cause this type of necrosis

Answer 48

Coagulative

Question 49

Common causes of acute pancreatitis in children

Answer 49

Blunt abdominal injury | Viral illness

Question 50

Which pancreatic enzyme is more specific for acute inflammatory pancreatitis?

Answer 50

Lipase

Question 51

Sign in acute pancreatitis that refers to subcutaneous hemorrhage

Answer 51

Cullen sign

Question 52

Sign in acute pancreatitis that refers to retroperitoneal hemorrhage

Answer 52

Grey Turner sign

Question 53

Management for acute pancreatitis

Answer 53

NPO TPN Antibiotics Analgesic

Question 54

First clinical evidence of HBV infection is the elevation of

Answer 54

ALT levels 6-7 weeks after exposure

Question 55

Most valuable single serologic marker of acute HBV infection

Answer 55

Anti- HBc