Pediatric Gastrointestinal Diseases and Developmental Defects

Question 1

True or false: IBD, Crohn’s and Helicobacter gastritis do not occur until adolescence.

Answer 1

False. They can occur in kids as young as 3 months.

Question 2

Just note that this lecturer said all the exam questions will come from the PowerPoint, not the PDF (in case the PDF is super long).

Answer 2

Got it.

Question 3

Tracheo-esophageal fistulas have what incidence?

Answer 3

1/3,000 - 1/10,000 live births

Question 4

Most children with tracheo-esophageal fistula also have _______________.

Answer 4

esophageal atresia

Question 5

Tracheo-esophageal fistula presents with ____________ during pregnancy.

Answer 5

polyhydramnios

Question 6

What kind of tracheo-esophageal fistula is most common?

Answer 6

The proximal esophagus just stops, and the distal esophagus is connected to the trachea.

Question 7

True or false: bilious vomit comes from the gut.

Answer 7

False. It comes from the duodenum.

Question 8

Meckel diverticulum most often presents in the ____________.

Answer 8

distal small intestine –2 cm proximal to the ileocecal junction; the mnemonic for this is the “rule of 2s”: it presents in 2% of the population 2 cm proximal to the ileocecal junction

Question 9

Meckel diverticulum results from abnormal _____________.

Answer 9

remnant of vitelline duct (which connects the fetal intestine to the yolk sac)

Question 10

Which intestine (small or large) is fixed to the retroperitoneum?

Answer 10

The large intestine

Question 11

What increases risk of the disorder in which the intestines fail to return to the body?

Answer 11

Advanced maternal age

Question 12

What is the distinction between gastroschisis and omphalocele?

Answer 12

Gastroschisis also presents with intestines outside the abdomen, but there is no amniotic covering (as there is in omphalocele).

Question 13

Gastrointestinal duplications may or may not ____________ and are usually benign.

Answer 13

communicate with the true bowel

Question 14

What is the incidence of imperforate anus?

Answer 14

1/5,000

Question 15

How is Hirschsprung disease treated?

Answer 15

Surgical removal of the aganglionic segment

Question 16

Why is the distal colon the most commonly affected site in Hirschsprung’s disease?

Answer 16

Because the ganglion cells migrate from the mediastinum to the gut. The distal colon is the farthest site of migration, and thus the most likely area to be affected.

Question 17

What can cause neonatal necrotizing enterocolitis?

Answer 17

• hypoperfusion/ischemia
• enteric feeds
• poor immune system (leading to bacterial destruction of tissue)

Question 18

The most common form of tracheo-esophageal fistula is ____________.

Answer 18

when the distal esophagus connects to the trachea and there is no connection between the top and bottom esophagus

Question 19

The disorder that resembles omphalocele but lacks the amniotic covering results from what?

Answer 19

Defect in the congenital abdominal wall

Question 20

Hirschsprung’s is more common in ________.

Answer 20

males

Question 21

A neonate with ARDS develops bloody diarrhea and abdominal bloating. What treatment might he need?

Answer 21

• antibiotics and bowel rest (if mild)
• surgical resection (if severe)

The stem describes NEC.

Question 22

The trachea and esophagus develop from the ______________.

Answer 22

foregut

Question 23

The developmental abnormality that presents with heterotopic pancreatic and gastric tissue can lead to what symptoms?

Answer 23

Obstruction and bleeding

Question 24

If you’re looking at a fetus, the small intestines rotate ______________ and the large intestines rotate ______________.

Answer 24

clockwise; counterclockwise