Pediatrics

Question 1

Cyclic vomiting syndrome

Answer 1

Is an idiopathic disorder that typically presents in children 4-7 years old.
Repeated, intermittent, stereotypical bouts of severe nausea, vomiting, and lethargy, which are self-limited and have no apparent cause.
It is associated with a family (or personal) history of migraines. Supportive therapy may be required during acute episodes, and some evidence suggests the use of antimigraine medications may be beneficial as prophylaxis.

Question 1

Intestinal malrotation

Answer 1

presents in newborns with bilious emesis, an upper gastrointestinal series demonstrating a misplaced duodenum, and a “corkscrew” appearance of the distal duodenum and proximal jejunum.

Question 2

What is the best management to minimize the progression to amblyopia in the evidence of strabismus?

Answer 2

The unaffected left eye should be occluded or use Cycloplegic and mydriatic eye drops to “recruit,” and encourage use of the affected eye.

Question 3

Granulomatous infantiseptica

Answer 3

Listeria monocytogenes infection
the neonatal presentation is severe and fatal in 20 to 30% of cases.
Common manifestations in the newborn include sepsis, pneumonia, meningitis, and a pathognomonic finding, widespread microabscesses, and granulomas.

Question 4

Patient presents at one minute of life with a pulse of < 100/min and an Apgar score of 5. The best next step in management is?

Answer 4

Positive-pressure ventilation and reassessment of his Apgar score at 5 minutes.

Question 5

Intussusception

Answer 5

Acute abdominal distress and jelly stools “target sign” on ultrasonography.
Pneumatic enema is very effective at diagnosing and reducing intussuscepted sections of bowel.

Question 6

Neonates with meconium ileus should undergo?

Answer 6

Sweat testing to evaluate for underlying cystic fibrosis.

Question 7

Signs of duodenal atresia occur?

Answer 7

Immediately after birth with bilious emesis and no abdominal distention.

Question 8

Neonatal malrotation with volvulus

Answer 8

Occurs due to an incomplete malrotation of the intestines during the 7-12th weeks of development. Patients will feed well until 3-7 days of life when bilious vomiting, abdominal distention, and rapid decompensation may occur.
Complications: intestinal ischemia, infection, necrosis, perforation of bowel, and ultimately shock.

A corkscrew pattern in an upper gastrointestinal series. This is a common finding of midgut volvulus.

Question 9

The patient’s postprandial non-bilious vomiting, persistent appetite, and “olive-like” mass is highly suggestive of?

Answer 9

Pyloric stenosis (PS), is due to hypertrophy of the pylorus muscle.
symptoms appearing around 3-to-5 weeks of life