PreTest Pediatrics: "The Gastrointestinal Tract"

Question 1

Functional constipation –evinced by a normal exam and stools that occur roughly weekly –can start as early as __________________.

Answer 1

six months old

Question 2

True or false: functional abdominal pain can present with occult blood in the stool.

Answer 2

False.

Occult blood in the stool warrants a more extensive workup.

Question 3

What kind of GI bleed can be inherited?

Answer 3

PUD

It has a strong genetic component.

Question 4

Eosinophilic esophagitis is treatable with ______________.

Answer 4

inhaled or systemic steroids

Question 5

Malrotation/volvulus can present with _____________ on barium x-ray.

Answer 5

the “curly Q” sign (showing barium passing through the volvulus

Question 6

Echogenic bowel on prenatal ultrasound is suggestive of _______________.

Answer 6

meconium ileus

Question 7

A barium enema of a newborn with meconium ileus may show __________________.

Answer 7

microcolon

This occurs from not using the colon. The meconium generally gets stuck at the ileocecal junction, so the colon atrophies.

Question 8

Anti-Saccharomyces cerevisiae antibodies are found in about half of those with ____________.

Answer 8

Crohn disease

Question 9

pANCA is positive in which of the IBD disorders?

Answer 9

Ulcerative colitis

Question 10

The most serious acute complication of ulcerative colitis is _______________.

Answer 10

toxic megacolon

Question 11

How can you differentiate Hirschprung’s from functional constipation based on history?

Answer 11

Functional generally presents with constipation with leakage of loose stool, while Hirschprung’s presents with constipation without leakage of loose stool.

Question 12

Cholecystitis is uncommon in kids so _________________.

Answer 12

look for a predisposing cause: pregnancy, CF, obesity, weight loss, or prior gut surgery

Question 13

Pancreatitis in kids can be caused by ____________.

Answer 13

trauma, other diseases, or nothing at all

Question 14

Air contrast enemas can be used to diagnose _______________.

Answer 14

intussusception

Question 15

The best treatment for rumination is _____________.

Answer 15

behavioral training

It’s thought that many children regurgitate and re-swallow food to get attention. Training parents to ignore this behavior can cause it to resolve.

Question 16

The best diagnostic for Meckel diverticulum is ______________.

Answer 16

radionuclide labeling (technetium that binds to gastric mucosa)

Barium studies will usually not identify Meckel’s.

Question 17

The hydrogen breath test can diagnose _____________.

Answer 17

lactase deficiency (because bacteria produce H+ when they process lactose)

Question 18

In general, __________ teeth erupt first.

Answer 18

mandibular central incisors

Question 19

Prolonged use of a baby bottle (particularly with sugary juices) causes what pattern of tooth decay?

Answer 19

Frontal maxillary damage with normal mandibular teeth

Question 20

What is recommended for care of avulsed teeth in older children?

Answer 20

• Immediate reimplantation (less than 5% are viable after two hours)
• Do not brush or clean it because the roots may be damaged
• Transport in milk, sailne, or a cooperative child’s mouth

Question 21

Indirect inguinal hernias (going into the scrotum) require ______________.

Answer 21

surgical repair

Question 22

How should you manage ingestion of drain cleaner?

Answer 22

Endoscopically view the damage in 12 to 48 hours to assess need for surgical management.

Question 23

___________ can isolate E. coli O157:H7.

Answer 23

Sorbitol-MacKonkey agar

Question 24

Bone pain and petechiae are suggestive of what micronutrient deficiency?

Answer 24

Vitamin C

Question 25

A modified barium swallow with fluoroscopy can show ______________.

Answer 25

uncoordinated suck-swallow reflex