Rita's GI Questions Flashcards
What is the first line test for suspected Crohn’s disease?
a) ESR
b) abdominal CT
c) anti-gliadin antibodies
a) ESR
You are assessing for appendicitis. Which of the following signs involve internal rotation of the femur?
a) Psoas sign
b) Obturator sign
c) Rovsing sign
d) Rebound
b) Obturator sign
A 9-month old preemie presents with intermittent crying in which the mother notes a bulge in the groin. You find nothing on exam. What is the best course of action?
a) Reassurance
b) close follow-up
c) Referral to pediatric surgery
c) Referral to pediatric surgery
–inguinal hernia: the sooner the better!
A 20-month-old presents with diarrhea. The hx is remarkable for 24 ounces of juice a day. The physical exam is normal. The diarrhea is most likely from:
a) A virus
b) Too much juice
c) Parasites
d) Bacterial infection
b) Too much juice
What is the tx for mild gastroesophageal reflux in infant?
a) Proton pump inhibitors
b) Small frequent feeding
c) Burping normally
b) Small frequent feeding
Which hx or exam findings is the most indicative of Hirschsprung’s disease in a newborn?
a) Straining to have a normal soft stool
b) Stooling every other day
c) Tight anal sphincter with no stool in the vault
d) Mildly distended abdomen prior to having a stool
c) Tight anal sphincter with no stool in the vault
**key = no stool in the vault
A 5 yo is brought with complaints of nocturnal anal itch. The most appropriate tx plan is:
a) Metronidazole
b) Mebendazole
c) Quinacrine hydrochloride
d) Thiabendazole
b) Mebendazole
A 4 yo comes for abdominal pain. He is otherwise well. On exam, a large firm mass in the LLQ is felt. What is the next best step?
a) order an abdominal ultrasound
b) Order a CT of the abdomen
c) order a u/a
d) do a digital rectal exam
d) do a digital rectal exam
What’s a sign of psychological failure to thrive?
a) crying
b) making no contact
c) frequent stooling
d) vomiting
b) making no eye contact
A 2 month old is spitting up one ounce with every feed. The infant has normal weight and exam. Mom doesn’t think it’s a problem. What is the most likely dx?
a) Gastroesophageal reflux
b) Gastroesophageal reflux disease
c) Metabolic disease
d) Brian tumor
a) Gastroesophageal reflux
How do you treat mild dehydration in a baby with vomiting and diarrhea?
a) small amts of oral rehydration solution frequently
b) small amts of formula frequently
c) IV hydration
d) diluted formula
a) small amts of oral rehydration solution frequently
A baby presents with a 2 cm easily reducible umbilical hernia. What is the best course of action?
a) reassurance
b) referral to pediatric surgery
c) referral to peds GI
d) umbilicus belly button band
a) reassurance
OR
c) referral to peds GI
An 8 yo has a 7 lb weight loss, intermittent diarrhea, and vague abdominal pain. His physical is remarkable for an anal skin tag. Which of the following is the most likely dx?
a) Functional abdominal pain
b) Viral syndrome
c) Crohn’s disease
d) Cystic fibrosis
c) Crohn’s disease
What’s the most worrisome sign in a 4 month old?
a) Feeling a spleen tip
b) Feeling a liver edge
c) Seeing peristaltic waves
c) Seeing peristaltic waves
–> sign of obstruction!
A child is diagnosed with celiac disease. What type of food must the child avoid?
a) Lactose
b) Wheat
c) Sugars
d) Rice based
b) Wheat
A baby presents with 4 cm umbilical hernia, soft, reducible, with 1 cm umbilical “defect.” What is the next best step?
a) refer to surgery
b) refer to pediatrician
c) measure defect monthly
d) tell mom this is normal/monitor
d) tell mom this is normal/monitor
Which of the following is a sign of Hirschsprung’s?
a) anal strictures
b) diarrhea
c) abdominal distention
c) abdominal distention
What is the presentation of a patient with Meckel diverticulum?
a) Vomiting
b) Small streak of blood in the stool
c) Tarry stools
d) Abdominal pain
c) Tarry stools
A 24 month child presents with painless bleeding per rectum mixed with stool. Which is the most likely dx?
a) Volvulus
b) Colonic polyps
c) Intussusception
d) H. pylori induced ulcer
b) Colonic polyps
Intussusception –> currant jelly stool
H. pylori ulcer would –> tarry stool (higher up)
How would you test for a positive obturator sign in a child with abdominal pain?
a) Passively rotates the right hip from 90 degree hip/knee flexion position
b) Have the child take a deep breath while you apply pressure to the RUQ
c) Percuss over the costovertebral angle
d) Have the child raise up the leg, while you press down on the thigh
a) Passively rotates the right hip from 90 degree hip/knee flexion position
