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Flashcards in Gastrointestinal Disorders Deck (78)
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1

A 10 mo has been diagnosed with gastroenteritis. He attends a child-care facility. What is the most likely cause of his illness?
a) clostridium difficile
b) rotavirus
c) salmonella
d) cryptosporidium

b) rotavirus

2

In a healthy 8 mo with diarrhea but no dehydration, what would be the most appropriate advice to give parents?
a) encourage 1/2 strength formula for 12 hours
b) give oral rehydration solution for 12 hours
c) give only fluids until stools return to normal
d) give bananas and cereal as tolerated

d) give bananas and cereal as tolerated

3

When evaluating a child with abdominal pain, what symptom would lead to a likely organic etiology?
a) night waking
b) pallor
c) suprapubic pain
d) sweating

a) night waking

4

Vomiting in infancy has a long list of differential diagnoses. Which accompanying symptom would most likely point to pyloric stenosis?
a) diarrhea
b) appropriate growth
c) acts hungry after vomiting
d) sausage shaped mass in abdomen

c) acts hungry after vomiting

5

Which of the following is the appropriate regimen for pinworm medication?
a) daily times 7 days, repeat as needed
b) three times a day for 10 days, repeat as needed
c) twice daily for 3 days, repeat in 2 weeks
d) One dose x 1, repeat in 2 weeks

d) One dose x 1, repeat in 2 weeks

6

A 2 mo's frequent vomiting has his mother convinced that something is seriously wrong. Which of the following is most suggestive of GER?
a) He's gained 5 ounces this month
b) He has a slight wheeze today
c) He eats hungrily after vomiting
d) He drinks 7-8 ounces every 3-4 hours.

d) He drinks 7-8 ounces every 3-4 hours.

7

A 20 mo with normal growth and development is being seen for diarrhea. His mother tells you that he is passing up to three loose stools a day and that he drinks 20 oz of apple juice a day. What is the most likely diagnosis?
a) crohn's disease
b) giardia lamblia
c) celiac disease
d) nonspecific toddler diarrhea

d) nonspecific toddler diarrhea

8

A 6 mo was seen last week for a WCC, and her weight was 7 kg. Today she presents with diarrhea and vomiting for 4 days. Today her weight is 6.5 kg. What is her percentage dehydration?
a) 5%
b) 7%
c) 10%
d)

b) 7%

9

What clinical signs would you expect to see in a pt with 7% weight loss from dehydration?
a) normal capillary refill
b) normal fontanel
c) cool mottled skin
d) dry mucous membranes

d) dry mucous membranes

10

The 6 mo's vomiting and diarrhea has stopped. If she needs oral replacement therapy today, what would be the appropriate amount to recommend?
a) 325-350 cc over 4 hours
b) 600-700 cc over 4 hours
c) 600-700 cc over 12 hours
d) 325-350 cc over 8 hours

b) 600-700 cc over 4 hours

11

Pinworms can cause which of the following?
a) constipation
b) anal itching
c) abdominal pain
d) diarrhea

b) anal itching

12

In evaluating a child with bloody diarrhea, which of the following would be an appropriate first action?
a) check growth chart
b) stool culture
c) upper GI
d) hemoccult test stools

b) stool culture

13

A family eats at fast food restaurants 4-5 times each week. If you suspect a child's bloody diarrhea is infectious in nature, what is the likely causative organism?
a) adenovirus
b) e. coli
c) giardia lamblia
d) s. aureus

b) e. coli

14

Which of the following conditions would be most likely to occur in a 4 yo boy?
a) pyloric stenosis
b) recurrent abdominal pain
c) intussusception
d) giardia infection

d) giardia infection

15

Which of the following findings could be expected to occur in a baby with intussusception?
a) inconsolable screaming
b) olive shaped mass
c) left to right peristaltic waves
d) weight loss

a) inconsolable screaming

16

Which of the following may occur with suspected appendicitis?
a) pain not relieved with ambulation
b) young children appear very ill in the early phase
c) fever of 102-103
d) leukopenia with left shift

a) pain not relieved with ambulation

17

In the US parasitic gastroenteritis is most commonly caused by which organism?
a) enterobius vermicularis
b) entamoeba histolytica
c) cryptosporidium parvum
d) giardia lamblia

d) giardia lamblia

18

Which of the following serological findings indicates a carrier state for HBV?
a) HBsAg negative for 6 months
b) IgM anti-HBc negative and HBsAg positive
c) Anti-HBc positive
d) Anti-HBs positive

b) IgM anti-HBc negative and HBsAg positive

19

Children in child-care facilities are at greater risk of being exposed to which of the following infections?
a) HAV
b) HBV
c) HCV
d) HDV

a) HAV

20

Infant immunization for hepatitis B often raises many parental questions about the disease. Which of the following is not true about hepatitis B virus?
a) it can survive for more than 1 week on fomites
b) it is the most common form of hepatitis in the world
c) contaminated water and shellfish are the major source
d) perinatally infected infants are likely to become carriers

c) contaminated water and shellfish are the major source

21

A 2 do baby is in the hospital nursery and still has not passed meconium. This is a red flag for what condition?
a) intussusception
b) HUS
c) pyloric stenosis
d) hirschsprung's disease

d) hirschsprung's disease

22

Consistent with findings of hirschsprung's disease, findings on rectal exam would be which of the following?
a) tight anal canal with no stool in vault
b) impacted stool with fissure
c) large, dilated rectum
d) soft stool, normal tone

a) tight anal canal with no stool in vault

23

What treatment would be appropriate for hirschsprung's disease?
a) emulsified mineral oil, 1/2 tablespoon per day
b) referral to gastro/surgeon
c) malt soup extract, 2 tsp for 3 days
d) rectal dilation with thermometer

b) referral to gastro/surgeon

24

When evaluating a child with suspected inflammatory bowel disease, which of the following diagnostic tests would not be helpful?
a) amylase and lipase
b) ESR
c) serum total protein and albumin
d) CBC with differential

a) amylase and lipase

25

Your patient has inflammatory bowel disease. Which finding is most consistent with ulcerative colitis?
a) occult blood
b) perirectal abscess
c) aphthous ulcers
d) left sided abdominal pain

d) left sided abdominal pain

26

Antimicrobials will improve the condition of a 4 yo child with diarrhea caused by which of the following organisms?
a) salmonella
b) rotavirus
c) shigella
d) e. coli

c) shigella

27

A pt has functional abdominal pain. When counseling her family on management of painful episodes, you would recommend which of the following?
a) take IBU 200 mg for pain
b) stay home from school during episodes
c) decrease milk products
d) go to school during episodes

d) go to school during episodes

28

Which of the following would not be consistent with a diagnosis of functional constipation in an infant?
a) vomiting
b) anal fissure
c) straining
d) starting solids

a) vomiting

29

A child has developed her second perirectal abscess in 6 months. She should be evaluated for which condition?
a) giardia lamblia
b) crohn's disease
c) ulcerative colitis
d) enterobiasis

b) crohn's disease

30

Which of the following symptoms are most common in the early phase of appendicitis in children?
a) abdominal pain after eating
b) fever and diarrhea
c) severe localized RLQ pain with pallor and sweating
d) anorexia, vague, diffuse pain

d) anorexia, vague, diffuse pain