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CMN 568 Unit 4: Questions & Answers (100% Accurate)
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CMN 568 Unit 4: Questions & Answers (100% Accurate)
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CMN 568 Unit 4: Questions & Answers (100%Accurate)
When does malrotation occur? Right Ans - at about the 10th week of
gestation
What is a malrotation? Right Ans - a congenital abnormality that occurs
during the embryonic phase of development when the midgut retracts into
the abdominal cavity. The midgut rotates counterclockwise
When do infants typically become symptomatic with a malrotation? Right
Ans - at 3 weeks of life
What is the classic sign of a malrotation? Right Ans - bilious vomitting
How is a malrotation diagnosed? Right Ans - upper GI study
What are some radiologic findings that are indicative of a malrotation?
Right Ans - corkscrew appearance with barium swallow; Signs of obstruction
(air-fluid levels) may be present, along with an abnormal gas pattern at the
stomach and duodenum.
What is pyloric stenosis? Right Ans - results from hypertrophy of the
pyloric sphincter (muscle in the distal stomach), which leads to poor gastric
emptying into the duodenum.
When does pyloric stenosis usually present? Right Ans - At 2-4 weeks of
age
What are the symptoms of pyloric stenosis? Right Ans - vomiting that
becomes projectile; typically occurs immediately after feeding, is nonbilious,
and the infant is hungry after vomiting. The parents may also report
constipation, excessive crying and weight loss, or failure to gain weight
What can delay symptoms of pyloric stenosis? Right Ans - breastfeeding
What is pyloric stenosis usually mistaken for? Right Ans - reflux or formula
intolerance
,What is the hallmark finding of pyloric stenosis? Right Ans - an olive-
shaped mass in RUQ
What are typical lab and radiologic findings of a baby with pyloric stenosis?
Right Ans - hypochloremia, metabolic alkalosis, Hypokalemia. KUB imaging
reveals a dilated gastric silhouette. An ultrasound typically reveals a thickened
and elongated pylorus, measuring greater than 4 mm.
What is intussusception? Right Ans - involves the invagination of a section
of the intestine into itself. The most frequent site is at the terminal ileum.
What is often a predisposing factor of intussusception? Right Ans - A recent
viral illness, mesenteric lymphadenitis, Henoch-Schonlein purpura, and cystic
fibrosis
What is the typical age of onset of idiopathic intussusception? Right Ans - 6
to 18 months, with an average age of 7 to 8 months
If intussusception occurs beyond 36 mths, it is typically due to a physical
abnormality such as? Right Ans - meckel's diverticulum or polyps
Is intussusception more common in girls or boys? Right Ans - boys
What is the classic presentation of intussusception? Right Ans - colicky
abdominal pain, recent viral illness with some vomiting and perhaps diarrhea.
The child begins to have episodes of colicky abdominal pain, draws up the
knees or stiffens the legs for a brief period, and then becomes quiet for several
minutes. The series of events recurs, typically every 15 to 20 minutes, and
continues for several hours. The child may have blood in his or her stools,
prompting the "currant jelly" descriptor
What is typically present on palpation with intussusception? Right Ans - A
sausage shaped mass typically in the right lower quad
What interventions should be considered when intussusception is suspected?
Right Ans - consult a pediatric surgeon. Initiate intravenous hydration and
order an air-contrast enema. Consider an abdominal ultrasound as well
, What will often diagnose and cure intussusception? Right Ans - an air
contrast enema
What are contraindication s to an air contrast enema? Right Ans -
perforation, shock, and peritonitits
What is usually classic hx of appendicitis? Right Ans - abd pain that starts
in the periumbilical area and migrates to the right lower quadrant, along with
low-grade fever, a small amount of emesis, and anorexia
What exacerbates the pain associated with appendicitis? Right Ans -
movement and the child frequently walks stooped over
What does examination of a child with appendicitis usually reveal? Right
Ans - point tenderness in the right lower quadrant with voluntary guarding,
and perhaps some rebound tenderness. He or she will typically move slowly,
grimace with sitting up, and grab his or her right side at the first jumping
attempt.
How can pain in the RLQ be illicited in a child that has suspected appendicitis?
Right Ans - Hitting the soles of the feet and jumping up and down
What findings would be indicative of an appendix rupture? Right Ans -
peritoneal signs: decreased bowel sounds, a distended abdomen, and
tenderness and guarding in all quadrants with palpation and percussion
What should you order if you suspect appendicitis, and what should you
initiate? Right Ans - CBC, electrolytes, and a u/a. Aggressive IV hydration.
What difference is seen in the cbc of a child with appendicitis vs. a ruptured
appendix? Right Ans - mildly elevated white blood count (WBC) with a left
shift vs. a white count is often markedly elevated, with a left shift and an
increased band count
What can often mimic appendicitis? Right Ans - ovarian torsion
The menstruating child will often be midcycle with an ovarian torsion? T/F
Right Ans - T
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