Peds GI and GU Practice Questions and Complete Solutions
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Course
GU Peds
Institution
GU Peds
A 5-day-old infant boy is brought to the pediatrician'soffice by his mother for his first visit. He was born full-term via spontaneous vaginal delivery with no complications. His mother is concerned because she noticed that milk continually flows out his nose during feedings and she is worried that...
Peds GI and GU Practice Questions and
Complete Solutions
A 5-day-old infant boy is brought to the pediatrician'soffice by his mother for his first
visit. He was born full-term via spontaneous vaginal delivery with no complications. His
mother is concerned because she noticed that milk continually flows out his nose during
feedings and she is worried that he is not getting enough nutrition. Examination of the
infant shows signs similar to that in the image depicted below. The mother is asked to
use specialized nipples when feeding the baby and is told that the boy will eventually
require surgery to fix the problem. What are come common complications you should be
concerned about? ✅Otitis media is a common complication of cleft lip or palate. This is
due to abnormal development of the eustachian tube.
Difficulty feeding and suckling due to inhaling air
A 6-month old infant is brought in by her parents for a pre-surgical consultation. Per the
parents, she was born with a cleft palate. Examination shows the presence of an
opening in the palate that extends back to the uvula, producing a bifid uvula.
What is the procedure that she will need? ✅Palatoplasty
A newborn baby boy is delivered via elective Cesarean section after an uncomplicated
pregnancy. Examination of the baby shows a large V-shaped defect in the midline of the
roof of his mouth, splitting the uvula and continuing anteriorly to involve the soft palate
and a small portion of the hard palate. There is no associated defect in the lip. When
would you recommend surgical correction? ✅Palatoplasty 6 months to 2 years
BEFORE SPEECH
A newborn boy is examined soon after birth. The patient was delivered at 39 weeks
gestation via an uncomplicated vaginal delivery. Examination shows a cleft lip on one
side that does not involve the alveolar process or the hard palate. What procedure
would you recommend? When should it be done ideally? ✅Cheiloplasty is functional
and cosmetic
Done between 3-6 months of life
Rule of 10s
10 weeks, 10lbs, hgb 10 before palatoplasty
A 10-month-old male infant is brought to the emergency department because of
intermittent crying and refusal to feed for the last 8 hours. Between episodes of crying
he appears happy and has a normal activity level.
He had one episode of vomiting, which was green in color but had no visible blood. He
passed multiple loose, dark bloody stools on the way to the emergency room. Physical
examination shows an irritable infant with a temperature of 39.2°C (102.5°F). The
, Abdominal examination shows a palpable sausage shaped mass in the right upper
quadrant. What is most likely diagnosis of his acute symtoms? ✅INTUSSUSCEPTION
he classic triad of intussusception includes colicky abdominal pain, bilious vomiting, and
red "currant jelly" stool.
Diagnosis can be made with ultrasound
Air or contrast enema is curative (encourage vasovagal/crying to prevent perf)
A 15-month-old infant is brought to the emergency department by her parents after they
notice blood in her stool with the consistency of "jelly." Over the last two days, she has
had intermittent episodes of severe pain, during which she pulls her legs toward her
chest, cries, and cannot be consoled. These painful episodes seem to resolve on their
own and she is calm in between episodes. Her parents report that she had cold-like
symptoms last week, but is an otherwise healthy infant. Abdominal examination shows
a long, sausage-shaped, palpable mass in the right upper quadrant. Where is the most
likely location of the pathology? ✅The ileocecal junction INTUSSUSCEPTION
A 5-month-old male infant is brought to the emergency department because of vomiting
and intermittent abdominal pain beginning early this morning. His mother describes
episodes as sudden and with severe pain, where the child pulls his knees toward his
chest. Since the onset of his pain, his parents have noted a few red, jelly-like stools in
his diaper. He had an upper respiratory infection for the past week, but is otherwise
healthy with no prior health issues. His temperature is 36.5˚C (97.7˚F), pulse is 117/min,
respirations are 30/min, and blood pressure is 89/53 mm Hg. Abdominal examination
shows a soft abdomen with mild tenderness to palpation in the right upper and lower
quadrants. A sausage-shaped mass can be palpated in the right upper quadrant. Which
of the following is the most appropriate imaging choice for this patient and what will it
show? ✅US will show target or donut sign which is a single hypo echoic risk with a
hyperechoic center.
Pseudokidney sign occurs when it is compressed in the mucosa layers
Crescent sign protrudes into he colon or mass filled pocket
INTUSSUSCEPTION
A 10-month-old male infant is brought to the emergency department by his parents who
are concerned about thick, red blood in his diaper. He is currently playful and
interactive, but has had intermittent episodes of severe pain and crying since yesterday
evening. On physical examination, an elongated mass is noted in his right upper
quadrant. His vital signs are stable. What is the most appropriate next step in definitive
treatment of the patient? ✅Intussusception
Surgical consult
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