Pediatrics Recalls By Subject – Gastroenterology

A 6-hour-old neonate presents with frothing from the mouth and nose, and difficulty in breathing during eating. On examination he is generally well, and cries without respiratory distress.

Which of the following is the next diagnostic test?

A 6-month-old infant is referred for work up of constipation and abdominal distention. The baby passed his first meconium at the age of 3 days, and has been padding stool every few days after insertion of a rectal thermometer. The imaging results are attached.

Which of the following test will contribute the most to diagnosis?

Blood work was obtained from a generally healthy 6-year-old boy, as per parental request.
Complete blood count was normal, and serum IgA anti TG2 was 100 units (normal value <15 units).
The boy does not have abdominal pain, and passes normal stool once a day. Family history is negative for celiac.

Which of the following describes the recommended approach?

An infant aged one year and six months suffers from recurrent, projectile vomiting after each feeding, as well as a lack of weight gain. Abdominal US demonstrates evidence of considerable thickening of the pylorus.

Which finding in the blood tests is highly likely to support the diagnosis?

A premature neonate was born at week 29, now week 32. Fed with infant formula in amounts suitable for his weight. On examination he is panting and grunting, pale, and his abdomen is swollen and tender, bloody stools.

What is the next step in the management of this case?

A 4-month-old girl, until now has been exclusively breastfed, is brought for examination due to bloody stools. On examination – gaining weight well, vital, soft abdomen, no signs of anal fissure. Stool PCR negative for enteropathogens. The mother indicates that for the past few weeks, she has been fed infant formula.

What is the most recommended treatment in this case?

A 3-year-old boy arrives at the pediatric ER after swallowing a cleaning agent. In a sampling of the agent: pH = 14.

Which of the following is the most recommended as an initial treatment after the cleaning agent ingestion?

A few hours old newborn presents with bilious vomiting. Pregnancy history includes polyhydramnios. Examination reveals a hypotonic newborn, with a soft and non-distended abdomen. Imaging is attached.

Which of the following is the most probable diagnosis?

A 3-week-old newborn was admitted due to jaundice. Laboratory results include total bilirubin of 12 mg/dl, and direct bilirubin 7.5 mg/dl (normal value <10% of total bilirubin).

Which of the following is the most probable diagnosis?

A 6-weeks-old male infant with a history of normal pregnancy and delivery, presents with vomiting after each meal, restlessness and failure to gain weight over the last few days. A photo of physical examination findings is below

Which of the following is the most appropriate treatment?

A 10-year-old generally healthy girl presents with 6 months of dysphagia to liquids and solids, and episodes of vomiting of undigested food. Weight loss of 2 Kg. Physical examination is normal.

Which of the following is the most appropriate diagnostic test?

A 14-year-old girl with diagnosed asthma presents with episodes of dysphagia to solids for the last 5 months. Gastroscopy image is attached

Which of the following is the most appropriate treatment?

A 13-year-old boy has been hit by a ball during a soccer game, two days prior to his arrival. He has been complaining of epigastric pain since, fever, and vomiting. His examination is positive for significant abdominal epigastric tenderness.

Which of the following tests will most probably promote diagnosis?

A 4-week-old infant is evaluated for projectile vomiting without bile content for the past 24 hours. The infant is in no distress, wants to eat, but vomits right after. He has passed a normal bowel movement about 4 hours prior to admission.
Abdominal ultrasound demonstrates the finding in the photo below.

Which of the following is the definitive treatment for the most likely diagnosis?

A 3-week-old breast fed newborn, born at term following a normal pregnancy and delivery presents with a few days of increasing vomiting, failure to gain weight and restlessness.

Below is an abdominal ultrasound

.

Which of the following are the most likely laboratory results?

An 18-months-old toddler presents with two days of fever, mild rhinorrhea, and vomiting that developed on the day of admission. The mother reports alternating episodes of restlessness, pain, apathy, and drowsiness. Examination reveals diffuse abdominal tenderness. Abdominal ultrasound is below.

Which of the following is the next step in managing this patient?

Which of the following is considered a risk factor for perforation in childhood appendicitis?

A 7-months-old infant presents with high fever, watery diarrhea, some containing mucus and some blood, and decreased appetite. He is generally well on examination. Stool culture reveals salmonella.

Which of the following is the most appropriate treatment?

4-months-old generally well infant presents with bloody diarrhea. He has lately changed his diet from breast milk to cow milk base formula.

Which of the following cannot explain this symptom?

A 5-year-old boy is examined due to periumbilical abdominal pain over the last few months. The pain recurs during the day, lasts about 30 minutes, and resolves spontaneously. Physical examination and laboratory test including serum chemistry, blood count, and CRP are normal.

Which of the following is the most appropriate next step in management?

A 7-year-old healthy boy presents with upper abdominal pain over the last 2 months, and dysphagia for the last week. Family history is positive for a maternal uncle with atopic dermatitis which resolved after childhood.

Which of the following is the most likely diagnosis?

A 13-year-old girl is referred for work up due to fatigue, malaise, and elevated liver enzymes over the last 3 months. Examination is positive for a palpable, tender liver, 3cm below the rib cage. Laboratory results include total bilirubin 3.5, direct bilirubin 2, ALT 90, AST 80, GGT 25, ALKP 145, albumin 3.5, total protein 8.

Which of the following will most likely be found in this patient?

A 13-year-old female complaining of asthenia, tremors in her hands and a decline in academic achievements. Referred to an ophthalmologist. The test found the described finding (in the below image).

Which of the following findings would most likely support the diagnosis?

A 4-year-old male was referred for an examination due to rectal bleeding. No abdominal pain or diarrhea, no increase in temperature. No pain when passing stool. In blood count, hemoglobin levels are 8.0 g% (norm above 11.5). Which test would advance his likely diagnosis?

A 4-week-old male is referred to the emergency room due to repeated emesis after eating. Blood tests demonstrate evidence of hypochloremic metabolic alkalosis and indirect hyperbilirubinemia. Which of the following tests would significantly advance the diagnosis?

A 4-year-old male has been suffering for the last week from abdominal pain, loss of appetite, diarrhea, and emesis. On the last day, the parents have noticed periorbital edema. In a blood test, electrolyte levels are within the norm, and albumin levels are 2.6 g/dL (norm above 3.5). Urinalysis with no evidence of protein. What is the standard treatment in this case?

An 8-year-old male is complaining of dysphagia to solids and recurrent complaints of epigastric abdominal pain. The father suffers from atopic dermatitis. Blood tests: high levels of IgE and eosinophilia in blood count. Typical findings in gastroscopy. What is the initial treatment for the probable diagnosis?

A 13-year-old male has been experiencing epigastric pain for several months, which worsens after eating. The symptoms are accompanied by nausea, and his stools are black. He reports medicinal treatment prior to the onset of symptoms.
What is the most likely cause of his condition?

A 2-year-old child is brought to the clinic with swelling around the eyelids. Laboratory tests reveal hypoalbuminemia with normal liver functions. Urine test shows no evidence of proteinuria.

What is the most likely diagnosis?

A 3-month-old male infant, with a history of normal pregnancy and birth, formula-fed, presents with frequent regurgitation, recurrent episodes of restlessness, and intermittently arches his upper body and tilts his head backward. The physical examination, including a neurological assessment, is unremarkable.

Which of the following treatments is suitable for his likely diagnosis?

Which of the following findings is more common in ulcerative colitis than in Crohn’s disease?

A male, 5 years of age, was referred for clarification of repeated episodes of abdominal pain that resolved after about 48 hours of fasting. In the past, he was hospitalized twice for similar complaints. While hospitalized, the amylase values were around 800 (norm: <140). It should be noted that on tests taken between the events, amylase levels were normal.

Which of the following tests would significantly advance the child’s diagnosis?

A 13-month-old male, known to suffer from a progressive neurological disease, was taken in due to episodes of considerable restlessness, multiple incidents of reflux, short pauses in breathing, and recently a lack of weight gain. In the past, there were two hospitalizations due to pneumonia. An endoscopy revealed multiple eosinophils (up to 15 on HPF) in the distal esophagus.

What is the most optimal treatment in this case?

Male, 2 months old, normal development/ Birth weight of 3000 grams, now weighing 4200 grams. Examined due to repeated episodes of non-stop crying, lasting about 3 hours, at a frequency of about 3 days a week. Posseting observed once every few days in a small amount.

What is the reasonable treatment approach for this case?

A 7-year-old boy was referred for investigation: a noticeable slowing of his growth rate in the last two years. Blood tests demonstrated a microcytic anemia that did not improve after the iron therapy attempt. Further investigations including thyroid functions and IGF-1 levels were normal.

What is the most reasonable next step in advancing the diagnosis?

A 3-day-old male, has not had bowel movement yet. Was examined due to a swollen abdomen and vomiting.

The abdominal X-ray demonstrates the following finding:

What is the probable diagnosis for the baby?

Male, two months old, healthy so far, with a normal obstetric history. Referred for examination due to repeated episodes of restlessness, posseting mainly after eating, and short episodes of apnea.

Which of the following is a common clinical characteristic in the probable diagnosis of the baby?

A 13-year-old boy was referred to assessment due to significant slowing down of growth in the past year. He complains of intermittent abdominal pains, rules out diarrhea. Microcytic anemia in blood count. Physical examination – the finding described in the image.

Which of the following tests will support his likely diagnosis?

Attached are growth charts of a 3-year-old toddler, who has been suffering from abdominal pains accompanied by diarrhea, vomiting, poor eating and irritability (agitation episodes). Attached is the growth chart of the toddler before and after initiation of treatment for his likely disease (beginning of intervention is marked by a double arrow on the graph).

What treatment did the toddler probably receive?

Below are the results of a patient’s blood serology tests
Total ANTI-HBc – positive
Anti HBs – positive
HBV DNA – negative
HBsAG – negative
Which of the following definitions most accurately describes his condition?

A 10-year-old boy was hospitalized due to fever with several diarrhea episodes, the diarrhea is with blood. PCR contains evidence for Salmonella enterica (nontyphoidal). The baby is in good general condition, eats well, no signs of dehydration.
What is correct regarding the management of this case?

A 13-year-old girl has been complaining of abdominal pains for several months, which worsen after meals. In her examination, epigastric tenderness. Evidence of microcytic anemia in blood test. Which of the following is the likely pathogen causing her condition?