Gastroenterology

1.    Tracheoesophageal Fistula.
***) The newly born regurgitates its entire first and every feed, pours saliva almost continuously. There are manifestations of:
A.    Imperforate anus
B.     Congenital diaphragmatic hernia
C.     Atresia of duodenum
D.    Atresia of the esophagus
E.     Meckel's diverticulum

Answer: D* Atresia of the esophagus

***) All of the following are features of isolated esophageal atresia, except:
A.    Excessive salivation
B.     Inability to pass nasogastrial tube
C.     Distended abdomen
D.    Pneumonia
E.     Cyanotic attacks after feeding

Answer: C* Distended abdomen

2.    Pyloric Stenosis.
***) A narrowing and elongation of the pyloric channel on X-ray in a 12 days old infant most strongly suggest:
A.    Duodenal atresia
B.     Duodenal ulcer
C.     Duplication of the stomach
D.    Infantile hypertrophic pyloric stenosis
E.     Annular pancreas

Answer: D* Infantile hypertrophic pyloric stenosis

***) Pyloric stenosis is characterized by all of the following, except:
A.    Usually present between 3 and 8 weeks of life
B.     Is commoner in first-born infants
C.     Is commoner in girls
D.    There is a family history of such disease
E.     Projectile vomiting

Answer: C* Is commoner in girls

***) All of the following are characteristics of pyloric stenosis, except:
A.    Commonly seen in the first born baby
B.     Bile stained vomiting
C.     Metabolic alkalosis
D.    Failure to thrive
E.     Ultrasound is helpful in confirming diagnosis

Answer: B* Bile stained vomiting

***) Regarding pyloric stenosis all of the following are true, except:
A.    Metabolic acidosis is presenting feature
B.     Barium meal confirm the diagnosis
C.     It affects more the first and male babies
D.    The baby is usually alert and sucking strongly
E.     Surgical management is pyloromyotomy

Answer: A* Metabolic acidosis is presenting feature

***) Concerning hypertrophic pyloric stenosis of following are true, except:
A.    Manifestations start usually 3-4 weeks after birth
B.     Bile stained projectile vomiting is the presenting symptom
C.     A visible peristalsis may be seen passing from the left to right across the upper abdomen
D.    Constipation and loss of weight are usually present
E.     Surgery is the treatment of choice

Answer: B* Bile stained projectile vomiting is the presenting symptom

***) Concerning hypertrophic pyloric stenosis all the following are true, except:
A.    Non-bilious projectile vomiting is the most common
B.     Visible peristalsis may be seen passing from left to right across the upper abdomen
C.     An olive-size mass can be felt in the right hypochondrium
D.    Constipation and loss of weight are usually present
E.     The usual management is by antispasmodics and laxatives

Answer: E* The usual management is by antispasmodics and laxatives

***) Concerning hypertrophic pyloric stenosis, all the following statements are true, except:
A.    First born male infants are most frequently affected
B.     Symptoms usually begin in the third week of life
C.     Bile stained vomiting after feeding is characteristic
D.    Other gastrointestinal anomalies are usually not present
E.     Preoperative preparation frequently requires potassium replacement

Answer: C* Bile stained vomiting after feeding is characteristic

3.    Duodenal Atresia.
***) A newly born presented with persistent bile stained vomiting. Straight, erect abdominal radiograph showed “double bubble” appearance in the upper abdomen. This infant has:
A.    Meconium ileus
B.     Duodenal atresia
C.     Imperforated anus
D.    Hypertrophic pyloric stenosis
E.     Congenital intussusception

Answer: B* Duodenal atresia

***) All of the following are causes of non bile stained vomiting, except:
A.    Feeding problem
B.     Gastro-esophageal reflux
C.     Pyloric stenosis
D.    Duodenal atresia
E.     Hidden infection (meningitis)

Answer: D* Duodenal atresia

4.    Vomiting.
***) Common causes of vomiting in children including all the following, except:
A.    Over feeding
B.     Duodenal atresia
C.     Gastro-esophageal reflux
D.    Gastroenteritis
E.     Pyloric stenosis

Answer: B* Duodenal atresia

***) The common cause of regurgitation in a normal young infant is:
A.    Faulty feeding technique
B.     Pyloric stenosis
C.     Gastroesophageal reflux
D.    Constipation
E.     Lactose intolerance

Answer: A* Faulty feeding technique

5.    Diarrhea.
***) The commonest cause for acute simple gastroenteritis is:
A.    Escherichia
B.     Shigella
C.     Rotavirus
D.    Salmonella
E.     Adenovirus

Answer: C* Rotavirus

***) All of the following are causes of chronic diarrhea in children:
A.    Enterobius vermicularis
B.     Lamblia giardia
C.     Entameba histolytica
D.    Celiac disease
E.     Cystic fibrosis

Answer: A* Enterobius vermicularis

***) One of the following measures is recommended in managing diarrhea in children:
A.    Using antibiotics for Gram-positive bacteria
B.     Using antibiotics for Gram-negative bacteria
C.     Attempting to reduce intestinal motility by using suitable drugs
D.    Attempting to stop vomiting by using suitable drugs
E.     Attempting to prevent reaching the stage when intravenous therapy is needed

Answer: E* Attempting to prevent reaching the stage when intravenous therapy is needed

6.    Celiac Disease.
***) Regarding celiac dieses all are true, except:
A.    Manifestations start after birth immediately
B.     Gluten-free diet is helpful
C.     Some cases may develop lymphoma
D.    Endomysial antibodies is useful test
E.     The main problem is in absorption

Answer: A* Manifestations start after birth immediately

***) All of the following are manifestations of celiac disease, except:
A.    Short stature
B.     Constipation
C.     Delayed puberty
D.    Pallor
E.     Bloody diarrhea

Answer: B* Constipation

7.    Milk Protein Allergy.
***) Cow's milk protein allergy may present in all of the following ways, except
A.    An exacerbation of eczema
B.     Infantile colic
C.     Chronic wheezing in the first year of life
D.    Bloody colitis in infancy
E.     Thrombocytopenia

Answer: E* Thrombocytopenia

8.    Constipation.
***) Which of the following statements about Hirschsprung's disease is not true:
A.    It may be a cause of neonatal intestinal obstruction
B.     It may involve the entire colon
C.     It may be associated with an increased incidence of Down's syndrome
D.    It may be associated with enterocolitis
E.     Barium enema is always diagnostic for infants older than one month

Answer: E* Barium enema is always diagnostic for infants older than one month

9.    Acute Abdominal Pain.
***) Intussusception is a cause of all of the following, except:
A.    A mass in the abdomen
B.     Abdominal colic
C.     Frequency of micturiuon
D.    Passage of blood per rectum
E.     Intestinal obstruction

Answer: C* Frequency of micturiuon

***) A previously healthy 8 months old boy started to suffer from repeated abdominal pain, vomiting and red currant jelly stool, he should be regarded to have:
A.    Volvulus neonatorum
B.     Intussusception
C.     Gastroenteritis
D.    Meconium ileus
E.     Meckel's diverticulitis

Answer: B* Intussusception

***) Current jelly stools are usually associated with:
A.    Hirschsprung’s disease
B.     Appendicitis
C.     Intussusception
D.    Bezoars
E.     Enterocolitis

Answer: D* Intussusception

10.           GI Bleeding.
***) Blood stained stools in an infant are associated with all of the following, except:
A.    Anal fissure
B.     Gastroenteritis
C.     Intussusception
D.    Appendicitis
E.     Meckel's diverticulum

Answer: D* Appendicitis

***) The most common cause of minimal bleeding per rectum in children is:
A.    Volvulus neonatorum
B.     Necrotizing enterocolitis
C.     Fissure in anus
D.    Hemorrhagic disease
E.     Polyp

Answer: C* Fissure in anus

***) The most common cause of rectal bleeding in infancy and childhood is:
A.    Anal fissure
B.     Volvulus
C.     Foreign body
D.    Intussusception
E.     Meckel's diverticulum

Answer: A* Anal fissure

Comments

Popular posts from this blog

شرح تخطيط القلب الكهربائي ECG وتحديد الحالة من رسم القلب

Water Balance in Human Body

Cestodes (tapeworms)