Pediatric GI disorder and failure-to-thrive workup and management scenarios tested on USMLE Step 2 CK.
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- At what age do infants typically present with pyloric stenosis?
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2 to 8 weeks of age- What is the character of vomiting in pyloric stenosis?
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Nonbilious, projectile vomiting immediately after feeding- What acid-base and electrolyte disturbance is classic for pyloric stenosis?
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Hypochloremic, hypokalemic metabolic alkalosis- What physical exam finding is classic for pyloric stenosis?
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A firm, mobile, olive-shaped mass in the epigastrium or right upper quadrant- What imaging study confirms pyloric stenosis?
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Abdominal ultrasound showing a thickened, elongated pylorus- What is the definitive treatment for pyloric stenosis?
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Pyloromyotomy (Ramstedt procedure)- What is the peak age range for intussusception?
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3 months to 3 years- What classic stool finding suggests intussusception?
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Currant jelly stools (blood and mucus)- What abdominal exam finding is associated with intussusception?
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A sausage-shaped mass, usually in the right upper quadrant- What is both diagnostic and therapeutic for most cases of intussusception?
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Air or contrast enema- In children older than 2 to 3 years, what is the most common pathologic lead point for intussusception?
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Meckel diverticulum- What is the classic presentation of malrotation with midgut volvulus?
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Sudden bilious vomiting in a neonate, a surgical emergency- What upper GI series finding suggests malrotation with volvulus?
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A corkscrew appearance of the duodenum and proximal jejunum- What abdominal X-ray finding is classic for duodenal atresia?
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The double bubble sign- Duodenal atresia is most strongly associated with which chromosomal condition?
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Down syndrome (trisomy 21)
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