Common pediatric surgical conditions (pyloric stenosis, intussusception, appendicitis) and their management 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 old- What is the classic character of vomiting in pyloric stenosis?
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Projectile, nonbilious vomiting- What abdominal exam finding is classic for pyloric stenosis?
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A palpable olive-shaped mass in the epigastrium- What acid-base and electrolyte disturbance results from pyloric stenosis?
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Hypochloremic, hypokalemic metabolic alkalosis- What is the imaging study of choice to confirm pyloric stenosis?
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Abdominal ultrasound- What is the definitive surgical treatment for pyloric stenosis?
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Pyloromyotomy- Before pyloromyotomy, what must be corrected first?
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Dehydration and the electrolyte/acid-base abnormalities, with IV fluids- What is the peak age range for intussusception?
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6 months to 3 years- What stool finding is classically described in intussusception?
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Currant jelly stools- What is the most common location for intussusception in children?
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Ileocolic (ileocecal) region- What is the first-line diagnostic and therapeutic procedure for intussusception?
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Air (or contrast) enema- In an older child with intussusception, what is a common pathologic lead point?
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Meckel diverticulum- How does the abdominal pain of acute appendicitis classically progress?
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It starts as vague periumbilical pain, then migrates to the right lower quadrant- The point of maximal tenderness in appendicitis, ____, lies one third of the way from the anterior superior iliac spine to the umbilicus.
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McBurney point- What is the preferred initial imaging modality for suspected appendicitis in children?
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Abdominal ultrasound
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