Ch. 40: Alterations of Digestive Function in Children

Question 1

Which of the following is TRUE regarding cleft lip?
Developmental anomaly of the first branchial arch
Caused by single gene mutations
Increased incidence in black populations
Increased incidence in males

Answer 1

Developmental anomaly of the first branchial arch

It is a developmental anomaly of the first branchial arch and is the fourth most common congenital anomaly. In most cases cleft lip and palate are caused by multiple gene-environment interactions. It has an increased incidence in whites and a decreased incidence in black populations. It is also increased in Asians and females.

Question 2

Which of the following is the name for the condition in which the esophagus ends in a blind pouch?
  Esophageal atresia 
  Tracheoesophageal fistula
  Pyloric stenosis
  Malrotation

Answer 2

Esophageal atresia

Esophageal atresia is a condition in which the esophagus ends in a blind pouch. This condition may be accompanied by a fistula or a connection between the esophagus and trachea (tracheoesophageal fistula). Pyloric stenosis involves the duodenum, and malrotation is a malpositioning of the entire gut.

Question 3

Which of the following is TRUE regarding pyloric stenosis?
  It is an uncommon disorder.
  The most common age is 6 months.
  It is more common in males. 
  Asians are more commonly affected.

Answer 3

It is more common in males

Pyloric stenosis is more common in full-term, white male infants. There is also a hereditary component. It most commonly occurs between the ages of 1 and 2 weeks or 3 and 4 months. This disorder is relatively common.

Question 4

Which of the following diseases has been associated with meconium ileus?
  Cleft palette
  Sickle cell disease
  Cystic Fibrosis
  Esophageal atresia

Answer 4

Cystic Fibrosis

Meconium ileus is found in 10% to 15% of newborns with cystic fibrosis.

Question 5

A person has impacted feces and constipation. The physician states there are abnormalities of the basement membrane and extracellular matrix with absence of the Meissner and Auerbach plexuses. Which of the following diseases is characterized by this description?
  Pyloric stenosis
  Esophageal atresia
  Congenital aganglionic megacolon
  Tracheoesophageal fistula

Answer 5

Congenital aganglionic megacolon

Hirschsprung disease or congenital aganglionic megacolon is characterized by constipation and large dilated colon. It is due to the absence of the appropriate parasympathetic nerves. There is no peristaltic movement in this section of the colon.

Question 6

A 1-year-old is very irritable and is passing currant-jelly stools. Which of the following is the primary treatment for this condition?
  Surgery
  CT scan
  Barium or air enema
  Antibiotics

Answer 6

Barium or air enema

This condition is intussusception and is caused by telescoping of one portion of the intestine into another. It is very serious but can be reduced by barium or air enema. Surgery may be indicated, but enemas are attempted first.

Question 7

Which of the following is NOT part of the triad of cystic fibrosis?
Overproduction of mucus in the respiratory tract
Pancreatic enzyme deficiency
Abnormally elevated sodium and chloride concentrations
Thin secretions

Answer 7

Thin secretions.

Cystic fibrosis has the hallmark of overproduction of mucus in the respiratory tract, pancreatic enzyme deficiency, and abnormally elevated sodium and chloride concentrations. The secretions are very thick.

Question 8

Which of the following conditions is NOT associated with gluten-sensitive enteropathy?
  Early constipation
  Deficiencies in fat-soluble vitamins
  Anemia
  Diminished growth

Answer 8

Early constipation

This condition is accompanied by early diarrhea with pale greasy stools. There can be growth failure, anorexia, and vitamin deficiencies. There also may be anemia.

Question 9

Which of the following is the appropriate term for a severe deficiency of all nutrients?
  Kwashiorkor
  Marasmus
  Necrotizing enterocolitis
  Gluten-sensitive enteropathy

Answer 9

Marasmus

Marasmus is a severe deficiency of protein and carbohydrates. Kwashiorkor is a protein deficiency. Necrotizing enterocolitis is a condition that can be fatal in premature infants. Gluten-sensitive enteropathy is a loss of villous epithelium after ingestion of gluten, the protein component of cereal grains.

Question 10

Which of the following is TRUE regarding physiologic jaundice of the newborn?
Generally chronic in nature
Occurs during the first week of life in full-term infants
Caused by indirect bilirubin reading of greater than 20 mg/dl
Caused by increased red cell breakdown

Answer 10

Occurs during the first week of life in full-term infants

It occurs in the first week of life, and one study has shown that a bilirubin level of 10 mg/dl at 3 days of life occurs in 49% of breast milk–fed infants. It is usually transient and benign. A bilirubin level of greater than 15 mg/dl (indirect) is considered pathologic. It is caused by mild hyperbilirubinemia.