GI

Question 1

Loss of normal peristalsis in the body of the esophagus and the failure of the LES to relax in response to swallowing

Ganglion Cells are decreased and surrounded by inflammatory cells

Difficulty in swallowing, regurgitation, cough and failure to gain

Answer 1

Achalasia

Question 2

Bird’s beak

Answer 2

Achalasia

Question 3

Air fluid levels in dilated esophagus “beaking” on barium swallow

Confirmed by Esophageal Manometry

Answer 3

Achalasia

Question 4

Treatment for achalasia only when definitive tx cant be given intersphincteric injection of botulinum toxin

Answer 4

Nifedipine

Question 5

MC esophageal motility disorder

Hypertensive peristalsis

Answer 5

Nutcracker esophagus

Question 6

Nonbilous vomiting starts at 3rd week of life

Blood types O and B

Pyloric mass, firm, movable 2cm in length olive shaped above and to the right of umbilicus

Answer 6

Pyloric stenosis

Question 7

Palpable olive mass in epigastrium

Answer 7

Pyloric stenosis

Question 8

Shoulder sign

String sign

Double tract sign

Answer 8

Pyloric stenosis

Question 9

Procedure done in pyloric stenosis

Answer 9

Ramstedt pyloromyotomy

Question 10

Bilous vomiting without abdominal distention noted in the 1st day of life

Answer 10

Duodenal atresia

Question 11

Failure to recanalize the lumen after the solid phase of the intestinal defelopmental during the 4th and 5th week AOG

Most are born premature

Associated with Down syndrome, malrotation, esophageal atresia, CHD, polyhydramnios

Answer 11

Duodenal atresia

Question 12

Double bubble sign

Answer 12

Duodenal atresia

Question 13

Ground glass appearance in the RLQ with trapped bubbles of air within the obstructing meconium

Associated with cystic fibrosis

Answer 13

Meconium ileus

Question 14

Soap bubble sign

Egg shell pattern

Answer 14

Meconium ileus

Question 15

MC in lower GI bleeding in children

Answer 15

Meckel Diverticulum

Question 16

Most common congenital GI anomaly

Omphalomesentric duct or vitelline duct - remnant of the embryonic yolk sac

36cm outpouching of the ileum along the antimesenteric border approximately 5075cm from the ileocecal valve

Answer 16

Meckel Diverticulum

Question 17

Significant painless rectal bleeding stool

Brick colored or currant jelly

Answer 17

Meckel Diverticulum

Question 18

Retching, hematemesis

Answer 18

Mallory Weiss

Question 19

Most common cause of Lower intestinal obstruction in the neonate

Absence of ganglion cells in the bowel wall

Answer 19

Hirschsprung Disease

Question 20

Absence of Meissner and Auerbach plexus

Associated with Down syndrome, Laurence-Moon-Bardet-Biedl

Answer 20

Hirschsprung Disease

Question 21

Failure to pass meconium after 48hrs after birth

Gold standard: Deep rectal biopsy

Answer 21

Hirschsprung Disease

Question 22

Telescoping

Answer 22

Intussuseption

Question 23

MCC of intestinal obstruction between 3months and 6 yrs of age

Answer 23

Intussuseption

Question 24

Ileocolic and Ileoileocolic

Sausage shaped mass on the right upper abdomen

Currant jelly stools

Coiled spring sign

Colicky pain

Answer 24

Intussuseption

Question 25

Prolonged elevated levels of conjugated bilirubin after 14th DOL

Jaundice, hepatomegaly, normal or acholic stool

KASAI or hepatoportoenterostomy for biliary atresia if performed before 8 weeks

Answer 25

Neonatal cholestasis