Exam (elaborations)
CMN 568 Unit 4 Questions and Answers
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Exam of 12 pages for the course CMN 568 at CMN 568 (CMN 568 Unit 4)
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CMN 568 Unit 4When does malrotation occur? - answer at about the 10th week of gestation
What is a malrotation? - answer a congenital abnormality that occurs during the
embryonic phase of development when the midgut retracts into the abdominal cavity.
The midgut rotates counterclockwise
When do infants typically become symptomatic with a malrotation? - answer at 3 weeks
of life
What is the classic sign of a malrotation? - answer bilious vomiting
How is a malrotation diagnosed? - answer upper GI study
What are some radiologic findings that are indicative of a malrotation? - answer
corkscrew appearance with barium swallow; Signs of obstruction (air-fluid levels) may
be present, along with an abnormal gas pattern at the stomach and duodenum.
What is pyloric stenosis? - answer results from hypertrophy of the pyloric sphincter
(muscle in the distal stomach), which leads to poor gastric emptying into the duodenum.
When does pyloric stenosis usually present? - answerAt 2-4 weeks of age
What are the symptoms of pyloric stenosis? - answervomiting that becomes projectile;
typically occurs immediately after feeding, is nonbilious, and the infant is hungry after
vomiting. The parents may also report constipation, excessive crying and weight loss, or
failure to gain weight
What can delay symptoms of pyloric stenosis? - answerbreastfeeding
What is pyloric stenosis usually mistaken for? - answerreflux or formula intolerance
What is the hallmark finding of pyloric stenosis? - answeran olive-shaped mass in RUQ
What are typical lab and radiologic findings of a baby with pyloric stenosis? -
answerhypochloremia, metabolic alkalosis, Hypokalemia. KUB imaging reveals a dilated
gastric silhouette. An ultrasound typically reveals a thickened and elongated pylorus,
measuring greater than 4 mm.
What is intussusception? - answerinvolves the invagination of a section of the intestine
into itself. The most frequent site is at the terminal ileum.
, What is often a predisposing factor of intussusception? - answerA recent viral illness,
mesenteric lymphadenitis, Henoch-Schonlein purpura, and cystic fibrosis
What is the typical age of onset of idiopathic intussusception? - answer6 to 18 months,
with an average age of 7 to 8 months
If intussusception occurs beyond 36 mths, it is typically due to a physical abnormality
such as? - answermeckel's diverticulum or polyps
Is intussusception more common in girls or boys? - answerboys
What is the classic presentation of intussusception? - answercolicky abdominal pain,
recent viral illness with some vomiting and perhaps diarrhea. The child begins to have
episodes of colicky abdominal pain, draws up the knees or stiffens the legs for a brief
period, and then becomes quiet for several minutes. The series of events recurs,
typically every 15 to 20 minutes, and continues for several hours. The child may have
blood in his or her stools, prompting the "currant jelly" descriptor
What is typically present on palpation with intussusception? - answerA sausage shaped
mass typically in the right lower quad
What interventions should be considered when intussusception is suspected? -
answerconsult a pediatric surgeon. Initiate intravenous hydration and order an air-
contrast enema. Consider an abdominal ultrasound as well
What will often diagnose and cure intussusception? - answeran air contrast enema
What are contraindication s to an air contrast enema? - answerperforation, shock, and
peritonitits
What is usually classic hx of appendicitis? - answerabd pain that starts in the
periumbilical area and migrates to the right lower quadrant, along with low-grade fever,
a small amount of emesis, and anorexia
What exacerbates the pain associated with appendicitis? - answermovement and the
child frequently walks stooped over
What does examination of a child with appendicitis usually reveal? - answerpoint
tenderness in the right lower quadrant with voluntary guarding, and perhaps some
rebound tenderness. He or she will typically move slowly, grimace with sitting up, and
grab his or her right side at the first jumping attempt.
How can pain in the RLQ be illicited in a child that has suspected appendicitis? -
answerHitting the soles of the feet and jumping up and down
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