Question 1

An 8-week-old female is diagnosed with a congenital heart disease and Down syndrome. Her parents report that she has difficulty defecating. X-ray reveals anorectal malformation that causes complete obstruction often referred to as:
A) intussusception.
B) imperforate anus.
C) anal stenosis.
D) megacolon.

Accepted Answer

C

Question 2

Examination of a newborn female revealed that the esophagus ends in a blind pouch. This condition is referred to as:
A) esophageal atresia.
B) tracheoesophageal stenosis.
C) tracheoesophageal regurgitation.
D) tracheoesophageal fistula.

Accepted Answer

Esophageal atresia is a congenital condition in which the upper esophagus ends in a blind pouch, rather than connecting to the rest of the digestive system. This results in difficulty or inability to swallow, and requires surgical intervention.

Question 3

Marasmus is a severe dietary deficiency of:
A) fatty acids.
B) protein.
C) iron.
D) all nutrients.

Accepted Answer

Marasmus is a form of severe malnutrition characterized by energy deficiency; it involves a deficiency of all nutrients, leading to significant weight loss and muscle wasting.

Question 4

A 2-month-old female is brought to the ER for persistent bile-stained vomiting after feeding. Physical examination reveals dehydration, and x-ray reveals that the colon is located in the upper right quadrant. The most likely cause of this condition is:
A) malrotation.
B) ileocecal displacement.
C) duodenal obstruction.
D) colomyotomy.

Accepted Answer

The presentation is consistent with malrotation, which is a congenital abnormality where the intestines do not properly rotate during fetal development. This can result in an abnormal location of the colon and duodenum, leading to obstruction and bile-stained vomiting. Ileocecal displacement and colomyotomy are not causes of this presentation, and duodenal obstruction would not lead to a displaced colon.

Question 5

A condition that occurs in many mothers carrying fetuses affected by esophageal malformations is:
A) enlarged placentas.
B) excessive amniotic fluid.
C) short umbilical cords.
D) thin fetal membranes.

Accepted Answer

Excessive amniotic fluid, also known as polyhydramnios, is commonly seen in mothers carrying fetuses with esophageal malformations. This is because the fetus is unable to swallow amniotic fluid properly, leading to a build-up of fluid in the amniotic sac. The presence of polyhydramnios can also increase the risk of preterm labor and maternal complications.

Question 6

A 13-month-old infant presents with vomiting; abdominal pain; and pale, bulky, greasy, and foul-smelling stools. A possible diagnosis would be:
A) failure to thrive.
B) gluten-sensitive enteropathy.
C) gastroesophageal reflux.
D) meconium ileus.

Accepted Answer

The symptoms suggest malabsorption, which is characteristic of gluten-sensitive enteropathy (also known as celiac disease). Failure to thrive may also be present, but it is not specific to this condition. Gastroesophageal reflux typically presents with regurgitation and heartburn, but not with the other symptoms mentioned. Meconium ileus, a blockage of the ileum with meconium, typically presents in the neonatal period, not at 13 months.

Question 7

Occurrence of gastroesophageal reflux is highest in which pediatric population?
A) Premature infants
B) Infants with Down syndrome
C) Children with cystic fibrosis
D) Children with esophageal atresia

Accepted Answer

Premature infants have an immature lower esophageal sphincter which can lead to gastroesophageal reflux. The other populations listed may also have an increased risk of gastroesophageal reflux, but it is not as high as in premature infants.

Question 8

The primary characteristic of Hirschsprung disease is:
A) bowel dilation and fecal impaction.
B) pancreatic insufficiency.
C) hyperactive peristalsis.
D) ileal or jejunal atresia.

Accepted Answer

The primary characteristic of Hirschsprung disease is bowel dilation and fecal impaction, caused by the absence or reduction of ganglion cells in the distal colon and rectum, leading to an obstruction in the bowel movement. This condition is also known as congenital aganglionic megacolon.

Question 9

A mother brings her 2-week-old infant to the pediatrician because he vomits forcefully for no apparent reason and food sometimes is regurgitated through his nose. The infant is most likely suffering from:
A) pyloric stenosis.
B) meconium ileus.
C) esophageal atresia.
D) galactosemia.

Accepted Answer

Forceful vomiting and regurgitation through the nose are classic symptoms of pyloric stenosis, a condition in which the muscle between the stomach and small intestine becomes thickened, making it difficult for food to pass through. Meconium ileus, esophageal atresia, and galactosemia do not typically present with these symptoms.

Question 10

A 3D ultrasound of a 9-week fetus revealed incomplete fusion of the nasomedial or intermaxillary process. This child will be born with:
A) cleft lip.
B) nasal passage atresia.
C) esophageal atresia.
D) lack of dentition.

Accepted Answer

Incomplete fusion of the nasomedial or intermaxillary process leads to cleft lip, which is a congenital facial anomaly where there is a separation or gap in the upper lip. Nasal passage atresia (B) refers to a blockage or narrowing of the nasal passages and is not related to incomplete fusion of the nasomedial or intermaxillary process. Esophageal atresia (C) is a congenital anomaly where the esophagus does not develop properly, leading to feeding difficulties. Lack of dentition (D) refers to the absence of teeth and is not related to incomplete fusion of the nasomedial or intermaxillary process.

Question 11

A sign that a newborn infant is suffering from pyloric stenosis is:
A) diarrhea.
B) bile regurgitation.
C) vomiting after feeding.
D) ascites.

Accepted Answer

Vomiting after feeding is a common sign of pyloric stenosis, as it occurs due to the narrowing of the pyloric sphincter, which prevents food from passing through the stomach and into the small intestine. The other options listed are not typically associated with pyloric stenosis in newborns.

Question 12

A 6-month-old male infant is brought to the ER after the sudden development of abdominal pain, irritability, and vomiting followed by passing of "currant jelly" stool. Ultrasound reveals intestinal obstruction in which the ileum collapsed through the ileocecal valve and invaginated into the large intestine. This type of obstruction is referred to as:
A) prolapse.
B) introlapse.
C) intussusception.
D) imperforation.

Accepted Answer

The given symptoms and ultrasound findings are consistent with intussusception, which is a telescoping of one segment of the bowel into another, most commonly the ileum into the cecum. This causes an obstruction of the bowel and can lead to the characteristic "currant jelly" stool due to mucosal ischemia and bleeding. Prolapse refers to the displacement of an organ or tissue from its normal position, introlapse is not a recognized medical term, and imperforation refers to a complete lack of an opening or passage, which is not consistent with the given scenario.

Question 13

Kwashiorkor is a severe dietary deficiency of:
A) fat-soluble vitamins.
B) carbohydrates.
C) protein.
D) calcium and magnesium.

Accepted Answer

Kwashiorkor is a condition that results from a severe protein deficiency. It is characterized by symptoms such as swelling, changes in skin and hair pigmentation, and stunted growth.

Question 14

Celiac disease or sprue is caused by alterations of the intestinal:
A) glands.
B) villi.
C) smooth muscle wall.
D) sphincters.

Accepted Answer

Celiac disease or sprue is caused by damage to the villi of the small intestine, which reduces nutrient absorption.

Question 15

A newborn male is diagnosed with cleft palate. The pediatrician counsels the parents that if left uncorrected, the child will probably suffer from:
A) tonsil atrophy.
B) recurrent pharyngeal infections.
C) difficulty breathing.
D) excessive dental decay.

Accepted Answer

The answer of A newborn male is diagnosed with cleft...

Question 16

A newborn male begins vomiting a few hours after birth. Physical examination reveals tachypnea, intercostal retractions, and grunting respirations. The next day he develops abdominal distention. The child should be screened for:
A) muscular dystrophy.
B) cerebral palsy.
C) cystic fibrosis.
D) multiple sclerosis.

Accepted Answer

The newborn's symptoms are consistent with meconium ileus, which is a complication of cystic fibrosis. The vomiting, respiratory distress, and abdominal distention are all indicative of a blockage in the intestines caused by thick, sticky meconium. This is more common in babies with cystic fibrosis, a genetic disorder that affects the respiratory and digestive systems, than in babies who do not have the condition.

Question 17

An 8-week-old male was recently diagnosed with cystic fibrosis. Which of the following digestive alterations would be expected?
A) Insufficient bile production
B) Gastric atrophy
C) Hypersecretion of stomach acid
D) Malabsorption

Accepted Answer

Cystic fibrosis affects secretions throughout the body, including those of the digestive system. Thickened secretions in the pancreas can lead to insufficient production of digestive enzymes, resulting in malabsorption. This can lead to nutrient deficiencies and failure to thrive. Bile production and gastric acid secretion are typically not affected in cystic fibrosis.

Question 18

A 2-month-old female with Down syndrome is diagnosed with Hirschsprung disease following chronic constipation. The most likely cause of these symptoms is a malformation in the:
A) central nervous system.
B) parasympathetic nervous system.
C) sympathetic nervous system.
D) somatic nervous system.

Accepted Answer

Hirschsprung disease is a congenital disorder of the parasympathetic nervous system resulting in absent ganglion cells in the distal colon, leading to chronic constipation. Down syndrome is a known risk factor for Hirschsprung disease. The other options (central nervous system, sympathetic nervous system, and somatic nervous system) are not directly involved in the pathophysiology of Hirschsprung disease.

Question 19

Congenital _____ is a functional obstruction of the colon caused by inadequate motility.
A) ganglionic microcolon
B) aganglionic megacolon
C) hyperganglionic megacolon
D) hyperparasympathetic megacolon

Accepted Answer

Aganglionic megacolon, also known as Hirschsprung's disease, is caused by an absence or decrease of ganglion cells in the colon leading to inadequate motility and functional obstruction. Choice A is incorrect because ganglionic microcolon is not a recognized medical condition. Choice C and D are not correct as they do not accurately describe the pathology of Hirschsprung's disease.

Question 20

A newborn male begins vomiting a few hours after birth. Physical examination reveals tachypnea, intercostal retractions, and grunting respirations. The next day he develops abdominal distention. The child's symptoms are most likely caused by:
A) increased production of meconium.
B) abnormally sticky meconium.
C) enteric dysfunction resulting in abnormal peristalsis.
D) abnormally high levels of digestive enzymes.

Accepted Answer

The symptoms described are indicative of meconium ileus, which is often caused by abnormally sticky meconium. This condition is commonly associated with cystic fibrosis, where thickened secretions lead to intestinal obstruction.

Quiz 35: Alterations of Digestive Function in Children

An 8-week-old female is diagnosed with a congenital heart disease and Down syndrome. Her parents report that she has difficulty defecating. X-ray reveals anorectal malformation that causes complete obstruction often referred to as:

Examination of a newborn female revealed that the esophagus ends in a blind pouch. This condition is referred to as:

Marasmus is a severe dietary deficiency of:

A 2-month-old female is brought to the ER for persistent bile-stained vomiting after feeding. Physical examination reveals dehydration, and x-ray reveals that the colon is located in the upper right quadrant. The most likely cause of this condition is:

A condition that occurs in many mothers carrying fetuses affected by esophageal malformations is:

A 13-month-old infant presents with vomiting; abdominal pain; and pale, bulky, greasy, and foul-smelling stools. A possible diagnosis would be:

Occurrence of gastroesophageal reflux is highest in which pediatric population?

The primary characteristic of Hirschsprung disease is:

A mother brings her 2-week-old infant to the pediatrician because he vomits forcefully for no apparent reason and food sometimes is regurgitated through his nose. The infant is most likely suffering from:

A 3D ultrasound of a 9-week fetus revealed incomplete fusion of the nasomedial or intermaxillary process. This child will be born with:

A sign that a newborn infant is suffering from pyloric stenosis is:

Kwashiorkor is a severe dietary deficiency of:

Celiac disease or sprue is caused by alterations of the intestinal:

A newborn male is diagnosed with cleft palate. The pediatrician counsels the parents that if left uncorrected, the child will probably suffer from:

A newborn male begins vomiting a few hours after birth. Physical examination reveals tachypnea, intercostal retractions, and grunting respirations. The next day he develops abdominal distention. The child should be screened for:

An 8-week-old male was recently diagnosed with cystic fibrosis. Which of the following digestive alterations would be expected?

A 2-month-old female with Down syndrome is diagnosed with Hirschsprung disease following chronic constipation. The most likely cause of these symptoms is a malformation in the:

Congenital _____ is a functional obstruction of the colon caused by inadequate motility.

A newborn male begins vomiting a few hours after birth. Physical examination reveals tachypnea, intercostal retractions, and grunting respirations. The next day he develops abdominal distention. The child's symptoms are most likely caused by: