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A Mother Took Her 20-Day-Old Baby Boy to a Pediatrician 2ft2 \mathrm{ft}

Question 15

Multiple Choice

A mother took her 20-day-old baby boy to a pediatrician because he had started to vomit after his feeds. The baby was breast-fed. For the first 15 days after birth, the baby had taken his feeds very well and had slept contentedly in his crib following the normal after-feed burp. However, in the previous 5 days, the baby had begun to vomit toward the end of each feed, shooting the milk out of his mouth for a distance of 1 to 2ft2 \mathrm{ft} . After carefully questioning the mother and after a physical examination of the boy, the pediatrician made the diagnosis of congenital hypertrophic pyloric stenosis.
-He was able to ascertain the following additional signs and symptoms except which?


A) Once the milk had been vomited, the child immediately would feed again, only to repeat the same performance.
B) On gentle palpation of the anterior abdominal wall, a small firm swelling was felt just below and medial to the tip of the left eighth costal cartilage.
C) On observing the anterior abdominal wall, an occasional wave of gastric peristalsis was seen traveling across the epigastrium from left to right.
D) The stools were small in quantity and infrequent.
E) The child showed signs of dehydration as evidenced by a depressed anterior fontanelle of the skull.

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