Comprehensive Practice & Review Guide
choledochal cyst - correct answer ✔✔ A 2-month-old boy with a history of abdominal
distension and tenderness is seen for an abdominal ultrasound scan. The ultrasound
examination reveals a cystic dilation of the common bile duct as seen in Figure 1. What is the
most likely diagnosis?
multicyclic dysplastic kidney - correct answer ✔✔ A 22-day-old boy is seen for renal ultrasound
scan for a history of an obstetric ultrasound examination that reported a large cyst in the right
renal bed and multiple cysts identified in the left kidney, as seen in Figure 5, A and B. The renal
ultrasound examination identified the findings in the right renal bed, as noted in Figure 5, C, and
the findings in the left renal bed, as seen in Figure 5, D. Normal adrenal glands and a normal
bladder were also identified. What is the most likely diagnosis?
pyloric stenosis - correct answer ✔✔ A 3300-g male infant is born after a full-term uneventful
pregnancy. His parents are healthy and have no history of icteric episodes. The infant is bottle
fed, and jaundice does not develop during the first 10 days. At 4 weeks of age, the infant is
admitted to the hospital for projectile vomiting. He then weighs 3950 g and is mildly icteric.
Serum bilirubin level is 165 µmol/L and is entirely unconjugated. An abdominal ultrasound scan
is ordered and reveals the finding in Figure 1. What is the most likely diagnosis?
intussusception - correct answer ✔✔ An 8-month-old male infant is brought to the office for a
well-child visit. The infant's mother incidentally notes that he had several episodes of vomiting
since the previous night, without fever or diarrhea. On physician examination, the infant is
observed to be listless, with a temperature of 100.4°F, otitis media on the right side, and
moderate dehydration. Findings on abdominal examination are unremarkable. A rectal
examination is not performed. The infant is sent to the emergency department where he is
aggressively rehydrated and observed. Results of laboratory tests are not specific. After several
hours of rehydration, the child's condition is unchanged and he passes a large grossly bloody
stool. An abdominal radiograph is ordered, but results are unremarkable. A barium enema is
ordered for diagnosis and therapeutic purposes (Figure 2). What is the most likely diagnosis?