CMN 568 Unit 4 Test QUESTIONS AND CORRECT DETAILED ANSWERS

CMN 568 Unit 4 Test QUESTIONS AND CORRECT DETAILED ANSWERS When 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 vomitting 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? - ANSWER At 2-4 weeks of age What are the symptoms of pyloric stenosis? - ANSWER vomiting 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? - ANSWER breastfeeding What is pyloric stenosis usually mistaken for? - ANSWER reflux or formula intolerance What is the hallmark finding of pyloric stenosis? - ANSWER an oliveshaped mass in RUQ What are typical lab and radiologic findings of a baby with pyloric stenosis? - ANSWER hypochloremia, 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? - ANSWER involves 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? - ANSWER A recent viral illness, mesenteric lymphadenitis, Henoch-Schonlein purpura, and cystic fibrosis What is the typical age of onset of idiopathic intussusception? - ANSWER 6 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? - ANSWER meckel's diverticulum or polyps Is intussusception more common in girls or boys? - ANSWER boys What is the classic presentation of intussusception? - ANSWER colicky 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? - ANSWER A sausage shaped mass typically in the right lower quad What interventions should be considered when intussusception is suspected? - ANSWER consult 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? - ANSWER an air contrast enema What are contraindication s to an air contrast enema? - ANSWER perforation, shock, and peritonitits What is usually classic hx of appendicitis? - ANSWER abd 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? - ANSWER movement and the child freq