CEN Pediatric and Obstetric Emergencies 1 — Questions and Answers
Question 1: A 6-week-old infant presents with nonbilious projectile vomiting after every feeding. The infant is hungry after vomiting and has an olive-shaped mass palpable in the epigastrium. Which diagnosis is most likely?
- Intussusception
- Pyloric stenosis (Correct answer)
- Volvulus
- GERD
Correct answer: Pyloric stenosis
Nonbilious projectile vomiting with a palpable olive-shaped mass in a 4–8 week old infant is classic for hypertrophic pyloric stenosis.
Question 2: A 2-year-old presents with sudden onset of choking, coughing, and unilateral decreased breath sounds. Parents report the child was playing with small toys. What is the most likely diagnosis?
- Croup
- Bronchiolitis
- Foreign body aspiration (Correct answer)
- Asthma exacerbation
Correct answer: Foreign body aspiration
Sudden onset choking with unilateral decreased breath sounds in a toddler after playing with small objects strongly suggests foreign body aspiration.
Question 3: Which formula is used to estimate the endotracheal tube size for a child between ages 1 and 10?
- (Age + 16) / 4
- (Age / 4) + 4 (Correct answer)
- (Age / 4) + 3.5
- Weight in kg / 10
Correct answer: (Age / 4) + 4
The formula (Age/4) + 4 estimates the uncuffed ETT size in mm for children aged 1–10 years.
Question 4: A 4-month-old presents with poor feeding, bulging fontanelle, and inconsolable high-pitched crying. Temperature is 38.8°C rectally. What is the most critical concern?
- Pyloric stenosis
- Intracranial hemorrhage or bacterial meningitis (Correct answer)
- Intussusception
- Febrile seizure
Correct answer: Intracranial hemorrhage or bacterial meningitis
A bulging fontanelle with fever and high-pitched cry in an infant suggests increased intracranial pressure from bacterial meningitis or hemorrhage.
Question 5: Which drug and dose is correct for pediatric epinephrine administration during cardiac arrest via IV/IO route?
- 0.01 mg/kg of 1:1000 concentration
- 0.01 mg/kg of 1:10,000 concentration (Correct answer)
- 0.1 mg/kg of 1:10,000 concentration
- 0.1 mg/kg of 1:1000 concentration
Correct answer: 0.01 mg/kg of 1:10,000 concentration
Pediatric IV/IO epinephrine dose is 0.01 mg/kg of the 1:10,000 (0.1 mg/mL) concentration during cardiac arrest.
Question 6: A 9-month-old presents with sudden onset of colicky abdominal pain, drawing up the legs, and currant-jelly stools. Which diagnosis should be suspected?
- Pyloric stenosis
- Necrotizing enterocolitis
- Intussusception (Correct answer)
- Hirschsprung disease
Correct answer: Intussusception
Intussusception classically presents in infants 6–36 months with episodic colicky pain, drawing up of the legs, and currant-jelly stools.
CEN Pediatric and Obstetric Emergencies 1
A 6-week-old infant presents with nonbilious projectile vomiting after every feeding.
The infant is hungry after vomiting and has an olive-shaped mass palpable in the epigastrium.
Which diagnosis is most likely?