Gastrointestinal Emergencies Flashcards
7 cards from real CPEN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Gastrointestinal Emergencies flashcards as text
A 3-year-old presents with sudden onset of inconsolable crying, drawing up the legs, and currant jelly stools. Which intervention is the priority?
Answer: Prepare for air or hydrostatic enema reduction
Currant jelly stools with colicky abdominal pain are hallmark signs of intussusception, and non-surgical reduction via air or hydrostatic enema is the first-line treatment.
An infant presents with bilious vomiting and abdominal distension within the first 24 hours of life. Which condition is most concerning?
Answer: Malrotation with midgut volvulus
Bilious vomiting in a neonate is a surgical emergency until proven otherwise, with malrotation and midgut volvulus being the most immediately life-threatening cause.
When performing a nasogastric lavage on a pediatric patient with suspected upper GI bleed, which finding would indicate active bleeding requiring urgent intervention?
Answer: Persistent bright red blood despite lavage
Persistent bright red blood despite gastric lavage indicates active, ongoing hemorrhage requiring urgent endoscopy or surgical intervention.
A 7-year-old with known short bowel syndrome presents with high-volume watery diarrhea, fever, and abdominal cramping after starting a new enteral formula. What is the most appropriate first action?
Answer: Hold the enteral feed and assess for formula intolerance or infection
High-volume diarrhea with fever in a child with short bowel syndrome warrants stopping enteral feeds and evaluating for infection (including C. difficile) or formula intolerance before resuming.
Which electrolyte abnormality is most commonly associated with prolonged, forceful vomiting in an infant with pyloric stenosis?
Answer: Hypokalemic hypochloremic metabolic alkalosis
Repeated loss of hydrochloric acid and potassium through vomiting in pyloric stenosis causes hypokalemic hypochloremic metabolic alkalosis.
A 5-year-old presents with sudden, severe periumbilical pain that migrates to the right lower quadrant, low-grade fever, and anorexia. The Rovsing sign is positive. Which diagnostic tool is preferred to confirm the diagnosis while minimizing radiation exposure?
Answer: Ultrasound of the right lower quadrant
Ultrasound is the preferred first-line imaging for suspected appendicitis in children to avoid ionizing radiation, with CT reserved for indeterminate ultrasound results.
A 10-year-old with Crohn disease presents to the ED with severe right lower quadrant pain and a palpable tender mass. Imaging reveals a periappendiceal abscess. What is the initial management?
Answer: IV antibiotics and interventional radiology-guided drainage
A periappendiceal abscess in pediatric patients is typically managed initially with IV antibiotics and percutaneous drainage, with interval appendectomy considered later.