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 neonate presents with failure to pass meconium in the first 48 hours of life, abdominal distension, and bilious vomiting. Rectal exam results in explosive release of gas and stool. Which diagnosis is most likely?
Answer: Hirschsprung disease
Hirschsprung disease classically presents with failure to pass meconium, abdominal distension, and explosive decompression upon rectal examination due to the absence of ganglion cells in the rectosigmoid.
A premature neonate at 28 weeks gestation in the NICU develops abdominal distension, bloody stools, and pneumatosis intestinalis on X-ray. What is the most critical immediate intervention?
Answer: Make the infant NPO and start broad-spectrum antibiotics
Necrotizing enterocolitis requires immediate bowel rest (NPO), nasogastric decompression, and broad-spectrum antibiotics as initial management.
A 14-year-old presents with rectal bleeding, urgency, and mucus in the stool for 6 weeks. Colonoscopy reveals continuous mucosal inflammation from the rectum. Which condition is most consistent with these findings?
Answer: Ulcerative colitis
Continuous mucosal inflammation starting at the rectum and extending proximally is the hallmark of ulcerative colitis, distinguishing it from the skip lesions of Crohn disease.
A child with known hemophilia A presents with acute abdominal pain and is found to have a retroperitoneal hematoma on imaging. What is the most appropriate initial treatment?
Answer: Administer factor VIII concentrate
In a child with hemophilia A, the priority is to restore factor VIII activity to stop the bleeding before any surgical consideration.
A 6-year-old ingests a button battery. X-ray confirms it is lodged in the esophagus. What is the most appropriate next step?
Answer: Immediate endoscopic removal
Button batteries lodged in the esophagus require immediate endoscopic removal due to the risk of liquefactive necrosis, perforation, and aortoesophageal fistula within hours.
Which assessment finding best differentiates peritonitis from a non-surgical cause of abdominal pain in a pediatric patient?
Answer: Abdominal guarding and rebound tenderness
Involuntary guarding and rebound tenderness indicate peritoneal irritation and are the most specific signs pointing to a surgical intra-abdominal emergency.
A 4-year-old who swallowed a coin has it confirmed by X-ray to be in the stomach. The child is asymptomatic. What is the recommended management?
Answer: Observation and follow serial X-rays, as most coins pass spontaneously
Coins in the stomach of asymptomatic children will pass spontaneously in most cases and require only observation with follow-up imaging if not passed within 4 weeks.