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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

  1. A 16-year-old with a history of alcohol use presents with epigastric pain radiating to the back, nausea, and vomiting. Serum lipase is 800 U/L. What is the most important initial management priority?

    Answer: Aggressive IV fluid resuscitation with lactated Ringer's solution

    Aggressive IV fluid resuscitation is the cornerstone of acute pancreatitis management, with lactated Ringer's preferred to reduce systemic inflammation.

  2. A 2-year-old presents with painless, maroon-colored rectal bleeding. The child is hemodynamically stable. Which diagnostic study is most appropriate to identify the bleeding source?

    Answer: Technetium-99m pertechnetate (Meckel) scan

    Painless lower GI bleeding in a toddler is classic for a Meckel diverticulum containing ectopic gastric mucosa, and a Meckel scan is the preferred diagnostic test.

  3. A child with end-stage liver disease presents with massive hematemesis. Which medication should be given immediately while preparing for endoscopy?

    Answer: Octreotide IV

    Octreotide (a somatostatin analogue) reduces portal pressure by causing splanchnic vasoconstriction and is the preferred pharmacologic agent for acute variceal bleeding in children.

  4. A 9-year-old is brought in after ingesting an unknown quantity of acetaminophen 3 hours ago. Labs are pending. Which antidote should be administered?

    Answer: N-acetylcysteine (NAC)

    N-acetylcysteine is the antidote for acetaminophen toxicity and is most effective when started within 8 hours of ingestion, before hepatic injury occurs.

  5. An 8-year-old with sickle cell disease presents with acute right upper quadrant pain, fever, and jaundice. Ultrasound shows gallstones and a distended gallbladder. Which complication is most concerning?

    Answer: Acute cholecystitis with possible perforation

    Children with sickle cell disease are at high risk for pigment gallstones and acute cholecystitis, which can progress to perforation if not managed promptly.

  6. A 3-month-old is brought in with a 2-day history of vomiting, dehydration, and a palpable olive-shaped mass in the epigastrium. Which diagnostic finding on ultrasound confirms the diagnosis?

    Answer: Pyloric channel length > 16 mm and muscle thickness > 4 mm

    Hypertrophic pyloric stenosis is confirmed on ultrasound when pyloric muscle thickness exceeds 4 mm and channel length exceeds 16 mm.

  7. A 12-year-old with a history of umbilical hernia repair now presents with sudden periumbilical pain, nausea, and a firm, tender, irreducible bulge at the umbilicus. What is the most appropriate action?

    Answer: Immediate surgical consultation for incarcerated hernia

    An irreducible (incarcerated) hernia risks strangulation and bowel ischemia, requiring immediate surgical consultation.