GI GI Pediatric & Geriatric Considerations 1 — Questions and Answers
Question 1: What is the most common cause of acute gastroenteritis in infants and young children in the United States?
- Salmonella
- Rotavirus (Correct answer)
- Norovirus
- Campylobacter
Correct answer: Rotavirus
Rotavirus is the leading cause of severe dehydrating diarrhea in children under 5, though vaccination has significantly reduced its incidence in the US.
Question 2: Which finding is most concerning for Hirschsprung's disease in a neonate?
- Projectile vomiting at 3 weeks
- Failure to pass meconium within 48 hours of birth (Correct answer)
- Bloody diarrhea
- Jaundice on day 2
Correct answer: Failure to pass meconium within 48 hours of birth
Hirschsprung's disease results from absent ganglion cells in the rectum, causing functional obstruction; failure to pass meconium within 48 hours is a classic early sign.
Question 3: In elderly patients, which change in GI physiology contributes most to constipation?
- Increased gastric acid production
- Decreased colonic motility and reduced physical activity (Correct answer)
- Increased intestinal secretion
- Faster orocecal transit time
Correct answer: Decreased colonic motility and reduced physical activity
Aging is associated with reduced colonic motility, decreased physical activity, polypharmacy, and poor fluid intake, all of which contribute to chronic constipation in the elderly.
Question 4: Pyloric stenosis in infants typically presents with which characteristic symptom?
- Bilious vomiting
- Non-bilious projectile vomiting at 3–6 weeks of age (Correct answer)
- Bloody stool
- Jaundice
Correct answer: Non-bilious projectile vomiting at 3–6 weeks of age
Hypertrophic pyloric stenosis causes gastric outlet obstruction, presenting with forceful non-bilious vomiting as the pyloric muscle hypertrophies, typically at 3–6 weeks of age.
Question 5: Which nutritional deficiency is a common GI-related concern in breastfed infants after 6 months without complementary foods?
- Vitamin C deficiency
- Iron deficiency (Correct answer)
- Calcium deficiency
- Folate deficiency
Correct answer: Iron deficiency
Breast milk contains low levels of iron, and fetal iron stores are depleted by 6 months; without iron-rich complementary foods, breastfed infants are at high risk for iron-deficiency anemia.
Question 6: Intussusception in children classically presents with which triad of symptoms?
- Fever, jaundice, right upper quadrant pain
- Colicky abdominal pain, vomiting, and currant jelly stools (Correct answer)
- Projectile vomiting, dehydration, olive-shaped mass
- Diarrhea, fever, tenesmus
Correct answer: Colicky abdominal pain, vomiting, and currant jelly stools
Intussusception causes telescoping of bowel that presents with the classic triad of intermittent colicky pain, vomiting, and blood-mucus 'currant jelly' stools from mucosal ischemia.
GI GI Pediatric & Geriatric Considerations 1
What is the most common cause of acute gastroenteritis in infants and young children in the United States?