A 42-year-old woman presents to the emergency department in active labor. She has had no prenatal care and is unsure of the gestational age. Labor progresses rapidly and spontaneous vaginal delivery of a baby boy occurs 3 hours after presentation. On initial exam, the child is 1.9 kg (4.2 lb) with a small head and jaw. A sac-like structure containing intestine, as can be seen in the picture, protrudes from the abdominal wall. What complication is closely associated with this presentation?
ALack of abdominal wall muscles
BDehydration and necrosis of bowel
CDuodenal atresia
DTwisting of the bowel around itself
ECardiac defect
During a surgical procedure to repair an abdominal aortic aneurysm, the surgeon must be careful to avoid injury to which of the following arterial structures that originates near the level of the renal vessels?
ALeft renal artery
BCeliac trunk
CRight renal artery
DSuperior mesenteric artery
A 4-week-old infant is brought to the emergency department by his parents with violent vomiting. It started about 3 days ago and has slowly gotten worse. He vomits after most feedings but seems to keep some formula down. His mother notes that he is eager to feed between episodes and seems to be putting on weight. Other than an uncomplicated course of chlamydia conjunctivitis, the infant has been healthy. He was born at 39 weeks gestation via spontaneous vaginal delivery. He is up to date on all vaccines and is meeting all developmental milestones. The physical exam is significant for a palpable mass in the right upper quadrant. What is the first-line confirmatory diagnostic test and associated finding?
AAbdominal ultrasound; elongated pyloric channel and muscle hypertrophy
BBarium upper GI series; GE junction and portion of the stomach in thorax
CAir enema; filling defect and coil spring sign
DBarium upper GI series; bird beak sign and corkscrewing
EAbdominal X-ray; ‘double bubble’ sign
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