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ChapterPediatrics Congenital defects

Gastrointestinal malformations

Free notes, MCQs, tables & flowcharts for USMLE Step 3 Pediatrics

10Questions
10Flashcards
3Tables & Flowcharts

Sample Questions

1

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

2

A 5-year-old boy with Down syndrome presents with his mother. The patient’s mother says that he isn’t playing or eating as much as he used to and seems lethargic. Expected developmental delays are present and stable. Physical examination reveals dry mucous membranes and abdominal distention with no tenderness to palpation. An abdominal radiograph is shown in the image below. Which of the following is the most likely diagnosis in this patient?

AUlcerative colitis

BAnal atresia

CHirschsprung's disease

DPyloric stenosis

EIncarcerated hernia

3

A new mother expresses her concerns because her 1-day-old newborn has been having feeding difficulties. The child vomits after every feeding and has had a continuous cough since shortly after birth. The mother denies any greenish coloration of the vomit and says that it is only composed of whitish milk that the baby just had. The child exhibits these coughing spells during the exam, at which time the physician notices the child’s skin becoming cyanotic. The mother states that the child was born vaginally with no complications, although her records show that she had polyhydramnios during her last ultrasound before the delivery. Which of the following is the most likely cause of the patient’s symptoms?

AFailure of recanalization of duodenum

BObstruction due to failure of rotation of pancreatic tissue

CHypertrophy of the pyloric sphincter

DFailure of neural crest cells to migrate into the myenteric plexus

EDefective formation of the esophagus with tracheoesophageal connection

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