Formative Evaluation
[page 8]

Question 71-77 : You are called to see a month-old infant. His mother informs you that he has had increasing vomiting since birth.
71. Indication that the vomiting is due to pyloric stenosis include all of the following except :
 
A. Bilious vomiting
B. Hypokalemic metabolic alkalosis
C. Failure to pass a meconium stool
D. Palpable mass in right upper quadrant
E. Maternal hydramnios
72. Appropriate initial treatment for this infant is :
 
A. Nasogastric suction until obstruction resolves
B. Gastrostomy
C. Gastrojejunostomy
D. Partial gastrectomy
E. Pyloromyotomy
73. Appropriate treatment for a three-year-old child with his second episode of varicela bleeding and esophageal varices is :
 
A. Nonoperative
B. Side-to-side portacaval shunt
C. End-to-side portacaval shunt
D. Mesocaval shunt
E. Distal splenorenal shunt
74. The most common type of esophageal atresia includes :
 
A. Blind proximal pouch, distal tracheoesophageal fistula
B. Blind distal pouch, proximal tracheoesophageal fistula
C. Distal and proximal tracheoesophageal fistula
D. No tracheoesophageal fistula
E. None of these
75. Congenital goiter usually occurs in babies whose mothers :
 
A. Had untreated hyperthyroidism
B. Had untreated hypothyroidism
C. Received thyroid suppression
D. Received supplemental thryoxine or T3
E. Received radioactive iodine therapy
76. The most common cause of neonatal massive pneumoperitoneum is :
 
A. Perforated duodenal ulcer
B. Perforated colon
C. Hirshsprung's disease with enterocolitis
D. Ruptured stomach
E. Iatrogenic
77. The most common type of anorectal anomaly in newborns is :
 
A. Type I-stenosis of terminal rectum
B. Type II-failure of rupture of proctodeum
C. Type III-true anal atresia
D. Type IV-rectal atresia, normal anus ends as blind pouch
E. None of these
Questions 78-80 : A newborn baby is born with marked abdominal distention. Meconium is not passed during the first 24 hours after birth. Stools are absent on rectal examination.
78. The most likely diagnosis is
 
A. Pyloric obstruction
B. Duodenal ateresia
C. Duplication of ileum
D. Hirschsprung's disease
E. Fecal impaction
79. Which test would be diagnostic?
 
A. Gastric pH measurement
B. Sweat test
C. Examine abdomen for an olive mass
D. Rectal biopsy
E. Upper GI series

80.

 Treatment of the mosty likely cause should be
 
A. Small-bowel resection
B. Gastrostomy
C. Colostomy
D. Ileostomy
E. Dilatation of rectum
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