Formative Evaluation
[page 15]
141. A two-week-old premature infant is found to have several milliters of formula still
present in the stomach two hours after being fed. Also noted are gastric distnesion and the passage of blood-streaked stools. Which of the following historical factors would best support a tentative diagnosis of necrotizing enterocolitis for this infant?
 
A. Passage of a thick tenacious meconium plug at 24 hours of age
B. Severe hyaline membrane disease with anoxic episodes in the first week of life
C. Hypocalcemia requiring oral calcium supplementation in the first week of life
D. A maternal history of severe ulcerative of life
E. A history of milk-protein allergy in family members
142. Pulmonary dysmaturity (Wilson-Mikity syndrome) and bronchopulmonary dysplasia are very similar in which of the following respects?
 
A. Characteristic pulmonary pathology
B. Early clinical course
C. Known etiologic factors
D. Radiographic findings
E. B and D are correct
143. Which of the following statements concerning the digestion and absorption of medium-chain triglycerides is NOT true?
 
A. Bile salts are required for their absorption
B. They are incorporated into chylomicrons only to a minor degree
C. During transport they are bound to albumin
D. They are rapidly hydrolyzed by pancreatic lipase
E. They are metabolized in the liver
144.

The x-ray shown below canbe suggestive of all the following diagnoses in a neonate EXCEPT

A. Cystic fibrosis
B. Trisomy 21
C. Malrotation and volvulus
D. Ileal atresia
E. Hirschsprung's disease
145. A three-week-old infant who is still at birthweight has bloody diarrhea. The child had delayed passage of meconium while in the newborn nursery. All of the following disorders should be strongly considered in the differential diangosis EXCEPT
 
A. Necrotizing enterocolitis
B. Cystic fibrosis
C. Hirschsprung's disease
D. Hypothyroidism
E. Salmonellosis
146. A six-week-old dehydrated child is admitted to a hospital following ten days of vomiting. Pyloric stensosi is suspected. Which of the following findings would be most consistent with this diangosis?
 
A. Jaundice and indirect hyperbilirubinemia
B. Hyponatremia with a hyperchloremic metabolic acidosis
C. An elevated serum potassium level
D. A urine specific gravity of 1.005
E. A urine pH of 4.5
147. A child who has undergone an ileal resection would be likely to exhibit all of the following findings EXCEPT
 
A. Iron-deficiency anemia
B. Renal oxalate stones
C. An abnormal Schilling test with intrinsic factor
D. A positive response to cholestyramine therapy
E. An increase in glycine-conjugated bile acids
148. Which of the following clinical and pathologic findings is most characteristic of Crohn's disease?
 
A. Rectal bleeding
B. Colonic granulomas
C. Pericholangitis
D. Toxic megacolon
E. Rectal friability
149. A six-week-old infant is amitted to a hospital because of jaundice. Which of the following disorders could be responsible for obstructive jaundice in this infant?
 
A. Cystic fibrosis
B. Gilbert's disease
C. Alpha1 -antitrypsin deficiency
D. Hypothyroidism
E. A and C are correct
150. Gastrointestinal manifestations of cystic fibrosis include
 
A. Portal hypertension and varices
B. An ileocecal mass
C. Abnormal gallbladder function
D. Constipation and obstruction
E. All are correct
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