Peds GI Quiz: Can You Spot The Obstruction?

1. Which electrolyte imbalance is most common in pyloric stenosis due to prolonged vomiting?

Hyperkalemia

Hypochloremic, hypokalemic metabolic alkalosis

Hypernatremia

Hypercalcemia

2. At what age does intussusception most commonly occur?

2-4 weeks

6 weeks to 3 years

6-12 months only

Older than 5 years

Submit

4. A 4-week-old presents with projectile vomiting but appears hungry immediately after. What nursing consideration is important?

Offer feeds immediately after vomiting

Restrict all oral intake until surgery

Refeeding after vomiting may be attempted cautiously

Administer antiemetics before feeding

5. What is the gold standard imaging for diagnosing pyloric stenosis?

Abdominal X-ray

CT scan

Ultrasound

Upper endoscopy

6. Which finding on abdominal ultrasound is characteristic of intussusception?

'Target sign' or 'doughnut sign'

Pyloric muscle hypertrophy

Dilated gastric antrum

Absence of peristalsis

7. What percentage of infants with intussusception have a lead point identifiable?

Less than 10%

25-40%

60-75%

Greater than 90%

8. Which imaging modality is both diagnostic and therapeutic for intussusception?

CT scan

Abdominal X-ray

Ultrasound or air enema

MRI

9. A 2-month-old with pyloric stenosis presents with dehydration and electrolyte imbalance. What is the priority before surgery?

Immediate surgical intervention

Fluid resuscitation and electrolyte correction

Antibiotic initiation

Feeding trial

10. A 3-week-old male presents with projectile vomiting and visible peristaltic waves. What is the most likely diagnosis?

Pyloric stenosis

Intussusception

Gastroenteritis

Malrotation

11. What is the classic triad of symptoms in intussusception?

Vomiting, abdominal pain, currant jelly stools

Fever, diarrhea, dehydration

Constipation, abdominal distension, weight loss

Bloody diarrhea, fever, lethargy

12. Intussusception most commonly involves which part of the bowel?

Sigmoid colon

Ileocolic junction

Gastrojejunal junction

Rectosigmoid junction

13. What is the definitive treatment for pyloric stenosis?

Nasogastric decompression and antibiotics

Pyloromyotomy (Ramstedt procedure)

Dietary modification and antispasmodics

Metoclopramide therapy

14. A 6-month-old presents with colicky abdominal pain, palpable abdominal mass, and currant jelly stools. What is the suspected diagnosis?

Pyloric stenosis

Intussusception

Appendicitis

Crohn's disease

15. Which imaging finding on ultrasound confirms pyloric stenosis?

Pyloric muscle thickness >3 mm and channel length >14 mm

Free fluid in the abdomen

Dilated small bowel loops

Air-fluid levels throughout the colon

16. Pyloric stenosis is more common in which demographic group?

Females and African Americans

Caucasian males with positive family history

Premature infants

Infants with maternal infections

17. What is a common risk factor for intussusception following rotavirus vaccination?

Vaccine strain replication in the bowel

Immune-mediated hypertrophy of Peyer's patches

Direct mechanical obstruction

Secondary bacterial infection