Congenital anomalies of bile ducts with cystic dilations of the extrahepatic biliary tree and/or intrahepatic biliary radicles

a) hydronephrosis

b) horseshoe kidney

c) choledochal cyst

d)meckels diverticulum

Abnormal enlargment of kidney cause dby acute ureteral obstruction of chronic kidney disease

a) hydronephrosis

b) horseshoe kidney

c) choledochal cyst

d)meckels diverticulum

Fusion of kidneys accross midline

a) hydronephrosis

b) horseshoe kidney

c) choledochal cyst

d)meckels diverticulum

Arises when proximal end of yold stalk does not fully detach from gut at the end of the 5th week and persists as diverticula of ileum

a) hydronephrosis

b) horseshoe kidney

c) choledochal cyst

d)meckels diverticulum

Lies immediatley below the right diaphragm and is the largest and heaviest organ in the body. Responsible for metabolizing carbohydrate, fats and protiens.

a) small intestine

b) large intesting

c) spleen

d) liver

Order of abdomen assessment

a) auscultation, palpation, percussion, inspection

b) inspection, palpation, percussion, auscultation

c) inspection, auscultation, percussion, palpation

d) none of the above

Normal bowel sounds are 

a) 4-5 seconds

b) 30-40 min

c) 10-20 sec

d) 40 seconds

Infants with a two-vessel cord:

a) may have other congenital anomalies and should be fully evaluated by a pediatric specialist

b) are normal

c) need immediate resuscitation, they are missing an artery!

d) had a stroke

Umbilical cords usually detach by the 10t day of life but can take up to 

a) 3 weeks to slough off

b) six months

d) 3 months

Mom calls because baby ellie has stool coming from her umbilicus you tell her

a) not to worry because stool is supposed to come out there until 3 weeks of age

b) that this is called an omphalomesenteric duct remnant and she needs to go the ER immediatley

c) that she should come to the office for her vaccinations

d) that mom should put a bandaid over it and it will go away

A wide bulging superior to the umbilicus is a common finding in children in whom the rectus abdominis muscles do not meet in the midline

a) abdominal hernia

b) diastasis rectus

c) ingunial hernia

d)dermatoid cyst

When would a child need a referall for an unbilical hernia?

a) the opening is larger than the width of 2 fingers

b) the child is 5 years old

c) the child is 2 years old

d) a and b

a) the opening is larger than the width of 2 fingers

b) the child is 5 years old

Most will spontaneously close by the time the child is 3-4

What is the most common umbilical mass?

a) dermatoid cyst

b) umbilical polyp

c) diastasis rectus

d) dermatoid polyp

a) dermatoid cyst

It appears as a firm, skincovered, non reducible mass that may have a slight discoloration and can be lobulated. Other cysts or an umbilical polyp should be refered to a pediatric surgeon.

If an inguinal hernia can be reduced you should

a) tell the parent not to worry it will resolve on its own

b) give them a referral for elective surgery and repair

c)tell the parents to keep pushing it back in

What is the most important technique in assessing the abodmoen and identifies areas of tenderness, masses, organomegaly, ascites, and signs of peritonitis. It should never be omitted:

a) auscultation

b) inspection

c) palpation

d) percussion

You have an infant in your practice that is btw the ages of 3 weeks and 8 weeks with projectile, nonbilious vomiting may have:

a) an obstruction

b) pyloric stenosis

c) rectosigmoid color

d) cancer

b) pyloric stenosis

Examine the infant while the abodmen is relaxed and plapate the upper abdomen, slightly right of the midline for a firm, olive shaped mass. 

If a child at your practice presents with consipation, a sausage shaped mass of stool may be palpated int eh left lower quadrant or int he midline below the umbilicus or:

a) small intestine

b) pyloric stenosis

c) rectosigmoid colon

Hepatomeagly is suspected if the liver is ___ cm below the costal margin

a) 0.5

b) 1

c) 2

d) 3

d) 3

causes of an enlarged liver include infeciton, liver mass, storage disorders, biliary masses, intrahepatic vascular disease, or cardiac disease

The spleen:

a) can always be palpated

b) should never be felt

c) can be felt in 5%-10% of children and slightly mobile

d) must be increased 2-3 times to be consistently palpable

c) can be felt in 5%-10% of children and slightly mobile

d) must be increased 2-3 times to be consistently palpable

An alternative technique in infants is to palpate teh spleet btw the thumb and forefinger of the right hand. If splenomeagly is supected and ultrasound shoudl be ordered

causes of splenomeagly include: infection, inflammation, blood dyscrasias, mass, or vascular and oncological conditions

constipation

acute gastroenteritis

appendicitis

intussusception

abdominal mass

foreign body 

posionous ingestion

appendicits

constipation

urinary tract infection

acute gastroenteritis

beta stretococcal pharyngitis/tonsillitis

lower lobe pneumonia

helicobacter pylori

abdominal mass

chrnoic abdominal pain

appendicits

lower lobe pneumonia

trauma

betastreptocccal pharyngitis/tonsillitis

inflammatory bowel disease

mass

henoch-schonlein purpura

mesenteric adenitis

blunt abdominal trauma

mononucleosis

superior mesentery artery syndrome

UTI

Ovarian cyst (rupture)

Torsion of ovary

STDs

PID

ectopic pregnancy

Incarcerated hernia

testicular torsion

epididymitis

orchitis