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Pediatric Rounds Review Questions

A Listless Infant with Vomiting

Mark A. Hostetler, MD, MPH

Dr. Hostetler is an Instructor, Department of Pediatrics, Division of Emergency Medicine, St. Louis Children’s Hospital, Washington University School of Medicine, St. Louis, MO.

The questions below are based on the February 2002 Pediatric Rounds article, “A Listless Infant with Vomiting.”

Choose the single best answer for each question.

1. A child presents at an emergency department with a history of vomiting and decreased activity. He is 12 months old and weighs 10 kg. His vital signs include: heart rate 180 bpm; respiratory rate 30 breaths/min; blood pressure 90/60 mm Hg; rectal temperature 37.0°C. Oxygen saturation is 99% on room air. Capillary refill is 3 seconds. The nurses have initiated intravenous access. What type and amount of fluid should be infused?
  1. Normal saline solution, 100 mL
  2. Normal saline solution, 200 mL
  3. 1/2 normal saline with 5% dextrose, 100 mL
  4. Normal saline solution with 5% dextrose, 200 mL
  5. Normal saline solution with 5% dextrose, 100 mL
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2. Intussusception is the most common cause of intestinal obstruction in children younger than what age?

  1. 2 months
  2. 6 months
  3. 2 years
  4. 5 years
  5. 16 years
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3. What is the “classic triad” of symptoms most often associated with intussusception?
  1. Vomiting, diarrhea, and abdominal pain
  2. Abdominal distention, bloody stools, and palpable abdominal mass
  3. Bilious vomiting, abdominal distention, and palpable abdominal mass
  4. Fever, vomiting, and diarrhea
  5. Vomiting, bloody stools, and abdominal pain
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4. How often are all three components of the “classic triad” present in proven cases of intussusception?

  1. Between 5% and 10%
  2. Fewer than 33%
  3. Approximately 50%
  4. Roughly 66%
  5. More than 90%
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5. In cases of suspected intussusception, what test can be recommended as being both diagnostic and therapeutic?

  1. Upper gastrointestinal (GI) series
  2. Lower GI series
  3. Ultrasonography
  4. Contrast enema
  5. Computed tomography-guided biopsy
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Updated 1/04/08 • kkj