A Child with an Abdominal Mass Riad M Rahhal, MD, Ahmad Charaf Eddine, MD, and Warren Bishop, MD Dr Rahhal is a fellow, Division of Pediatric Gastroenterology, Department of Pediatrics; Dr Charaf Eddine is a resident, Department of Pediatrics; and Dr. Bishop is an associate professor, Division of Pediatric Gastroenterology, Department of Pediatrics; all are at the University of Iowa, Iowa City, IA. The questions below are based on the February 2006 Pediatric Rounds article, “A Child with an Abdominal Mass” Choose the single best answer for each question.
	1. A 3-week-old African-American girl presents with decreased oral intake and progressive abdominal distension over the previous 7 days. Her physical examination reveals a left-sided abdominal mass that is dull to percussion. All of the following provide helpful clues to narrow the differential diagnosis EXCEPT: Patient’s age Patient’s ethnicity Patient’s sex Mass location Dullness to percussion Click here to compare your answer. 2. A 1-year-old boy is found to have a mid-abdominal mass on routine check-up. Which of the following findings would suggest an underlying malignant process? Dysuria Anxiety Regurgitation Pallor Diarrhea Click here to compare your answer. Questions 3 and 4 refer to the following case study: A 12-year-old patient presents to the general pediatric clinic with fatigue, pallor, and weight loss over the previous 3 months. Physical examination reveals a white female in no apparent distress with mild tachycardia and otherwise normal vital signs. She has prominent generalized lymphadenopathy and petechiae over her trunk and legs. A firm, nontender mass is palpable in the mid-abdominal region.		3. All of the following should be included in this patient’s initial evaluation EXCEPT: Abdominal ultrasound Complete blood count Electrolytes Urinalysis Urine culture Click here to compare your answer. 4. The complete blood count reveals a hemoglobin level of 7 g/dL and a platelet count of 24 x 103/µL with a normal leukocyte count and differential. Which of the following tests should this patient undergo based on these laboratory findings? Magnetic resonance imaging of the spine Bone marrow aspirate Urine pregnancy test Serum alpha-fetoprotein Urine homovanillic acid level Click here to compare your answer. 5. A 6-year-old child is found to have a cystic abdominal mass arising from the terminal ileum on ultrasound during evaluation for abdominal pain. At surgery, a 10- cm long tubular mass with direct communication with the intestinal lumen is discovered and resected. Which of the following best describes this lesion? Most often involves the colon High incidence of malignancy An acquired condition May contain heterotopic mucosa Rarely asymptomatic Click here to compare your answer.
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