A 17-Year-Old Boy with Umbilical Discharge Michael S. Martin, MD and Robert M. Lembo, MD Dr. Martin is a resident in pediatics and Dr. Lembo is an associate professor of clinical pediatrics and director of medical education, Department of Pediatrics; both are at New York University School of Medicine, New York, NY. The questions below are based on the May 2004 Pediatric Rounds article, “A 17-Year-Old Boy with Umbilical Discharge” Choose the single best answer for each question.
	1. Which of the following urachal anomalies occurs most frequently? Patent urachus Umbilical granuloma Umbilical-urachal sinus Urachal cyst Vesicourachal diverticulum Click here to compare your answer. 2. You suspect that a urachal anomaly is the underlying lesion in a young patient presenting with a clear, yellowish fluid from her umbilicus. Which of the following procedures would most likely confirm the diagnosis? Intravenous pyelography Magnetic resonance imaging Sinography Surgical excision Ultrasonography Click here to compare your answer. 3. Possible complications of urachal cysts include all of the following EXCEPT: Abscess formation Intraperitoneal rupture Malignancy Pelvic inflammatory disease Stone formation Click here to compare your answer.		4. A 3-month-old male infant presents to your clinic following completion of treatment of a urinary tract infection. You decide to order both a vesicoureterogram and renal ultrasound. The studies reveal posterior urethral valves and another finding. Which of the following findings was most likely seen? Omphalitis Patent omphalomesenteric duct Patent urachus Umbilical granuloma Urachal cyst Click here to compare your answer. You make the diagnosis of an infected urachal cyst in a 14-year-old patient with an oral temperature of 103°F. You decide to start the patient on antibiotics immediately rather than wait for culture results. In choosing antibiotics, which organism is most likely the cause of the infection? Citrobacter species Enterococcus species Escherichia coli Staphylococcus aureus Streptococcus species Click here to compare your answer.
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