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Pediatric Rounds Review Questions

A 4-Year-Old Boy with Abdominal Pain

Muhammad Waseem, MD

Dr. Waseem is an Assistant Professor, Emergency Medicine, Cornell University, New York, NY; and an Attending Physician, Department of Emergency Medicine, Lincoln Hospital, Bronx, NY.

The questions below are based on the October 2002 Pediatric Rounds article, “A 4-Year-Old Boy with Abdominal Pain.”

Choose the single best answer for each question.

1. What is the most common esophageal site for lodgment of foreign bodies?
  1. Cricopharyngeal muscle (at C6 vertebral level)
  2. Aortic arch (at T4 level)
  3. Lower esophageal sphincter
  4. Tracheal bifurcation (at T6 level)
  5. Diaphragmatic hiatus (at T10-T11 level)
Click here to compare your answer.

2. Foreign bodies generally require immediate removal from which of the following locations?

  1. Esophagus
  2. Stomach
  3. Duodenum
  4. Ascending colon
  5. Rectum
Click here to compare your answer.

3. A 3-year-old boy is brought to the emergency department by his mother, who witnessed him putting a coin into his mouth while playing with a jar of coins. The child is asymptomatic and interactive, and is playing in the emergency department. He swallows water without any difficulty. Which of the following is the best course of action for this child?
  1. Discharge home without any intervention
  2. Discharge home and instruct the mother to watch his stool for 3 days
  3. Discharge home with instructions to return if any symptoms develop
  4. Obtain mouth-to-stomach plain radiographs
  5. Admit for observation
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4. A young child is brought to the emergency department 6 hours after a choking episode. He is alert and playful. Plain radiographs are obtained (Figure). Where is the foreign body located?

  1. Esophagus
  2. Trachea
  3. Stomach
  4. Duodenum
  5. Colon
Click here to compare your answer.

5. A 2 year-old child swallowed a button battery 4 hours prior to arrival at the emergency department. He is asymptomatic. Plain radiographs reveal the battery to be located in the stomach. Which of the following options describes the most appropriate management of this child at this time?

  1. Observation with serial radiographs
  2. Administration of syrup of ipecac
  3. Gastric lavage
  4. Immediate endoscopic removal
  5. Administration of glucagon
Click here to compare your answer.

Click here to read “A 4-Year-Old Boy with Abdominal Pain” (Requires Adobe Acrobat Reader)


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