Category: Surgery

An 8-year-old boy is brought to your office with the complaint of abdominal pain. The pain is worse during the week and seems to be less prominent during the weekends and during the summer. The patient’s growth and development are normal. The physical examination is unremarkable. Laboratory screening, including stool for occult blood, complete blood count, urinalysis, and chemistry panel, yields normal results. Which of the following is the best next step in the care of this patient?

a. Perform an upper GI series

b. Perform CT of the abdomen

c. Administer a trial of H2 blockers

d. Observe the patient and reassure the patient and family

e. Recommend a lactose-free diet

the answer is below…

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A 14-year-old girl has a 9-month history of diarrhea, abdominal pain (usually periumbilical and postprandial), fever, and weight loss. She has had several episodes of blood in her stools. Which of the following is the most likely diagnosis?

a. Chronic appendicitis

b. Chronic pancreatitis

c. Crohn disease

d. Bulimia

e. Gallstones

the answer is below…

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A 2-year-old presents to the emergency center with several days of rectal bleeding. The mother first noticed reddish-colored stools 2 days prior to arrival and has since changed several diapers with just blood. The child is afebrile, alert, and playful, and is eating well without emesis. He is slightly tachycardic, and his abdominal examination is normal. Which of the following is the best diagnostic study to order at this time?

a. Exploratory laparotomy

b. Barium enema

c. Ultrasound of the abdomen

d. Radionucleotide scan

e. Stool culture

the answer is below…

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