Juicy MCQS Question bank 6

Question

A female infant was born by vaginal delivery at 33 weeks and 5 days of gestational age with respiratory distress and severe abdominal distension and bilious vomiting.

The plain radiograph is shown to the right.

What is the likely diagnosis?

Clinical presentation of meconium ileus » Juicy MCQS Question bank 6
  • A. Meconium ileus.
  • B. Duodenal Atresia.
  • C. Hirschsprung's Disease.
  • D. Inguinal Hernia.
  • E. Intestinal Malrotation.

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Explanation

Clinical presentation of meconium ileus is with abdominal distension and bilious vomiting.

Viscous meconium in the terminal ileum may cause intestinal obstruction. It may be a manifestation of cystic fibrosis in approximately 10% of the CF population. Therefore, any baby with meconium ileus requires further investigation for CF.

There are often many gas-filled bowel loops, but without air-fluid levels. Air-fluid levels are thought not to occur because the meconium does not provide a good air-fluid interface. There may be a "soapy" mass in the right lower quadrant. A contrast enema will show a microcolon secondary to distal ileal obstruction. Calcification may be seen on a plain radiograph if there has been meconium peritonitis.

Gastrografin enemas may relieve the obstruction, but surgery may also be required.

Obaid

Pharmacist, CPHQ, CHQO, Quality Coordinator, Chemotherapy Preparation incharge. Graduated pharmacy school in 2009 I stood with my classmates as we recited the “Oath of a Pharmacist” in. There is one particular vow that stood out to me as we recited the Oath and I embrace this vow, “I will apply my knowledge, experience, and skills to the best of my ability to assure optimal outcomes for my patients.” I love being a pharmacist because it allows me to use my knowledge, abilities, and talents to improve patient outcomes in the community hospital in which I am employed as the pharmacy clinical coordinator.

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