Cedrick
Esculapio
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A 1 year old newborn has has bilious vomiting that began 1 hr after birth
physical examination shows upward slating eyes,short small fingers,and a wide space between the first and second toes
peristaltic waves are seen,but there is no abdominal distention
which of the following is the most likely additional finding in this patient ?
a.-congenital aganglionic megacolon
b.-duodenal atresia
c.-meconium ileus
d.-pyloric stenosis
e.-thracheoesophageal fistula
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| robin082006
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B?
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| Cedrick
Esculapio
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Hi Robin
I just read that the slanting eyes is the NOONAN syndrome
and it has many malformations
I think it is D?
but I dont know for sure
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| qts
Forum Newbie
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these r the features of down's syndrome ...the GI defects in down's syndrome r congenital aganglionic megacolon, duodenal atresia...so it cud me A or B.but i wonder ow come he doesn't hav abdominal distension....
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| Cedrick
Esculapio
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you know you could be right since they did not specify if slanting is
horizontal.-Down
Vertical .-Noonan
let think about
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| robin082006
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I though it is Down's.
Option D is possible but how do you explain bilious vomiting?
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The Key to Succeed is Patience.
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| Cedrick
Esculapio
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I am still
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| star1
Forum Guru
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Its down syndrome and duodenal atresia present with vomiting at birth. Now why Billous vomiting here is the Answer.
read only the duodenal atresia but there are other interesting pics and discussing so u can read the whole page
http://www.aafp.org/afp/20000501/2791.html
good luck
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| Cedrick
Esculapio
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hey thanks Star
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| star1
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Welcome............
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| mjl1717
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i would have said duodenal atresia ,looking for other congental defects
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| malkia
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I would have said duodenal atresia, simply because he is vomiting bile. That's the only answer among the choices that would explain bile in his vomit
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| ndspider
Forum Senior
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B
Yawn
They are testing the concept of differeniating between pyloric stenosis and duodenal atresia.
Pyloric stenosis- projectile vomitng. palpable etccc.... of whivh you won't see on questons stem
Duodenal- downs, polyhydramnous... etc... etc....
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| mjl1717
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but seriously "star 1" gave Great info!
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| ndspider
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Or based on the title it is a chinese baby.
or korean.
I am korean.
So it could be korean.
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| Cedrick
Esculapio
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alright then
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| waqastariq
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just a point..
anything obstructing distal to ligament of trietz....bilious vomit
anything proxiam to it ....non bilious....
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| waqastariq
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its DOWN syndrome with duodenal atresia...
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| waqastariq
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B
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| alirizvi
Forum Elite
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D for sure.
It can not be B because Pyloric stenosis causes non billious. And occurs at 2-3weeks since its not complete obstruction.
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