ANSWER THESE QUESTIONs

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Introduction:

As a medical professor in charge of creating college assignments and evaluating student performance, it is important to have an updated knowledge of various medical conditions and their differential diagnoses. In this assignment, we will answer five questions related to pediatric conditions and their management.

Answer:

Question 1: Vomiting in infancy has a long list of differential diagnoses. Which accompanying symptom would most likely indicate pyloric stenosis?

Answer: Pyloric stenosis is a common cause of vomiting in infants. The hallmark of pyloric stenosis is projectile vomiting, which is not preceded by retching or nausea. Infants may also show signs of dehydration, such as decreased urine output, dry mouth, and lethargy. The most specific finding that indicates pyloric stenosis is the presence of a “sausage-shaped” mass in the abdomen, which represents the hypertrophied pylorus muscle.

Reference: UpToDate. (2021). Pyloric stenosis in infants and children: Clinical features and diagnosis.

Question 2: Which of the following findings could be expected to occur in a baby with intussusception?

Answer: Intussusception occurs when one segment of the bowel telescopes into the distal segment, leading to a partial or complete bowel obstruction. The clinical features of intussusception are the triad of colicky abdominal pain, vomiting, and currant jelly stools. Physical examination may reveal an “olive-shaped” mass in the right lower quadrant of the abdomen, corresponding to the intussusceptive lead point.

Reference: UpToDate. (2021). Intussusception in infants and children: Clinical features and diagnosis.

Question 3: A pediatric patient presents with symptoms consistent with the early phase of appendicitis. Which of the following would be the most likely presentation?

Answer: Appendicitis is a common surgical emergency in the pediatric population. The classic presentation of appendicitis is the gradual onset of periumbilical pain that migrates to the right lower quadrant of the abdomen over the next several hours. Other clinical features may include nausea, vomiting, fever, and anorexia. However, in the early phase of appendicitis, the most likely presentation would be severe localized right lower quadrant pain, which may be accompanied by mild fever and nausea.

Reference: UpToDate. (2021). Acute appendicitis in children: Clinical manifestations and diagnosis.

Question 4: The nurse practitioner is completing education with parents of a child with celiac disease. Which of the following foods would be most appropriate?

Answer: Celiac disease is an autoimmune disorder that affects the small intestine and causes a variety of gastrointestinal symptoms. The primary treatment for celiac disease is a gluten-free diet. Oatmeal and cream of wheat are not gluten-free, and therefore not appropriate for patients with celiac disease. Commercially baked bread may contain gluten, depending on the ingredients used. The most appropriate food for a patient with celiac disease would be boiled rice and butter, which is gluten-free.

Reference: UpToDate. (2021). Patient education: Celiac disease in adults (Beyond the Basics).

Question 5: A male patient presents with symptoms consistent with testicular torsion. What would be the first priority for this patient?

Answer: Testicular torsion is a surgical emergency that occurs when the spermatic cord twists, cutting off blood supply to the testicle. Patients with testicular torsion typically experience sudden onset of severe pain and swelling of the affected testicle. The first priority for a patient with testicular torsion is surgical referral, as this condition can lead to testicular ischemia and subsequent infertility if not promptly treated. Scrotal elevation and ice may provide symptomatic relief but are not a substitute for surgical intervention.

Reference: UpToDate. (2021). Testicular torsion: Evaluation and management.