A 2-day-old term male neonate is brought to the hospital with abdominal distension and bilious vomiting. The baby has not passed meconium since birth. Physical examination reveals a distended abdomen without tenderness. Abdominal X-ray shows dilated loops of bowel with no air in the rectum. Contrast enema reveals a microcolon with inspissated material in the terminal ileum. What is the most likely underlying cause of this neonate’s condition?
A newborn male, born at 38 weeks gestation via spontaneous vaginal delivery, presents with persistent vomiting shortly after the first feed. The mother reports greenish-colored vomit and mild abdominal distension. The baby has not passed meconium since birth. There are no significant complications during pregnancy, but the mother mentions a prenatal ultrasound showing polyhydramnios. She has some relatives with genetic disorders. On physical examination, the baby appears slightly dehydrated but is otherwise alert and active. The abdomen is mildly distended, with no palpable masses or tenderness. Bowel sounds are present but reduced. A nasogastric tube is inserted, and bilious fluid is aspirated. X-rays reveal two distinct air-filled bubbles in the stomach and the proximal duodenum, separated by the atretic segment. Which of the following conditions is most commonly associated with this disorder?
A newborn male, born at 38 weeks gestation via spontaneous vaginal delivery, presents with persistent vomiting shortly after the first feed. The mother reports greenish-colored vomit and mild abdominal distension. The baby has not passed meconium since birth. There are no significant complications during pregnancy, but the mother mentions a prenatal ultrasound showing polyhydramnios. On physical examination, the baby appears slightly dehydrated but is otherwise alert and active. The abdomen is mildly distended, with no palpable masses or tenderness. Bowel sounds are present but reduced. A nasogastric tube is inserted, and bilious fluid is aspirated. You suspect duodenal atresia and decide to order some x-rays. What is the most characteristic radiological finding in duodenal atresia?
A newborn male infant presented within the first 24 hours of life with persistent bilious vomiting. The infant appeared lethargic and had a distended abdomen. Physical examination revealed a dry mucous membrane and decreased bowel sounds. You suspected duodenal atresia. A plain abdominal X-ray was performed. Which of the following is a characteristic x-ray sign associated with this condition?
A 24-year-old woman comes to your office for some information. She has a history of type 1 diabetes for the last 4 years. As part of preconception planning, she would like to get some information on congenital anomalies of infants of diabetic mothers. Which of the following is a congenital anomaly observed in infants of diabetic mothers?
A newborn male infant presented within the first 24 hours of life with persistent bilious vomiting. The infant appeared lethargic and had a distended abdomen. Physical examination revealed a dry mucous membrane and decreased bowel sounds. You wondered about different causes of bilious vomiting in an infant. Which of the following is a cause of bilious vomiting in children?
A mother brings her 3-week-old baby because she is concerned about his feeding. After every feeding, he vomits a lot. On physical examination of the infant, you notice bulging fontanels, jaundice, lethargy, hypotonia, and hepatomegaly. You suspect galactosemia in this baby. Which of the following is not true/FALSE about this disorder?
Joanna, a 23-year-old college student, presents to the clinic for her first prenatal visit. During the visit, she mentions occasional recreational drug use and expresses concern about the health effects of cannabis. She says she uses cannabis socially on weekends and perceives it as harmless because it’s legal in her state. She denies using other substances like cocaine, heroin, or prescription drugs. Her physical examination is unremarkable, and she appears healthy. During the discussion, she asks: “Is cannabis really the most commonly used drug, or are there other substances more popular?” Which of the following is the most commonly used illicit substance in the United States?
In the neonatal unit, you went to visit a mother and her 6 day old male baby. She reports that he is hardly sleeping at all, he is ‘super irritable’, his muscles feel tight, he is sweating a lot, sneezing, yawning, vomiting and having diarrhea. In the physical examination, you noticed a jittery baby with high pitched cry, who has a poor sucking reflex, nasal stuffiness, fever, tremors and hypertonia. He has tachycardia and tachypnea. Mother reports the use of buprenorphine through her 9 months of pregnancy for opioid use disorder. She is now breast feeding her baby. What is the next best step in the management of this baby?
A 35-year-old woman presented with fatigue, weakness, and weight loss. She had a history of postpartum hemorrhage following her last delivery, requiring blood transfusions. Physical examination revealed pallor, hypotension, and decreased axillary hair. Laboratory tests revealed low levels of thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4), as well as low levels of cortisol. Additionally, the patient had low levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), leading to amenorrhea. A diagnosis of Sheehan syndrome is made. Why is a steroid emergency card recommended for this patient?
