A newborn's failure to pass meconium within the first 24 hours after birth may indicate which of the following?

Abdominal wall defect

Celiac disease.

Intussusception

Hirschsprung disease

Answer and Explanation

The Correct Answer is D

A. Abdominal wall defect:

Failure to pass meconium within the first 24 hours after birth can indicate a potential obstruction in the gastrointestinal tract. While an abdominal wall defect could potentially cause gastrointestinal issues, it is not specifically associated with failure to pass meconium.

B. Celiac disease:

Celiac disease is an autoimmune disorder characterized by an abnormal immune response to gluten. While celiac disease can cause gastrointestinal symptoms, such as diarrhea and abdominal pain, it is not typically associated with failure to pass meconium in the newborn period.

C. Intussusception:

Intussusception occurs when one segment of the intestine telescopes into another, causing a bowel obstruction. While intussusception is a cause of bowel obstruction in infants, it typically presents with symptoms such as colicky abdominal pain, vomiting, and the passage of "currant jelly" stool, rather than failure to pass meconium.

D. Hirschsprung disease:

Hirschsprung disease is a congenital condition characterized by the absence of ganglion cells in the distal portion of the colon, leading to functional obstruction. Failure to pass meconium within the first 24 hours after birth is a classic sign of Hirschsprung disease. This condition requires surgical intervention to remove the affected portion of the colon and restore normal bowel function.

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Correct Answer is A

Explanation

A. No treatment is necessary, the fluid is reabsorbing normally:

- This option suggests that the hydrocele is resolving spontaneously, which is often the case in infants. The physician may choose to observe the hydrocele over time as it is likely to resolve without intervention.

B. Keeping the infant in a flat, supine position until the fluid is gone:

- This option does not address the underlying cause of the hydrocele and is not a standard treatment recommendation. Additionally, positioning changes are unlikely to affect the resolution of the hydrocele.

C. Referral to a surgeon for repair:

- Surgical repair may be considered if the hydrocele persists beyond a certain age or if it causes discomfort or complications. However, it is typically not recommended in infants unless the hydrocele persists beyond infancy or causes other issues.

D. Massaging the groin area twice a day until the fluid is gone:

- Massaging the groin area is not a recommended treatment for hydrocele and may not be effective in resolving the condition. Additionally, manipulating the scrotum may cause discomfort or injury to the infant.

A. Projectile vomiting B. Metabolic acidosis C. Effortless regurgitation D. Distended abdomen

Correct Answer is A

Explanation

A. Projectile vomiting

Projectile vomiting is a classic symptom of pyloric stenosis in infants. It typically occurs within 30 minutes of feeding and is forceful, often projecting several feet away from the infant. This occurs due to the obstruction at the pyloric sphincter, leading to the stomach forcefully emptying its contents.

B. Metabolic acidosis

Metabolic acidosis is not a typical finding associated with pyloric stenosis. Pyloric stenosis leads to vomiting, which can result in dehydration and electrolyte imbalances, but it typically does not cause metabolic acidosis directly.

C. Effortless regurgitation

Effortless regurgitation is not a characteristic finding of pyloric stenosis. In pyloric stenosis, vomiting is forceful and projectile, rather than a passive regurgitation of stomach contents.

D. Distended abdomen

A distended abdomen can be a finding in pyloric stenosis. The obstruction at the pyloric sphincter can lead to gastric retention, causing the stomach to become distended over time. However, it's important to note that not all infants with pyloric stenosis will present with a visibly distended abdomen.

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A newborn's failure to pass meconium within the first 24 hours after birth may indicate which of the following?

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Correct Answer is A

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