A 6-month-old infant with heterotaxy syndrome is found incidentally on an upper GI series to have the duodenojejunal junction to the right of the spine. The infant is asymptomatic. What is the most significant potential life-threatening complication associated with this finding?
A 10-year-old immunocompetent boy develops watery diarrhea that becomes bloody after 2 days, associated with cramps and fever of 38.9°C (102°F). He ate undercooked chicken at a barbecue 3 days ago. Stool studies are pending. His physician considers starting antibiotics. Which statement regarding antibiotic use is most accurate in this context?
A 12-year-old boy is diagnosed with inflammatory bowel disease. Endoscopy shows continuous inflammation limited to the mucosa from the rectum to the cecum. Serology is positive for perinuclear antineutrophil cytoplasmic antibody (pANCA). Which feature, if it develops later, would most strongly suggest the diagnosis should be revised from ulcerative colitis to Crohn disease?
A 6-year-old boy with a family history of migraines has had four episodes of intense, non-bilious vomiting over the past 6 months. Each episode starts abruptly in the morning, lasts for 24 hours with vomiting up to 6 times per hour, and is associated with pallor. Between episodes, he is completely well. Which medication is a recommended first-line agent for prophylactic management in this child?
A 7-year-old child undergoes an abdominal computed tomography (CT) scan for evaluation of flank pain concerning for a kidney stone. The scan is negative for urolithiasis, but an incidental, densely calcified appendicolith is noted within a normal-appearing, non-inflamed appendix. The child is asymptomatic. What is the most appropriate management for this finding?
A newborn is delivered to a mother who is found to be hepatitis B surface antigen (HBsAg)-positive and hepatitis B e antigen (HBeAg)-positive. The infant does not receive any immunoprophylaxis after birth. What is the approximate risk of this infant developing a chronic hepatitis B virus infection?
A 10-year-old girl with type 1 diabetes is diagnosed with celiac disease after screening revealed anti-tissue transglutaminase IgA levels > 10 times the upper limit of normal and positive endomysial antibodies. A strict gluten-free diet is initiated. What is the expected outcome for her type 1 diabetes?
A 2-year-old child is brought for a well-child visit. The mother asks about the appropriate amount of fluoridated toothpaste to use for her child’s daily brushing to prevent dental caries, as she is concerned about fluorosis. What is the correct amount to recommend for a child this age?
A 3-year-old child is brought to the emergency department after swallowing a 20 mm lithium button battery one hour ago. An x-ray confirms the battery is lodged in the mid-esophagus. The child is currently asymptomatic and handling secretions well. What is the most appropriate next step in management?
A 4-week-old, firstborn male infant presents with 1 week of progressive, nonbilious, projectile vomiting immediately after feeding. He appears hungry after emesis. On examination, a firm, 2-cm, mobile mass is palpated in the midepigastrium. Which of the following is the most likely diagnosis?
