A Absent peristalsis

B Increased bowel wall perfusion

C Pneumatosis intestinalis

D Portal venous gas

E Simple ascites​[/size]

A Whole body cooling to 33-34 degrees Celsius

B Avoiding an intestinal anastomosis if bowel resection is necessary

C Placing a peritoneal drain if pneumoperitoneum occurs

D Holding feeds for at least 14 days

E Proceeding quickly to laparotomy if there is clinical deterioration[/size]

A Contrast studies are not required prior to ostomy reversal so no further testing is needed​

B Contrast studies are only needed in patients who have difficulty tolerating enteral feeds, so no further testing is needed in this case

C Contrast studies should be obtained prior to ostomy reversal in cases of NEC and anorectal malformations, but can be avoided in other diagnoses

D Contrast studies should always be performed prior to ostomy reversal, regardless of the underlying diagnosis​[/size]

A Delay initiation of enteral feedings for 7 days

B Advance enteral feedings by 18 ml/kg/day

C Daily administration of Bifidobacteriuminfantis

D Enteral administration of metronidazole

E Use of pasteurized breast milk​[/size]

Which statement is true regarding his survival and 2-year neurodevelopmental status?

A The likelihood for neurodevelopmental impairment in infants with NEC with initial laparotomy or initial peritoneal drain placement is equivalent.

B With this gestational age and surgical condition, he has a 90% probability of having some degree of neurodevelopmental impairment.

C There are currently no data from randomized clinical trials addressing this question.

D Initial laparotomy doubles the rate of survival without impairment at 2-years compared to initial drain placement for infants with presumed NEC.

E Initial drain placement with subsequent laparotomy if needed has been shown to increase survival without impairment in high-risk NEC infants.[/size]

[size=20px]The next best step in managing this infant with perforated necrotizing enterocolitis is

A placing another drain.

B changing antibiotic therapy.

C laparotomy.

D administration of corticosteroids.

E administration of probiotics.[/size]

A observation

B laparoscopy

C placement of a second drain

D laparotomy and primary anastomosis

E laparotomy and stoma[/size]

Edit: available without restrictions

A short bowel syndrome

B bowel stricture

C neurodevelopmental problems

D stoma-related electrolyte imbalance

E inflammatory bowel disease [/size]

A four-day old term newborn with congenital heart disease (atrial and ventricular septal defect) develops feeding intolerance and bloody stools. The abdominal radiograph is pictured below.

[size=20px]Which of the following is the next best step in the management of the this full term infant with bloody stools?

A switch to a nonmilk based formula

B administer a diuretic

C start broad spectrum parenteral antibiotics

D obtain a contrast enema

E perform an exploratory laparotomy[/size]

WBC: 10000, Platelets: 270000. PH: 7.31, HCO3: 25 ,

abdomen X RAY revaled pneumoperitoneum. How to manage ?

[center][/center]

Disclaimer: this is not my case, this case from Saudi pediatric surgery club, only to test forums