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S1

A 10-year-old male presents with a historyof fever and cough over the past 4 days.Vital signs: pulse 130 !"! ## temp

10#.1$% &'# (() on room air. &hysicale*am reveals rhonchi in the left +ase.

•  ,he correct interpretation of this -ray is

• &roper management include the following

• At this age the most li/ely pathogenwould +e

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S#

An -year-old child presents with recent headachecough fever and nausea. pulse ( !"! #0 temp10#.1$% p'# ().

•  ,he correct interpretation of this -ray is

•  2ou suspect an infectious process +ut schedule afollow-up -ray. After the acute illness hasimproved how long does it ta/e for a pneumonicinltrate to resolve on -ray

• &opulations with high incidence of tu+erculosisnclude the following

• 5hest -ray ndings in tu+erculosis include

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S3

A 1(-year-old male presents with acomplaint of shortness of +reath.history of smo/ing. Vital are normaland auscultation reveals an additionalgrating sound in synchrony with theheart rate.

•  2our interpretation of this -ray is

•  ,his -ray nding is consistent with

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S4

A 14-month-old child is placed in a +athtu+. ,hemother returns in 6less than minutes7 to ndthe child 8oating face up with no spontaneous

respirations. 'n emergency medical servicesarrival the child has spontaneous respirationswhich are assisted +y +ag-valve mas/. pulse11 !"! 4 temp (9.$%. &hysical e*am revealswheeing and rales +ut is otherwise normal.

•  2our interpretation of this -ray is:

• nitial management would include

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S

A 10-year-old male with 4 to 9 episodes ofvomiting at home and continues to feel ill andhad a +rief fainting episode. ;e is o+ese

reports poor appetite and had a low-gradefever at home. pulse 110 !"! ## temp(.4$% &o# (). &hysical e*am is otherwiseunremar/a+le including distant +reath sounds

in this o+ese child. 2our interpretation of these -rays is* ray #

 ,hese -rays are consistent with ray 3

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S9

A #-month-old female with an episode of hemoptysis thatevening. ,he child has had a 3- to 4-wee/ history ofcoughing and wheeing. pulse 130 !"! 40 temp ((.($% &o# (( thereis a dry cough +ut the remainder of the e*am is normal.

•  2our interpretation of this -ray is

• 5omplications can include all of the following e*cept

• ?enitive management of this child should include

• 5ommon sites of foreign +ody impaction in children include

• @hat percentage of foreign +odies pass withoutintervention

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S

An 11-month-old male presents to the emergency withvomiting. ;is mother states has had ve episodes of

vomiting since the previous night. ;e has +een cryingintermittently every 10

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S

A 3-wee/-old male presents with vomiting for 3 days.Dother states that the vomiting is forceful non+loodynon+ilious and occurs only after eating. E*am shows anonto*ic- appearing infant with the following vital signs:temp (.$% pulse 140 r"r 3 +p (1"3. &hysical e*am isunremar/a+le. the infant appears well hydrated.

• Fased on the clinical history and the -ray a+ove what isthe most li/ely diagnosis

• 5ommon characteristics with this condition include the

following•  ,he +est test to conrm the diagnosis is

• 5omplications of this condition are

• ?enitive treatment for this condition is

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S(

A 1-month-old female presents to the emergencydepartment with non+ilious vomiting for # days.

 ,he vital signs are normal and the infant appearswell hydrated.

• @hat is the correct interpretation of this -ray

•  ,his condition can occur most commonly after

• Adynamic ileus can result from

•@hich condition shows preferential collection ofair '+struction"leus. 5hoose one

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S10

A #0-month-old female presents withhistory of ingestion of coin.,he patientis in no distress. She is not coughing or

vomiting. ,he vital signs are normal andthe physical e*am is unremar/a+le.

• @here is the coin

• @hat are the common areas in whichcoins come to rest in the esophagus

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S11

A -wee/-old male is +rought in +y his motherafter a few episodes of +ilious vomiting. ,here isno a+dominal tenderness and the patientCs vitalsigns are normal.

• @hat is the correct interpretation of these -rays

• f no strangulation is occurring what study is+est to diagnose this condition

•  ,reatment for this includes

• 5omplication of this congenital anomaly inchildren is

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S1#

A 1-month-old male presents with poor feedingand occasional vomiting. 5omparison of his +irthweight to his current weight shows poor weightgain. ,emp (.9$% h"r 149 r"r 40 +"p (9"4(. ,hee*am was unremar/a+le and the patient wasadmitted for failure to thrive. ,he vomiting then+ecame +ilious and the following a+dominalseries was o+tained.

• @hat is the correct interpretation of these -rays

•  ,reatment for this would consist of

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S13

A 4-year-old male is seen for a+dominal pain for 3days. temperature of (.9$% heart rate 109respiratory rate #9 +lood pressure 100"0. &hysicale*am reveals a slightly uncomforta+le child who has

ma*imal tenderness to the right lower Guadrant.•  ,he correct interpretation of this -ray is

• you correctly point out the a+normal peritoneal fatstripes on this -ray. ,his gives you the correct

diagnosis of• Hiven this clinical setting and diagnosis what is

the preferred treatment

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S14

A 3-day-old female presents with vomiting and fussiness.;er vital signs are normal +ut she does appear to cry morewith palpation of the a+domen. ,here are no a+dominalmasses and the rest of the physical e*am is normal.

•

@hat is the correct interpretation of this -ray• @hich of the following causes an appearance of dilated

+owels with smooth +owel walls resem+ling sausage'+struction" leus. 5hoose one

• Sentinel loops are short segments of +owel dilation ne*t to

areas of in8ammation that usually represent which of thefollowing leus"'+struction. 5hoose one

• @ith regard to arrangement of +owel loops which has amore orderly appearance leus"'+struction. 5hoose one

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S1

A 3-year-old female presents with vomiting and somea+dominal pains. She has vomited four times in thelast # days. ,he vomiting is non+ilious and non+loody.

• @hat is the most correct interpretation of this -ray

• @hat other ndings do you see on this -ray

• After correctly identifying the pertinent ndings onthis -ray what is your ne*t plan of action

•  2ou do notice that the patient has a large amount of

stool on -ray. you have the nurse give the patientan enema. ,he patient passes a large amount ofstool and feels +etter. @hat do you do now

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S19

A 3-year-old male presents with a -minute tonic clonicseiure associated with a high temperature. &arents reportthat his appetite is poor and he was complaining of someright-sided a+dominal pain. ,emp 103.9$% h"r 1# r"r #3+"p 11#"#. &hysical e*am reveals an uncomforta+le child.;e has no signs of menigismus> heart and lung sounds arenormal. ;is a+domen is soft and nondistended with active+owel sounds. you +elieve he has some tenderness in theright lower Guadrant. ;is gait is normal.

• @hat is the correct interpretation of these -rays

• Hiven the clinical picture along with -ray ndings and yoursuper+ e*amination s/ills the most li/ely diagnosis is

• !adiological signs of appendicitis include

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S1

A -month-old male presents with vomiting. ;e isgiven 8uids and discharged home. ;e develops+loody diarrhea over the ne*t # days and returnsto the E?. ;e is found to +e lethargic and

moderately dehydrated. =a+s were drawnintravenous 8uid was started and the followinga+dominal series was o+tained.

• @hat is the correct interpretation of this -ray

•  @hat is the classic nding on this -ray with thisdisease process

• nitial management of this condition includes:

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S1

A 10-year-old male presents with # days of a+dominalpain that is worse today. ,he pain is perium+ilical andthere is no associated vomiting or diarrhea. ;is vitalsigns are normal. ;is physical e*am reveals guarding

and tenderness over the perium+ilical region.•  @hat is the correct interpretation

• @hat is the most common ectopic tissue present inDec/elCs

•

 ,he most common presentation is:• @hat is the +est diagnostic test to perform to rule in

Dec/elCs

• @hat is the current treatment

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S1(

A 9-year-old male presents with fever and stomach pain for1 day. ;e has not had any vomiting or diarrhea. ;is last

+owel movement was 3 days ago. temp 100.$% h"r 134r"r #4 +"p 113"91. &hysical e*am reveals an alert active

male in no acute distress. ;eart sounds are normal lungsclear a+domen positive for tenderness in the epigastrium.

!ectal e*am was normal. 2ou o+tain the followinga+dominal series.

• @hat is the most correct interpretation of these -rays

•

@hat would +e the most useful study you would wantne*t in this patient

• @hat would +e your ne*t step in treating this patient

•  @hat is the correct diagnosis

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S#0

A (-day-old male presents with vomiting. ,hechild appears well-hydrate +ut is fussy andcrying. ,he vital signs are normal. ,he physicale*am is unremar/a+le e*cept for the fact thatyou have a diIcult time determining anya+dominal tenderness.

•  @hat is the correct impression of this -ray

•

  potential causes of this are •  ,he most li/ely diagnosis is

•  ,reatment for this condition includes

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