Recent content by Ahmed Nabil

In these cases first priority is resuscitation (securing central IV access, IV fluids, antibiotics, NPO, TPN, warming the baby), then protection of the bowel with moist towel + sterile plastic wrap to decrease heat loss, then VACTRL screening specially for associate EA/TEF, ECHO, renal us, then...

d Observation

c total thyroidectomy

An MCT (Medium-Chain Triglyceride) diet is a key treatment for chylothorax (lymph fluid in the chest), reducing lymphatic flow by providing fats absorbed directly into the bloodstream, bypassing the compromised lymphatic system, thereby promoting healing of the leak while ensuring adequate...

correct answer b Ultrasound The stream of urine from the umbilicus is highly suggestive of an urachal remnant. Since the baby has not voided for several hours, there should be concern for posterior urethral valves. The first study should be an abdomen pelvic ultrasound to look at the kidneys...

correct answer d Epidermolysis bullosa Pyloric atresia is a rare disease entity first described by Calder in 1749. It occurs in approximately 1:100,000 live births and makes up about 1% of all gastrointestinal atresias. It was not until 1940 that the first successful repair was documented...

correct answer c Perform a tapering enteroplasty followed by anastomosis Type III b atresia may present with significant loss of intestinal length leaving the infant at risk for short bowel syndrome. In these cases, preservation of intestinal length and mucosal absorptive surface area is...

correct answer b Injection of botulinum toxin into the internal sphincter. Botulinum toxin works by temporarily inhibiting acetylcholine release at the neuromuscular junction, resulting in chemical denervation and relaxation of the internal anal sphincter. In children with Hirschsprung disease...

correct answer b Consideration of a GLP-1 Agonist The GLP-1 agonists liraglutide and exenatide have both been studied in adolescents and shown significant effects, although modest, on weight loss compared to diet and exercise alone. They have also shown improvements in glucose tolerance and...

correct answer b Emergently intubate This patient presents with a severe traumatic brain injury with evidence of herniation and elevated intracranial pressure. Management of the intracranial pressure to relieve intracranial hypertension is paramount to improve and optimize cerebral perfusion...

Diagnosis of malrotation on upper GI study mandate the performance of Ladd procedure ASAP. Also urgent exploration is needed in volvulus cases.

correct answer d Open muscle repair Femoral hernias are rare in children, with an incidence < 1% of all pediatric groin hernias. Because of the rarity, they are often not recognized until the time of surgery and surgeons may not be as familiar with the optimal repair in these patients. The...

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May be as a joined case with a vascular surgeon colleague.

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