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You are called by a physician at a local urgent care facility about a 12-year-old boy with 8 hours of right scrotal pain. A scrotal ultrasound shows twisting of the right spermatic cord and there is an absence of testicular blood flow on color doppler. The most appropriate plan is to a transfer...

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A three-kg term infant with prenatally identified congenital diaphragmatic hernia (CDH) is on high frequency oscillation ventilation. Persistent pulmonary hypertension and evidence of left ventricular dysfunction is noted on echocardiogram. Addition of which of the following pharmacologic agents...

A 27-week neonate weighing 950g is born at an outside hospital. The neonate is in respiratory distress. The airway is secured after three attempts, There are also several attempts to pass an NG tube each of which meets resistance at 8 cm.The infant has stabilized after intubation and an...

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Correct answer d Observation with ultrasound surveillance at 6 and 12 months This patient has a breast mass less than 5 cm in diameter with benign sonographic features and no high-risk history. Current guidelines recommend observation and serial imaging for low-risk fibroadenoma-like lesions of...

A 14-year-old girl presents to your clinic with a palpable, non-tender right breast mass noted for the past 3 weeks. She denies trauma, fever, or nipple discharge. On exam, the mass is firm, mobile, and measures approximately 4 cm in diameter. An ultrasound shows a solid, well-circumscribed...

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An 11-year-old girl presents to your clinic with a history of chronic constipation. She underwent a Duhamel procedure for Hirschsprung disease when she was a newborn. Previous transition zone was identified in the proximal-descending colon based upon review of medical records. She is markedly...

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A 13-year old girl presents with mild epigastric pain. Laboratory studies include an AST 135 IU/L, ALT 173 IU/L, total bilirubin 1.9 mg/dL, direct bilirubin 1.4 mg/dL, amylase of 400 u/L, lipase of 500 u/L. Right upper quadrant ultrasound shows small stones in the gallbladder with a 7-mm...

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Quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "The breast tissue present in gynecomastia is most often tender, firm, and subareolar. One third of boys will present with unilateral gynecomastia. A mass in the breast that is not subareolar and is...

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Quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "After the hernia is reduced, an attempt is made to visualize the ipsilateral lung. This is usually done by retracting the anterior rim of the diaphragm. Often, a hypoplastic lung can be observed at the...

You are consulted on a sixteen-year-old who is being evaluated for wheezing unresponsive to bronchodilators. A computerized tomography (CT) scan of the chest is obtained. The most likely diagnosis in this patient with wheezing is a congenital pulmonary airway malformation b intralobar...

Quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "Three easily detectable features—polyhydramnios, mediastinal shift, and the absence of an intra-abdominal stomach bubble—should prompt a more careful search for herniated abdominal organs in the chest...