Causes of Constipation in childhood

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Q) A 4-year-old child presents with a history of infrequent, hard stools associated with painful defecation. There is no history of vomiting, fever, or blood in the stool. On examination, there is a palpable fecal mass in the left lower abdomen, and the anal tone is normal. What is the most likely diagnosis? # Theme from Mock test 32

A) Hirschsprung disease
B) Functional constipation
C) Intussusception
D) Anal fissure

Ans b

Functional constipation is the most common cause of constipation in children. It is characterized by hard stools, infrequent bowel movements, and often associated with painful defecation leading to stool withholding.

It is diagnosed clinically based on the Rome IV criteria, with no evidence of an organic cause.

Why the other options are incorrect:

A) Hirschsprung disease:

  • Typically presents in infancy with failure to pass meconium within 48 hours, abdominal distension, and bilious vomiting. The anal tone may be increased, and rectal examination may reveal an explosive release of stool.

C) Intussusception:

  • Presents with intermittent, severe abdominal pain, vomiting, and "currant jelly stools." A palpable "sausage-shaped" mass is found in the abdomen, not a fecal mass.

D) Anal fissure:

  • Can cause painful defecation, but it is usually associated with streaks of bright red blood on the stool and pain during defecation, without palpable fecal masses.

Glenn Procedure

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Q) Which of the following best describes the main goal of the Glenn procedure performed in patients with single-ventricle congenital heart defects, such as after the Norwood operation? #Congenital cardiac mock test on 8th Dec 24

A) To create a two-ventricle circulation by repairing the mitral and tricuspid valves.
B) To establish direct pulmonary blood flow by redirecting the superior vena cava to the pulmonary arteries.
C) To replace the right ventricle with a synthetic pump for systemic circulation.
D) To connect the left atrium directly to the right ventricle to improve systemic oxygenation.

 

Top tv Shows for Surgeons to watch

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Top TV shows for surgeons

Papillary Thyroid carcinoma

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Q) A 30-year-old female is diagnosed with papillary thyroid carcinoma (PTC) following a fine-needle aspiration biopsy. Ultrasound shows a 1.8 cm solid nodule in the left thyroid lobe, and the ultrasound reveals no evidence of cervical lymphadenopathy. The patient's medical history is unremarkable, and she has no family history of thyroid cancer. According to the NCCN guidelines, which of the following management strategies is MOST appropriate for this patient?

A. Total thyroidectomy, as the tumor size exceeds 1 cm and there is a risk of contralateral disease.

B. Lobectomy with careful monitoring, as there is no extrathyroidal extension or lymph node involvement, and the tumor size is less than 2 cm.

C. Active surveillance with regular follow-up and ultrasound monitoring, given the tumor size and absence of aggressive features.

D. Lobectomy followed by radioactive iodine ablation to reduce the risk of recurrence.

 

Full article how to prepare for neet ss surgery 25

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