Systemic paediatrics: pyloric stenosis management: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Systemic paediatrics: pyloric stenosis management

Sample item

A 5-week-old boy with projectile non-bilious vomiting has a palpable olive and is dehydrated. What must be done before pyloromyotomy?

AImmediate surgery without preparationBStart proton pump inhibitor and observeCInsert a jejunal feeding tubeDCorrect fluid and electrolyte deficits

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Correct fluid and electrolyte deficits

The infant loses hydrochloric acid and develops hypochloraemic, hypokalaemic metabolic alkalosis. This is corrected with saline and potassium before surgery, because anaesthesia in an alkalotic child risks post-operative apnoea. Pyloromyotomy is then curative.

Option by option

A. Immediate surgery without preparation
Surgery without correction raises anaesthetic risk.
B. Start proton pump inhibitor and observe
A PPI does not treat the obstruction.
C. Insert a jejunal feeding tube
Jejunal feeding is not the standard treatment.
D. Correct fluid and electrolyte deficits (correct)
Correct. Resuscitation corrects the alkalosis and dehydration before surgery.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Correct fluid and electrolyte deficits. The infant loses hydrochloric acid and develops hypochloraemic, hypokalaemic metabolic alkalosis.

Why is "Immediate surgery without preparation" not the answer?

Surgery without correction raises anaesthetic risk.

Why is "Start proton pump inhibitor and observe" not the answer?

A PPI does not treat the obstruction.

Why is "Insert a jejunal feeding tube" not the answer?

Jejunal feeding is not the standard treatment.

What concept does this question test?

It tests Systemic paediatrics: pyloric stenosis management in Pediatrics. This is corrected with saline and potassium before surgery, because anaesthesia in an alkalotic child risks post-operative apnoea. Pyloromyotomy is then curative.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Systemic paediatrics: pyloric stenosis management?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.