A 6-Week-Old Boy Is Brought to the Physician with Persistent

question 521

Multiple Choice

A 6-week-old boy is brought to the physician with persistent, worsening vomiting over the past 2 weeks.  The emesis occurs with every feed, is nonbilious, and is projectile in nature.  The emesis has persisted even though his mother has tried small, frequent feeds and holding the infant upright after feeds.  On physical examination, peristaltic waves are seen over the upper abdomen, and an olive-shaped mass is palpated in the right upper quadrant.  Laboratory results are as follows: Which of the following is the most appropriate next step in management of this patient?

• A)Elective surgery later in childhood
• B)Immediate surgery
• C)Intravenous hydration and potassium replacement
• D)Oral metoclopramide
• E)Switch to a hydrolyzed formula

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Definitions:

Chlorination

The addition or substitution of chlorine in a molecule, commonly used in disinfection and organic synthesis processes.

Reactivity

A term describing how readily a substance undergoes chemical change, influenced by factors like chemical structure, surrounding environment, and energy barriers.

Electrophilic Aromatic Substitution

A chemical reaction in which an atom, typically a halogen, is substituted for a hydrogen atom on an aromatic ring, facilitated by an electrophile.

Drug Addiction

A chronic disease characterized by compulsive drug seeking and use, despite harmful consequences.