February JPGN Article
 
1 - Which of the following diagnostic procedures are recommended routinely in diagnosing functional constipation in infants and children?
A   - Abdominal X-ray.
B   - Colonic transit study.
C   - Rectal ultrasound.
D   - None
2 - When is a digital examination of the anorectum NOT necessary?
A   - If the diagnosis of functional constipation is clear.
B   - If only one of the Rome III criteria is present and the diagnosis of functional constipation is uncertain.
C   - In the presence of alarm signs or symptoms.
D   - In patients with intractable constipation.
3 - Which of the following diagnostic tests should be performed routinely in children with constipation in order to diagnose an underlying disease?
A   - Routine allergy testing
B   - Laboratory testing for hypothyroidism
C   - Laboratory testing for celiac disease
D   - Laboratory testing for hypercalcemia
E   - None
4 - Which of the following statements is true?
A   - Evidence does not support the use of fiber supplements in the treatment of functional constipation.
B   - Evidence does support the use of extra fluid intake in the treatment of functional constipation.
C   - Evidence does support the use of pre- or probiotics in the treatment of childhood constipation.
D   - Evidence does support the use of biofeedback in the treatment of childhood constipation.
5 - Which of the following statements is incorrect?
A   - The use of polyethylene glycol (PEG) with or without electrolytes orally 1-1.5 gm/kg/day for 3-6 days is recommended as first-line treatment for children presenting with fecal impaction.
B   - An enema once a day for 3-6 days is recommended for children with fecal impaction if PEG is not available.
C   - The use of PEG with or without electrolytes is recommended as first-line maintenance treatment. A starting dose of 0.4 gm/kg/day is recommended and the dose should be adjusted according to the clinical response.
D   - The use of lactulose as first-line maintenance treatment is recommended if PEG is not available.
E   - Use of milk of magnesia, mineral oil and stimulant laxatives may be also considered as first-line maintenance treatment.
6 - Which of the following statements is correct?
A   - The routine use of lubiprostone in children with intractable constipation is not recommended.
B   - The routine use of linaclotide and prucalopride in children with intractable constipation are not recommended
C   - Antegrade enemas in the treatment of selected children with intractable constipation are recommended in some instances.
D   - Routine use of Transcutaneous nerve stimulation (TNS) in children with intractable constipation is not recommended.
E   - All statements
7 - Which of the following statements is incorrect among children referred to pediatric gastroenterologists?
A   - 50% will recover (3 or more bowel movements per week without fecal incontinence) and be without laxatives after 6?12months.
B   - 50% will recover (3 or more bowel movements per week) and be without laxatives after 3 months.
C   - 50% of the children are recovered after 5 years with the vast majority of patients no longer taking laxatives.
D   - 80% of the children are recovered after 10 years with vast majority of patients no longer taking laxatives.