Mock oral exams › Primary closure of gastroschisis in a late-preterm neonate
Full access · Session 2: short stem · 13 questions · 35 min
Primary closure of gastroschisis in a late-preterm neonate
Full access
Unlock this mock exam
Full access opens all 15 mock oral exams, all 39 OSCE stations and the timed seven-station circuit. One payment of $99 for 90 days, no subscription.
The stem
A boy born 7 hours ago by vaginal delivery at 35 weeks, 2.3 kg, has gastroschisis: edematous small bowel herniates to the right of a normally inserted cord, with no covering membrane. The bowel is wrapped in a sterile bag and he lies on his right side. The pediatric surgeon wants primary reduction and fascial closure in the operating room this evening.
He breathes spontaneously on room air. A peripheral IV runs 10% dextrose at 8 mL/h, and an orogastric tube is on suction. Prenatal ultrasound showed no other anomalies.
- Heart rate 168, blood pressure 50/28 (mean 35), respiratory rate 52, preductal SpO2 96%
- Axillary temperature 36.0 °C; capillary refill 3 seconds
- Glucose 41 mg/dL; sodium 136, potassium 4.8 mEq/L; ionized calcium 1.0 mmol/L
- Hematocrit 52%; platelets 210,000; lactate 3.4 mmol/L; urine output 0.6 mL/kg/h