A newborn's failure to pass meconium within the first 24 hours after birth may indicate which of the following?
Abdominal wall defect
Celiac disease.
Intussusception
Hirschsprung disease
The Correct Answer is D
A. Abdominal wall defect:
Failure to pass meconium within the first 24 hours after birth can indicate a potential obstruction in the gastrointestinal tract. While an abdominal wall defect could potentially cause gastrointestinal issues, it is not specifically associated with failure to pass meconium.
B. Celiac disease:
Celiac disease is an autoimmune disorder characterized by an abnormal immune response to gluten. While celiac disease can cause gastrointestinal symptoms, such as diarrhea and abdominal pain, it is not typically associated with failure to pass meconium in the newborn period.
C. Intussusception:
Intussusception occurs when one segment of the intestine telescopes into another, causing a bowel obstruction. While intussusception is a cause of bowel obstruction in infants, it typically presents with symptoms such as colicky abdominal pain, vomiting, and the passage of "currant jelly" stool, rather than failure to pass meconium.
D. Hirschsprung disease:
Hirschsprung disease is a congenital condition characterized by the absence of ganglion cells in the distal portion of the colon, leading to functional obstruction. Failure to pass meconium within the first 24 hours after birth is a classic sign of Hirschsprung disease. This condition requires surgical intervention to remove the affected portion of the colon and restore normal bowel function.

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Correct Answer is B
Explanation
A. Ridged abdomen - This finding is not typically associated with Hirschsprung disease. Instead, the abdomen may appear distended or bloated due to the accumulation of stool in the colon.
B. Ribbonlike, foul-smelling stools - This is a characteristic finding in Hirschsprung disease. Because the affected portion of the colon lacks nerve cells (ganglion cells) responsible for peristalsis, stool movement is impaired, leading to the passage of narrow, ribbonlike stools. These stools may also have a foul odor due to bacterial overgrowth in the affected area.
C. Projectile vomiting - Projectile vomiting is not a common finding in Hirschsprung disease. It is more commonly associated with conditions such as pyloric stenosis or gastroesophageal reflux.
D. Chronic hunger - Chronic hunger is not a typical finding in Hirschsprung disease. Instead, affected infants may experience feeding difficulties, constipation, and failure to thrive due to the obstruction of stool in the colon. They may also exhibit symptoms such as abdominal distention, vomiting, and refusal to feed.

Correct Answer is A
Explanation
To predict the expected weight of the 12-month-old boy, we can use the general guideline that a child's weight should triple from birth to 12 months.
Given that the boy weighed 8 lb 2 oz at birth, we can calculate the expected weight at 12 months by tripling this weight.
8 lb 2 oz = 8.125 lb
Tripling this weight:
8.125 lb * 3 = 24.375 lb
Now, we convert this weight back to pounds and ounces:
0.375 lb * 16 = 6 oz
So, the expected weight of the 12-month-old boy should be approximately 24 lb 6 oz.
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