umbilical hernia

Practice targeted AMC-style multiple-choice questions on umbilical hernia.

Image by Ibrahim Husain Meraj — CC BY-SA 4.0 · Source

A 3-year-old child is brought to the GP by their parents who are worried about the appearance of their child's abdomen, as shown in the image. The child is otherwise well, active, and has no pain, vomiting, or changes in bowel habits. On examination, the finding is soft and easily reducible. Vital signs are normal. Based on this presentation and the image, what is the most appropriate initial management?

A. Application of a binder or tape over the area.

B. Advise strict bed rest to prevent worsening.

C. Request an abdominal ultrasound to assess contents.

D. Reassurance and observation for spontaneous closure.

E. Urgent surgical referral for repair.

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Image by Ibrahim Husain Meraj — CC BY-SA 4.0 · Source

A 1-year-old child is presented to the general practitioner by their parents who are concerned about the appearance of their child's umbilicus, as depicted in the accompanying image. The parents report the bulge is more prominent with crying but is easily reducible. The child is otherwise well, feeding normally, and has no history of pain, vomiting, or constipation. Physical examination reveals normal vital signs and a soft, non-tender abdomen. Considering the clinical presentation and the finding shown, what is the most appropriate advice to give the parents regarding initial management?

A. Recommend an abdominal ultrasound scan to rule out incarceration or other complications.

B. Instruct the parents on how to apply a binder or tape to the area to help it close faster.

C. Provide reassurance that this is a common condition in infants and toddlers that often resolves spontaneously, advising observation.

D. Explain that surgical repair is typically required and arrange a referral to a paediatric surgical service.

E. Advise investigation for potential underlying genetic syndromes or metabolic disorders.

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Image by Ibrahim Husain Meraj — CC BY-SA 4.0 · Source

A 3-year-old child is presented to the general practitioner by their parents who are concerned about the appearance of their child's umbilicus, as depicted in the accompanying image. The child is reported to be entirely asymptomatic, feeding and playing normally, with no history of pain, discomfort, or vomiting. Physical examination reveals normal vital signs and a soft, non-tender abdomen with no signs of obstruction. Considering the clinical presentation and the finding shown, what is the most appropriate initial management plan for this child?

A. Order an abdominal ultrasound scan to evaluate the contents and size of the defect.

B. Arrange an urgent consultation with a paediatric surgeon for immediate operative repair.

C. Prescribe a course of simple analgesia and schedule a routine follow-up appointment in one week.

D. Recommend the application of a firm abdominal binder or tape over the affected area to prevent enlargement.

E. Provide reassurance to the parents regarding the benign nature and likelihood of spontaneous resolution, advising them on signs requiring further assessment.

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Image by Ibrahim Husain Meraj — CC BY-SA 4.0 · Source

A 14-month-old child is presented to the general practitioner by their parents, who are concerned about a noticeable protrusion around the navel. They report this bulge is more prominent when the child cries or strains but easily disappears when the child is relaxed or sleeping. There are no reports of pain, discomfort, changes in bowel habits, or feeding difficulties. The child is meeting all developmental milestones and appears well. On examination, vital signs are stable and within age-appropriate ranges. The abdomen is soft and non-tender, with no distension. The finding illustrated in the accompanying image is observed. Based on this clinical presentation and examination, what is the most appropriate initial management plan?

A. Refer the child urgently to a paediatric surgeon for immediate assessment and potential repair.

B. Recommend applying a specific binder or tape over the area to facilitate closure.

C. Provide reassurance to the parents regarding the benign nature of the finding and advise observation, explaining the high likelihood of spontaneous resolution by school age.

D. Advise the parents to present immediately to the nearest emergency department if the bulge is visible.

E. Order an abdominal ultrasound to assess the contents and size of the defect.

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Image by Ibrahim Husain Meraj — CC BY-SA 4.0 · Source

A 14-month-old child is brought to the general practitioner for a routine check-up and immunisations. The parents express mild concern about a bulge they have noticed around the child's navel, which seems more prominent when the child is crying or straining. They report it is easily pushed back in and does not appear to cause the child any pain or discomfort. The child is otherwise thriving, with normal feeding, bowel movements, and developmental progress. On physical examination, the child is alert and interactive. Vital signs are within normal limits for age. Abdominal examination reveals no distension or tenderness. The finding illustrated in the image is noted. Based on this clinical presentation and examination finding, what is the most appropriate initial management plan?

A. Refer the child for urgent surgical consultation due to the presence of a visible abdominal wall defect.

B. Arrange for an abdominal ultrasound scan to assess the contents and size of the defect.

C. Refer the child to a paediatric gastroenterologist to investigate potential underlying causes of increased intra-abdominal pressure.

D. Provide reassurance to the parents regarding the benign nature of the finding and advise observation, explaining the likelihood of spontaneous closure.

E. Recommend the application of a supportive abdominal binder or tape to facilitate closure of the defect.

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Image by Ibrahim Husain Meraj — CC BY-SA 4.0 · Source

A 1-year-old child presents to the GP with parental concern about a bulge on the abdomen, as shown in the image. The child is asymptomatic, feeding well, and has normal bowel movements. Examination reveals a soft, reducible finding at the umbilicus; the abdomen is non-tender with normal bowel sounds. Based on this presentation and the image, what is the most appropriate initial management?

A. Arrange an urgent abdominal ultrasound.

B. Recommend applying a binder or tape over the area.

C. Prescribe analgesia for potential pain.

D. Reassure parents about likely spontaneous resolution and schedule routine follow-up.

E. Refer urgently to paediatric surgery for repair.

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Image by Ibrahim Husain Meraj — CC BY-SA 4.0 · Source

A 14-month-old child is brought to the general practitioner for a routine check-up and immunisations. The parents express mild concern about a bulge they have noticed around the child's navel, which seems more prominent when the child is crying or straining. They report it is easily pushed back in and does not appear to cause the child any pain or discomfort. The child is otherwise thriving, with normal feeding, bowel movements, and developmental progress. On physical examination, the child is alert and interactive. Vital signs are within normal limits for age. Abdominal examination reveals no distension or tenderness. The finding shown in the image is noted. Based on this clinical presentation and examination finding, what is the most appropriate initial management plan?

A. Provide reassurance to the parents that spontaneous closure is likely and no immediate intervention is required.

B. Arrange an abdominal ultrasound to assess the size of the fascial defect and contents of the sac.

C. Schedule elective surgical repair within the next 6 months to prevent future complications.

D. Recommend applying a firm abdominal binder or tape over the area to facilitate closure.

E. Refer the child for urgent surgical consultation due to the risk of incarceration or strangulation.

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umbilical hernia

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