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Pyloric stenosis — USMLE Step 3 MCQ

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EasyPediatrics (well-child, chronic management)Pyloric stenosisUSMLE Step 3

A 5-week-old boy has progressively worsening nonbilious projectile vomiting after feeds. He remains hungry after vomiting. Examination shows mild dehydration and a small olive-like mass in the epigastrium. Labs show hypochloremic metabolic alkalosis. Which of the following is the most appropriate at this time?

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Correct answer: C — Correct fluid and electrolyte abnormalities before pyloromyotomy

Pyloric stenosis requires correction of dehydration and hypochloremic metabolic alkalosis before definitive pyloromyotomy.

Reference: Nelson Textbook of Pediatrics; AAP Pediatric Surgery Guidance