Rosh Pediatrics Practice Exam

A newborn with recurrent bilious vomiting is suspected to have which congenital anomaly?

1. Klinefelter syndrome

2. Triple X syndrome

3. Trisomy 21

4. Turner syndrome

The correct answer is: Trisomy 21

Recurrent bilious vomiting in a newborn is a concerning symptom that often points toward a gastrointestinal obstruction or an anomaly requiring further investigation. This symptom is classically associated with intestinal malrotation or other congenital intestinal defects. Among the congenital anomalies listed, Trisomy 21, or Down syndrome, has associations with duodenal atresia and other gastrointestinal anomalies, which can lead to bilious vomiting. The presence of bilious vomiting can indicate that there is a blockage distal to the entry of bile into the gastrointestinal tract, which is more frequently observed in newborns with Trisomy 21. The other conditions listed—Klinefelter syndrome, Triple X syndrome, and Turner syndrome—do not have established correlations with gastrointestinal anomalies leading to symptoms of bilious vomiting in neonates. Thus, recognizing Trisomy 21 as the condition most commonly linked to these symptoms helps to understand the broader context of congenital anomalies and their presentations in neonates.