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NBME 20 Answers

nbme20/Block 2/Question#28

At a postnatal checkup, a 6-week-old female newborn ...

Annular pancreas

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submitted by monoloco(31),

Annular pancreas is the only answer that accounts for the bile in the vomit; of the choices, it is the only obstruction distal to where bile enters the GI tract.

ergogenic22  Meckel diverticulum also occurs distal to the CBD but less likely to be associated with bilious vomiting +  
sympathetikey  Correct. Might cause pain due to ectopic gastic tissue. +  

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submitted by strugglebus(46),

Also, Meckels would have describe hematochezia or failure to pass meconium

sugaplum  I believe failure to pass meconium is Hischsprung's Meckels don't present within the first few days of life, so meconium wouldn't be a factor FA 2019 378 +