2CK question: management of pyloric stenosis

[AKAdemic]

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Ok so the case is a 4wk old who has come in with the classic hx of pyloric stenosis. Labs are significant for hyponatremia (130), hypokalemia (3.5) and hypochloridia (93) bicarb is 29. Most appropriate next step in management?

Question answer per qbook is to obtain an immediate surgical consult. However, per MTB management includes 1st correcting metabolic irregularities and then also decompressing the stomach with an NG tube and then performing a myotomy.The qbook says "the surgeon will correct the metabolic alkalosis pre-op" --- really? The next step is to immediately consult someone else? I thought this was NEVER the answer on the boards. Help!?!?!?!?! What do y'all think? This is a Kaplan Qbook question btw - so pretty reliable right?

Please forgive my brevity or mistakes. Sent from my iPad

 

[Bagheera]

That's one reason to avoid using outdated kaplan material lol. Correct metabolic abnormalties first step

 

[AKAdemic]

That's one reason to avoid using outdated kaplan material lol. Correct metabolic abnormalties first step

Thanks - I feel alot better about my answer choice now. They didn't have the option on there to correct the metabolic abnormalities but they did have the NG tube so I chose that. Still right or would you consult surgery before decompressing?