This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': "All are false except one in case of hypertrophic pyloric stenosis - \nSelect and explain. \nA. Symptomatic within one week, B. Lump is always clinically palpable, C. T/t of choice is Finney's pyloroplasty, D. Ultrasonography is diagnostic test", 'role': 'user'}, {'content': 'Answer: D \nExplanation: Hypertrophic Pyloric Stenosis (HPS) \n\nThe musculature of the pylorus and adjacent antrum is grossly hypertrophied, the hypertrophy being maximum in the pylorus itself.\nIt occurs in approximately 3 in 1000 live birth and is the most common surgical cause of vomiting in infancy.\nM> F (4 : 1)*\nCharacteristically the first born male child is affected.\n\n\nThe condition is most commonly seen at 4 wks after birth ranging from the 3rd wk to on rare occasion, the 7th. However, 20% of infants are symptomatic from birth, and most are symptomatic within the first 2 months after birth.\n\n\nNon-bilious vomiting, becoming increasingly projectile, occurs over several days to weeks. Eventually the infant will develop a nearly complete obstruction by the second to fourth week of life and will not be able to hold down even clear liquids. This invariably proceeds to severe dehydration if not t/t.\nThese infants develop a metabolic alkalosis with severe depletion of potassium and chloride ions.\n" The diagnosis of pyloric stenosis usually can be made on physical examination by palpation of the typical \'olive\' in the right upper quadrant and the presence of visible gastric waves on the abdomen.\nWhen the olive cannot be palpated, ultrasound in experienced hands will diagnose the condition accurately in 95 percent of pts." - Schwartz.\n\nTreatment\n\nPyloric stenosis is never a surgical emergency although dehydration and electrolyte abnormalities may present a medical emergency\nFluid resuscitation and correction of electrolyte, abnormalities and metabolic alkalosis is essential before surgery.\n\n-\xa0\xa0\xa0\xa0 Surgery : Fredet-Ramstedtpy/oromyotomy. (In it the pyloric mass is split without cutting the mucosa)\nAlso know\n\nAdministration of erythromycin in early infancy has been linked to the subsequent development of HPS.\nJaundice may be seen in HPS, although cause is not clear.', 'role': 'assistant'}]