Gastroenterology — Prometric Style Questions, Set 2

What this deck covers

Gastroenterology — Prometric Style Questions, Set 2 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. A shiny disc from the remote
2. A drink from the wrong bottle
3. Clearing the organism for good
4. Lying still after months of indigestion
5. One defect that travels in company
6. Two beads that found each other
7. Loose stools in a blocked baby
8. Bowel outside the belly wall
9. Nothing passed by thirty hours
10. A colon that was never used
11. Trouble months after recovery
12. A flat belly and a shifted heart
13. Eight hours of colic in a baby
14. Sudden pain on the left side
15. Six-year-old with a tender belly
16. A lump that will not go back
17. Pain that comes on school days
18. Feeling fine after the tablets
19. Pain after every fatty meal
20. Beaded ducts in a well boy
21. A family with lungs and livers
22. Preventing the next bleed
23. A mother asking about her baby
24. Confused after a small bleed
25. Three months of bloody stools
26. A test before the first dose
27. A boy who stopped growing
28. Eyes, skin and a swollen knee
29. No better after three days
30. Greasy stools despite treatment
31. A test that can read falsely low
32. Better off the formula, worse back on
33. A rash that ignores the cream
34. Loose stools in a thriving child
35. Diarrhoea after a hospital course
36. Weeks of wind after a holiday
37. Pale and passing no water
38. Fever that climbs by steps
39. A baby who cannot have this one
40. A carpet of growths at thirteen
41. Spots on the lips and colic
42. Screaming on the toilet
43. Something showing after every stool
44. When to stop the medicine
45. Pancreas, marrow and bones
46. Four attacks in two years
47. A lump three weeks later
48. Whether to feed or fast
49. A baby with doughy skin
50. Getting fluid into a sick toddler

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Observe for 24 hours and repeat the film, Acute pancreatitis has developed, Oral rehydration solution and discharge home, A normal colon that excludes obstruction, Reduction by air enema under radiological control, Reassure and arrange elective repair in six months, Urgent endoscopic retrograde cholangiography, Long-term proton pump inhibitor treatment alone, Ulcerative colitis, Side effects of his current medication, A full blood count and iron studies, Toddler diarrhoea, worsened by excess fruit juice, Remove polyps endoscopically as they appear, Coeliac disease.

Clinical pearls from this deck

• Count the rims on the film. A coin has one edge and a battery has two, and that single detail changes an outpatient problem into an emergency.
• Everything instinctive is wrong here. Do not make her sick, do not pass a tube, do not neutralise; look at the oesophagus instead.
• Treating the ulcer is not treating the infection. Confirm eradication weeks later, because feeling better proves nothing.
• A child who will not move has peritonitis until proved otherwise. Look for the crescent of gas before you look for anything else.
• One anomaly is an instruction to look for five more. Echocardiography comes first, because the surgeon needs to know which side the arch is on.
• One magnet is a coin. Two magnets are an operation waiting to happen, and the child will look well until it does.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Gastroenterology case decks · pediatric reference values.