Gastrointestinal Bleeding in Children: Board Questions

What this deck covers

Gastrointestinal Bleeding in 18 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 18 cases, in order

1. Blood on day three, baby thriving
2. It hurts every time he goes
3. A fright four times in two months
4. A lot of blood and no pain at all
5. Screaming, then quiet and pale
6. Twelve days old and going off
7. Bile, then blood, in one hour
8. Vomiting blood with a big spleen
9. Blood only after the eighth vomit
10. Night pain and black stools
11. A rash, sore joints and blood
12. Blood, a farm, and a stool result
13. The injection they said no to
14. Two big vomits and no access
15. Is that blood or is it beetroot?
16. Eight months of tablets for his joints
17. How much blood to give him
18. Which one cannot wait

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Blood swallowed from his mother’s cracked nipples, An anal fissure, A juvenile polyp, A technetium pertechnetate scan, Intussusception, A Mallory-Weiss tear, Upper gastrointestinal endoscopy, Henoch-Schonlein purpura, Antibiotic treatment, Non-accidental injury, Melaena with a falling haemoglobin and a raised urea.

Clinical pearls from this deck

• Look at the mother’s nipples before you investigate the baby. It is the commonest answer.
• Painful bleeding in a toddler is a fissure. Painless bleeding is everything else.
• Painless small bleeds in a thriving preschooler: refer for colonoscopy, and it is cured that day.
• Painless, large volume, well child: think of the pouch that thinks it is a stomach.
• The blood is the late sign. Waiting for it is how these children reach theatre instead of radiology.
• Dilated loops mean nothing on their own. Gas in the wall is the sign that names it.

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 Board Questions case decks · pediatric reference values.