Chronic Diarrhoea and Malabsorption

What this deck covers

Chronic Diarrhoea and Malabsorption in twelve illustrated clinical cases with worked explanations – case presentations built around teaching illustrations of clinical signs, histology, endoscopy and radiology, alongside laboratory data with the reference range beside every value a case quotes. This visual, data-interpretation style of practice suits candidates preparing for MRCPCH AKP in particular, alongside the Saudi Prometric (SCFHS) exam, the Arab Board, DHA and OMSB. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong.

The twelve cases, in order

1. Peas and carrots in the nappy
2. The diet that was started too soon
3. Short, pale and iron-deficient
4. Streaks of blood at eight weeks
5. Watery again after the rotavirus
6. Bloating after the summer trip
7. Salty kisses and bulky stools
8. Greasy stools and a low neutrophil count
9. Growth that stopped first
10. Always wet, never formed
11. Swollen ankles with a clean urine dipstick
12. The first forty-eight hours of refeeding

What this deck teaches

• Growth decides the road. A thriving toddler with loose stools has a diet problem; a falling centile is malabsorption until proven otherwise.
• The four F’s fix most toddlers. Fluid, fat, fibre and fruit juice – no stool cultures, no exclusion diets, no antimotility drugs.
• Never diet before you test. Coeliac serology and biopsy are gluten-dependent; a diet started early costs a six-week challenge to undo.
• Total IgA with every transglutaminase. Selective IgA deficiency is ten times commoner in coeliac disease and makes the antibody falsely negative.
• Acid stool means sugar, not protein. pH under 5.5 with reducing substances after gastroenteritis is transient lactase loss – reduce lactose for weeks, not years.
• Low elastase, normal sweat – check the marrow. Shwachman-Diamond is pancreas plus neutropenia plus metaphyseal bone; the blood count is the next test.

Exam pearls from this deck

• A thriving toddler with peas in the nappy has a diet to correct, not a gut to investigate.
• Order the total IgA on the same form as the transglutaminase, or a negative may only mean the child cannot make the antibody.
• A salty child with bulky stools and a falling weight gets a sweat test, not another formula change.
• In an adolescent, a flat growth line with mouth ulcers is inflammatory bowel disease until the scope says otherwise.

The twelve worked cases in this deck, with the illustrations and the full explanation of every option, are part of Pediatric Case Review membership. See what is included, or start with the free Prometric question sets.

More from this system: all gastroenterology illustrated case decks · gastroenterology board questions for bank-style drilling · the free Pediatric Prometric question sets · pediatric reference values.