Gastroenterology – Set 2

What this deck covers

Gastroenterology – 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 paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Frothy saliva and a blocked tube
2. Frothy baby with an airless belly
3. Loops outside a newborn abdomen
4. Before the thoracotomy
5. Blue after mask breaths at birth
6. Midline sac holding liver
7. Green vomits from the first day
8. What the first films will show
9. Low obstruction on the film, next
10. Grey plug and a swollen belly
11. Parents ask what else may be wrong
12. Preterm baby with green aspirates
13. No meconium by 52 hours
14. Supporting picture on the enema
15. Newborn girl with no anal opening
16. Film detail that changes the plan
17. Bloody stool on day 12 of CPAP
18. Night before the chest operation
19. Known hernia, gasping after birth
20. Route to reach the defect
21. Two green vomits in an hour
22. Proof before the operation
23. How it began before birth
24. Pellets in a narrow terminal loop
25. Looking for an underlying cause
26. Dusky with the first swallows
27. Imaging a hidden oblique tract
28. Enema after a diabetic pregnancy
29. Choice of repair in theatre
30. Well baby, normal film, green vomit
31. What the contrast study shows
32. Waiting for the surgical team
33. Constipation with giant ganglia
34. Parents ask when to operate
35. Weeks of intravenous feeding
36. Severity on the repeat film
37. Safest agent for a choking baby
38. One green vomit, parents want home
39. Floppy infant with dark green vomit
40. Partial clearance, still swollen
41. Steps of the standard operation
42. Fever and foul stools after surgery
43. Ward plan after the fluid bolus
44. One perineal opening and a mass
45. Brassy cough and blue spells
46. The day before the neck operation
47. New distension weeks after recovery
48. Trainee names the wrong film sign
49. Swollen belly a year after surgery
50. Referral letter rules it out

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Oesophageal atresia with a distal fistula, Echocardiography, Hirschsprung disease, Passing some meconium rules out an atresia, Meconium ileus, A long fluid level in the dilated stomach, Start nasal CPAP and wait for the chest film, Absent rectoanal inhibitory reflex on manometry, Serum immunoreactive trypsinogen alone, Caudal regression syndrome, Corkscrew duodenum, DJ flexure low and right, As an emergency within the first hours of life, Barium sulphate suspension, Repeat the hyperosmolar enema after rehydration.

Clinical pearls from this deck

• Coiled tube plus bowel gas: atresia with a distal fistula, the commonest type.
• Keep the native oesophagus if you can: gastrostomy now, join it later.
• Look where the cord inserts: into a sac means exomphalos, into normal skin beside the defect means gastroschisis.
• Before the thoracotomy, know the heart and the side of the arch.
• A blue newborn with a scaphoid abdomen: think diaphragm, and stop mask ventilation.
• Sac and liver in the midline: screen the heart and the chromosomes.

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.