Gastroenterology – Set 5

What this deck covers

Gastroenterology – Set 5 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. Infant vomiting blood, red skin marks
2. Occult stool test pitfall
3. Maroon clots and cool peripheries
4. Small haematemesis, the telling story
5. Bleed settled after two boluses
6. Visceral vascular lesions, first drug
7. Crampy pain eased by the toilet
8. Episodic central tummy pain
9. Sixth identical early-morning illness
10. Tummy aches, what would worry you
11. Evening screaming in a thriving baby
12. Two years of pain, every test normal
13. Post-meal regurgitation in a teen
14. Long-term outlook for a worried girl
15. Watery stools from birth, alkalaemia
16. Thriving toddler, loose stools
17. Unwell since weaning onto purée
18. Gas pattern that points elsewhere
19. Puffy eyelids, clean urine
20. Stools continue while nil by mouth
21. Stool and urine salts, watery boy
22. Miserable toddler with a pot belly
23. Stools settle on clear fluids
24. Short child, gut or glands?
25. Down syndrome, bloating and low iron
26. Negative screen, almost no IgA
27. Itchy blisters in a diabetic boy
28. Parents took wheat out early
29. Very high antibody, no scope wanted
30. A mother’s question about the brain
31. Pale, yellow and a high retic count
32. Planning the scope, positive screen
33. Reading the duodenal samples
34. Yearly review, diabetic teenager
35. Bloating after milkshakes
36. Breaking down a dairy carbohydrate
37. Frothy motions after a tummy bug
38. Boring epigastric pain in CF
39. Greasy motions and weight loss in CF
40. Upper limit for capsule dosing
41. Colicky pain and a right-sided lump
42. Bloody stools and a narrow right colon
43. Measuring what the surgeon left
44. Bloating years after gut resection
45. Why children end up drip-fed
46. Lifelong vitamin checks after surgery
47. Gut acts blocked, nothing blocking
48. Unsafe swallow, tube keeps falling out
49. Best chance of weaning off the line
50. Proving why the stools smell

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Haemangiomas of the gut, Blood in vomit after a night-time nosebleed, Irritable bowel syndrome, Weight dropping across two centiles, Food brought up effortlessly and rechewed, Start regular loperamide, Faecal elastase, Cystic fibrosis, tTG-IgA together with total IgA, Replace serology with HLA typing, Haemoglobin electrophoresis, Eosinophilic oesophagitis, Alkaline pH, no reducing sugars found, 2,500 lipase units/kg/day.

Clinical pearls from this deck

• Many skin haemangiomas plus gut bleeding: look inside for more.
• Guaiac: vitamin C hides blood; meat and swallowed blood fake it.
• Circulation first, bleeding point second.
• Clear vomit first, then blood after retching: Mallory-Weiss.
• Stable child, bleeding stopped: the transfusion trigger is Hb below 7.
• Haemangioma treatment starts with propranolol, even when the lesion is inside the gut.

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.