Gastroenterology – Set 7

What this deck covers

Gastroenterology – Set 7 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. Putty stools at 7 weeks
2. New arrival with a positive screen
3. Teen with pain after fatty meals
4. Clues to a syndromic variant
5. Jaundice after fever and paracetamol
6. Meaning of the e marker
7. Colic, yellow eyes and a right mass
8. Itchy infant with a murmur
9. Inconclusive scan before an operation
10. Doctor wants a core antigen test
11. Bruised, jaundiced boy at 7 weeks
12. Positive antibody at four years
13. Scan after bouts of right-sided pain
14. What the fasting scan may show
15. Globular lump beneath the liver edge
16. Jaundiced girl, one antibody positive
17. What the spine film may add
18. Proving the cause on the first sample
19. Tracer reaches the bowel at 24 hours
20. Yellow eyes weeks after a tattoo
21. A duct lesion found at 7 weeks
22. Two days of constant pain and fever
23. Liver core in a low-antitrypsin baby
24. Screening a baby exposed in the womb
25. Reading the liver core at 7 weeks
26. Ten weeks on, a gap in the markers
27. Murmur heard across the back
28. Shaking chills while awaiting surgery
29. When the spread to family happened
30. Rising ALT on long-term follow-up
31. Heavy teenager, no haemolysis
32. The test that settles the diagnosis
33. Scratching toddler, normal GGT
34. Well sister of a jaundiced boy
35. Baby of a mother with high viral load
36. Cirrhosis and a variceal bleed at six
37. Repeat scan for a feverish girl
38. Planning surgery in the eighth week
39. Feeding advice for an infected mother
40. Persistently raised ALT and fibrosis
41. Cousin parents and a lost brother
42. What the bloods show with rigors
43. Parents ask what lies ahead
44. After the infected duct settles
45. Choosing the operation for a duct cyst
46. Parents ask how to protect his lungs
47. Viraemic at six, no fibrosis
48. Jaundice months after a transplant
49. Itch persisting on three medicines
50. Still yellow months after surgery

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Stop breastfeeding for 48 hours, then recheck, Dextrocardia with a midline liver, Choledochal cyst, HBcAg is not in serum; follow DNA and ALT, Fixed echogenic foci with no shadowing, Vaccine immunity; seek another cause, Biliary atresia is confirmed, Uncomplicated biliary colic, Bile ductular proliferation with bile plugs, Pyogenic liver abscess, Haemolysis, forming black pigment stones, None unless she becomes jaundiced, Thickened wall with pericholecystic fluid, Lamivudine monotherapy.

Clinical pearls from this deck

• A yellow baby with pale stools is a same-day referral, not a clinic appointment.
• HBsAg beyond 6 months with IgG-class anti-HBc means chronic hepatitis B.
• Pain alone is colic, pain with fever is cholecystitis, and pain with fever and jaundice is cholangitis.
• Examine the heart and look for the spleen in every infant with biliary atresia: laterality defects mean the syndromic form.
• Fever first, jaundice second: the classic order of acute viral hepatitis.
• e antigen means replication and infectivity.

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.