Exomphalos – Board-Style Questions

What this deck covers

Exomphalos in 20 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 20 cases, in order

1. An early scan
2. Who carries the risk
3. What to look for next
4. Which sac worries more
5. What sets the outlook
6. Above the umbilicus
7. Below the umbilicus
8. Clamping the cord
9. What covers it
10. How urgent
11. Fluid needs
12. A torn sac
13. Too big to close
14. Painting for weeks
15. A change in the sac
16. A twisted gut
17. Feeding after a small repair
18. Noisy feeding
19. The bulge that remains
20. Vomiting and arching

Diagnoses and management options tested

Across the 20 cases you are asked to choose between options such as: It is the normal gut loop, Smoking and recreational drug use in pregnancy, A detailed fetal heart scan and a chromosome test, The one with the liver, because the defect is larger, The exact size of the defect in the abdominal wall, Pentalogy of Cantrell, Bladder exstrophy alone, Right at the skin, so that no stump is left, It is covered by skin rather than a thin membrane, Much less than normal, since the sac holds fluid in, As planned, with elective repair later this week, Remove part of the liver so the rest will fit, His hearing, since the antiseptic can damage the ear, The liver inside has bled into the sac.

Clinical pearls from this deck

• Bowel in the cord before twelve weeks is physiology, not pathology.
• Old mother, membrane-covered sac: think exomphalos and chromosomes.
• In exomphalos, look beyond the sac: the heart and the chromosomes set the outlook.
• Small sac, bigger chromosome worry; big sac, bigger lung worry.
• In exomphalos the company it keeps decides the outcome.
• Exomphalos above the umbilicus and a heart you can see: think Cantrell.

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 Neonatology case decks · pediatric reference values.