Extrahepatic Portal Vein Obstruction – Board-Style Questions

What this deck covers

extrahepatic portal vein obstruction in 18 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 18 cases, in order

1. Blood from a thriving boy
2. Looking back to the start
3. What the scan shows
4. Worried about the liver
5. Fainting on the track
6. Low levels on screening
7. Slipping at school
8. Blue on standing
9. Itching in a teenager
10. Swelling after the bleed
11. Too small for the kit
12. Bleeding again and again
13. Planning the graft
14. Short for his family
15. The spleen question
16. When the recess is closed
17. A sprain at football
18. Red blood, no pain

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Hepatic venous outflow obstruction, Umbilical venous catheterisation after birth, Reversed flow within a dilated but patent main trunk, ALT above 1000 U/L with a rising bilirubin, Portopulmonary hypertension, Inherited protein C deficiency needing warfarin, Absence epilepsy with frequent daily seizures, Sweat chloride testing for cystic fibrosis, Portal biliopathy from pericholedochal collaterals, Spontaneous bacterial peritonitis after the bleeding, Long-term octreotide infusion at home, A transjugular intrahepatic shunt, A patent left portal vein in the Rex recess, Constitutional delay of growth and puberty.

Clinical pearls from this deck

• Big spleen, normal liver, big bleed: think EHPVO.
• Old neonatal lines: ask about the portal vein.
• Doppler at the hilum: a cavernoma, not a vein.
• Prehepatic block: the liver tests stay normal.
• Faints and a loud P2 with a cavernoma: portopulmonary.
• Low protein C with a cavernoma: often acquired.

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 Board Questions case decks · pediatric reference values.