Gastroenterology – Set 6

What this deck covers

Gastroenterology – Set 6 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. Teen losing weight and height
2. Hand sign with bloody diarrhoea
3. Picking who needs a scope
4. Planning the full work-up
5. First treatment for new ileal disease
6. What the scope and scan should show
7. Symptom-free after induction
8. Who gets a biologic first
9. Painful swelling stops him sitting
10. Green vomit and a swollen abdomen
11. Mother requests ciprofloxacin tablets
12. Falling height centile, no puberty
13. Tired with numb feet after surgery
14. Three weeks of blood and mucus
15. Scoping a boy with bloody motions
16. Scoring a 2-day symptom diary
17. An unexpected stomach biopsy finding
18. Starting therapy in a mild attack
19. Nine bloody motions a day, bedbound
20. Request to slow severe diarrhoea
21. Severe flare, distended tender belly
22. Large red cells on long-term therapy
23. Worse after three days in hospital
24. Persistently abnormal liver tests
25. Years of faintly yellow eyes
26. Pain boring to the back in leukaemia
27. Girl with vomiting, pain under ribs
28. Spherocytosis, pain and yellow eyes
29. Which criteria make the diagnosis
30. Parents fear a worsening attack
31. Feverish on day 3, mother’s question
32. Fluid collection weeks after an attack
33. Discomfort after rich meals
34. Newborn double bubble, later attacks
35. Why a hormone is given at the scan
36. Girl with recurrent attacks, MRCP
37. Attacks that keep coming back
38. Yellow eyes after a sore throat
39. Telling the two inherited types apart
40. Three weeks old and still yellow
41. Yellow palms, white eyes
42. Cousin parents, deepening jaundice
43. Lifelong mild icterus, dark urine
44. Mother wants to be certain
45. Mother’s question about her milk
46. Preterm baby still yellow at 25 days
47. Where the abnormal line is drawn
48. Imaging a cholestatic baby first
49. Heel-prick site keeps oozing
50. Two surgical causes on imaging

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Ulcerative colitis, Flexible sigmoidoscopy with rectal biopsies only, Oral mesalazine twice daily, Immediate laparotomy and ileal resection, Intramuscular hydroxocobalamin, In remission (below 10), Intravenous methylprednisolone, Vitamin B12 injections, Black, with a normal shape and surface, An inherited PRSS1 gene variant, Prophylactic meropenem for every severe attack, Duodenal web with a windsock, PRSS1, SPINK1 and CFTR gene testing, Conjugated and unconjugated bilirubin fractions.

Clinical pearls from this deck

• In an adolescent, abdominal pain plus weight loss plus anaemia is organic until proven otherwise.
• Clubbing plus chronic diarrhoea in a child: think Crohn disease first.
• Thrombocytosis plus raised ESR plus weight loss: check calprotectin and refer for endoscopy.
• Paediatric IBD work-up: two scopes, many biopsies, and a radiation-free look at the small bowel.
• Luminal paediatric Crohn disease: feed first, steroids second, antibiotics never for induction.
• Crohn disease skips and goes deep; ulcerative colitis is continuous and superficial.

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.