Langerhans Cell Histiocytosis – Board-Style Questions

What this deck covers

Langerhans Cell Histiocytosis 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. Is this the usual pattern
2. Not just cradle cap
3. The ear that keeps running
4. Teeth with nothing under them
5. What the second stain marks
6. A result on the tissue
7. Before anything is decided
8. Which scan finds the holes
9. What makes it high risk
10. An eye pushed forward
11. Only the skin, so far
12. A flattened vertebra
13. Standard first line
14. Failing the first course
15. Three bones, one child
16. Will the thirst go away
17. Back again
18. Clumsy years later

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Bone lesions of this kind are seen mainly in adults, Greasy yellow scale over the scalp, Biopsy of the granulation tissue with immunostaining, Early loss of teeth from simple dental decay, Myeloperoxidase, the enzyme stored in myeloid blasts, It proves a viral infection is driving the disease, The liver dysfunction and the low platelets, Reassurance and discharge, as it always disappears, High-dose radiotherapy to the whole thoracic spine, Observation, since most lesions heal without help, Radiotherapy to the enlarged liver and spleen, Observation alone, as bone lesions usually heal, Side effects of desmopressin causing low sodium.

Clinical pearls from this deck

• The commonest face of this disease is one hole in the skull under a sore lump.
• Cradle cap does not bleed into the skin: petechiae in a scalp rash mean biopsy.
• An ear that runs for months and eats bone needs a biopsy, not another antibiotic.
• Floating teeth at three years: think of a disease that eats bone.
• CD207 is langerin, and langerin builds the Birbeck granule.
• BRAF V600E: a somatic driver, a worse prognosis and a drug target.

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 Haematology case decks · pediatric reference values.