Severe Combined Immunodeficiency – Board-Style Questions

What this deck covers

Severe combined immunodeficiency 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. Thrush that will not clear
2. A number read against the wrong ruler
3. The first test to send
4. A spot of blood on day five
5. Breathless with a quiet chest
6. Loose stools after the oral drops
7. A shoulder scar that grew
8. What is missing on the film
9. A rash she did not catch
10. Red all over, with big nodes
11. Boys on the mother’s side
12. More than the immune system
13. Two gone, one left
14. The treatment that cures it
15. Keeping her safe until then
16. The other child at home
17. Watching the new marrow
18. Planning the next pregnancy

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Cows’ milk protein allergy, It is low for her age, though normal for an adult, Immunoglobulin levels measured on their own, A full blood count on every newborn baby, Pneumocystis jirovecii, Lactose intolerance following a gastroenteritis, A staphylococcal abscess of the axillary node, An enlarged cardiac silhouette, Maternal T cells that crossed the placenta, Severe atopic eczema, A new mutation in the child alone, Wiskott-Aldrich syndrome, A recombination-activating gene defect, Long-term antibiotic and antifungal prophylaxis.

Clinical pearls from this deck

• Thrush, loose stools and no growth: think SCID.
• Infant lymphocyte counts must be read by age.
• Suspected SCID: count the T, B and NK cells.
• Newborn screening finds SCID before infection.
• Clear chest, low oxygen, diffuse shadowing: PJP.
• Live oral vaccine can persist in T cell defects.

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 rheumatology and immunology case decks · pediatric reference values.