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Inflammatory bowel disease — RACP Paediatrics MCQ

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ModerateGIInflammatory bowel diseaseRACP Paediatrics

A 14-year-old presents with a 3-month history of bloody diarrhoea, abdominal cramping, weight loss, and fatigue. Blood tests show elevated CRP, ESR, and thrombocytosis with iron deficiency anaemia. What is the most appropriate investigation to confirm the diagnosis?

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Correct answer: B — Upper GI endoscopy with biopsy

The presentation suggests inflammatory bowel disease (likely ulcerative colitis given bloody diarrhoea). Upper and lower GI endoscopy with multiple biopsies is required for diagnosis, classification, and assessment of disease extent. Faecal calprotectin is a useful screening tool but endoscopy with histology is the gold standard for diagnosis.

Reference: RCH Melbourne – 2023 – Inflammatory Bowel Disease CPG; RACP Paediatric Curriculum – Gastroenterology