A 14 year old girl is brought to the hospital by her mother who explains that her daughter is complaining of fatigue and myalgia for 2-3 months. She indicates the girl gets tired easily while playing badminton for half an hour. Earlier should would play for up to an hour. No history of breathlessness, wheezing, palpitations, oedema, orthopnea. No history of dizziness or syncope. No history of weakness of extremities, joint pain, muscle tenderness. The girl has been vaccinated up to date. There were no developmental delays. The mother says that the child was taken to the outpatient department two to three times in the past due to diarrhoea with no history of fever. The girl was not admitted for it and was treated symptomatically for diarrhoea. On inquiry, the girl admits that she passes loose stools on and off, especially when she eats pizza, burger or a sandwich which she eats occasionally. No other significant past history. No history of prior surgeries. Family history of a maternal aunt with similar complaints of diarrhoea on eating certain food items. The girl has not attained menarche. She has a mixed diet, no addictive habits, and regular bladder movements. Heart rate is 82/min, blood pressure is 110/72mmHg, respiratory rate is 20/min. On examination, conjunctival pallor is seen. Bilateral breath sounds are normal, S1 and S2 are heard with no added sounds or murmurs. Abdominal examination is unremarkable. No neurological deficits were seen.

1. What is the next step to do? [press play to know the answer for this question]

2. What investigations do we do? [press play to know the answer for this question]

3. What is your differential diagnosis? [press play to know the answer for this question]

4. What investigation(s) do we do next? [press play to know the answer for this question]

5. What is the cause of her iron deficiency? [press play to know the answer for this question]

6. What test(s) do we do? [press play to know the answer for this question]

7. What is the confirmatory test? [press play to know the answer for this question]

8. What do we see in the biopsy? [press play to know the answer for this question]

9. How do we treat it? [press play to know the answer for this question]

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