Pica and rumination disorder — branching viva

You are the general paediatric registrar in an outpatient clinic. The examiner will move from a toddler with paint-chip eating, to an iron-deficient adolescent with ice craving, to an adolescent with effortless post-prandial regurgitation and weight loss, to an autistic child with persistent pica, and to a safeguarding scenario where new rumination follows family stress.