Multiple Choice Questions (MCQ)

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Category: Emergency Medicine--->Gastroenterological Emergencies
Page: 1

Question 1# Print Question

Regarding the assessment and classification of dehydration in children with acute gastroenteritis, which ONE of the following is TRUE?

A. The degree of dehydration can accurately be determined on the basis of symptoms and signs
B. Modern classification systems describe the degree of dehydration as mild, moderate or severe
C. Prolonged capillary refill time, abnormal skin turgor and abnormal respiratory pattern are the three best clinical signs for identifying dehydration
D. Renal function and electrolytes are useful in determining the degree of dehydration

Question 2# Print Question

An 18-month-old boy is diagnosed with acute gastroenteritis. On examination he appears miserable but alert, has sunken eyes, dry mucous membranes and reduced skin turgor. His vital signs are normal with good peripheral pulses and capillary refill < 2 seconds. He refuses to drink oral rehydration solution (ORS) offered to him.

Which ONE of the following is the MOST appropriate next step?

A. He should be offered fruit juice or lemonade to encourage oral intake
B. An intravenous line should be inserted and his deficit replaced over the next 8–12 hours
C. He should receive an intravenous fluid bolus with 10–20 mL/kg of 0.9% saline
D. A nasogastric tube should be inserted and the deficit replaced with a hypotonic rehydration solution over 4 hours

Question 3# Print Question

Regarding the management of children with acute gastroenteritis after successful rehydration, which ONE of the following statements is MOST appropriate?

A. A period of fasting is recommended
B. Clear fluid should be given until the diarrhoea settles followed by full-strength milk
C. Formula-fed infants should initially receive diluted milk, after which the concentration should gradually be increased to full-strength milk (graded feeding)
D. Children receiving cow’s milk as part of their diet should be given full-strength cow’s milk

Question 4# Print Question

A 4-year-old boy presents with two episodes of bloody diarrhoea in the preceding 24 hours. He is apyrexial and clinically well with no travel history. His mother has just recovered from gastroenteritis.

Which ONE of the following is the MOST appropriate answer?

A. He should be treated with antibiotics if Escherichia coli O157:H7 is isolated on his stool sample to prevent development of haemolytic uremic syndrome (HUS)
B. He should be admitted and empiric antibiotics started
C. Stool should be collected for microscopy and culture and he can be discharged with follow-up within 24–48 hours
D. Stool should be collected for microscopy and culture and he can be discharged with empiric antibiotic therapy until follow-up in 24–48 hours

Question 5# Print Question

A 23-year-old female presents with 2 days’ history of watery, non-bloody diarrhoea. She is otherwise well. She has recently returned from a visit to SouthEast Asia and will return there in 1 month on an important business trip.

Which ONE of the following is TRUE?

A. Campylobacter is a common pathogen in this scenario
B. Short-course antibiotic treatment with a fluoroquinolone should be commenced early to prevent protracted illness
C. Combination therapy with antibiotics and loperamide is limited to patients with a fever and bloody diarrhoea
D. There is no role for antibiotic prophylaxis to prevent traveller’s diarrhoea

Category: Emergency Medicine--->Gastroenterological Emergencies
Page: 1 of 6