NEET PG / USMLE – MCQ 23

A 17-year-old boy comes to the emergency department because of severe thirst and weakness and a 4-kg (1.8-lb) weight loss over the past 36 hours. He began having voluminous painless watery diarrhea on the airplane while returning from a trip to Thailand 36 hours ago. He has not vomited. While supine, pulse is 110/min and blood pressure is 110/60 mm Hg. While standing, pulse is 170/min and blood pressure is 70/40 mm Hg. His abdomen is nontender and bowel sounds are increased. Which of the following treatments is most appropriate at this time?
A. Ciprofloxacin
B. Doxycycline
C. Exploratory laparotomy
D. Potassium chloride
E. Rehydration
F. Trimethoprim-sulfamethoxazole

Correct answer : E. Rehydration

The boy is dehydrated as a result of the watery diarrhoea. This explains the tachycardia, low BP and postural hypotension. The first thing to be done is immediate re-hydration. This can be followed by specific antibiotic therapy.

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