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.
Rehydration
the cause of the boys diarrohea could be due to cholera which is manifested by the painless nature of the stools and large amount of weight loss which has led to a fall in his wt orthostatic hypotension is characteristic of hypovolemia hence at dis point of time it is needed to correct his dehydration hence rehydration could be the answer
first rehydration must be done…
ans E) rehydration
explanation : this is a case of CHOLERA with moderate dehydration
(painless watery diarrhea,
GRADES OF DEHYDRATION
mild volume loss 2-5 % symptoms of ^thirst,
moderate volume loss 5-10% tachycardia, postural hypotension,
severe : >10 % shock)
early volume replacement is THE MUST TO prevent death from hypovolumic shock..
rehydration
E
b doxycycline
F
rehydration
might be rehydration
rehydration
E
rehydration
rehydration
rehydration