Gastroenteritis in Children under 5 years of age

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Question 1 of 10

1. Question
Which of the following is the commonest cause of paediatric gastroenteritis within the UK?
- Adenovirus
- Salmonella
- Rotavirus
- Cryptosporidium
- Campylobacter
Question 2 of 10

2. Question
Regarding the epidemiology of paediatric gastroenteritis, which of the following statements is correct?
- It is not necessary to take a travel history when the child is well
- Most cases occur within the summer months
- Most cases are spread by the faecal-oral route
- Although common within the community, children rarely present to the emergency department (ED)
- Most cases occur in school age children
Question 3 of 10

3. Question
Which of the following is NOT a risk factor for severe dehydration in cases of paediatric gastroenteritis?
- Children who are malnourished
- Infants with low birth weight
- Children under 1 year of age
- Those who have been offered supplemental fluids prior to presentation
- More than 2 vomits and 5 diarrhoeal stools within the preceding 24 hours
Question 4 of 10

4. Question
Which of the following statements regarding hypernatraemic dehydration is correct?
- Children are at the greatest risk between the ages of 6-12 months of age
- Aggressive treatment can result in central pontine myelinosis
- Affected children rarely have any associated symptoms or signs
- Intravenous rehydration is the preferred management
- Serum sodium should be monitored carefully during treatment
Question 5 of 10

5. Question
Regarding assessment of dehydration in young children, which of the following statements is correct?
- The use of high osmolality WHO solution is recommended for oral rehydration in the UK
- U&Es should not be taken unless there is an indication for IV fluids or suspicion of hypernatraemic dehydration
- Degree of dehydration cannot be assessed clinically
- Capillary refill time has high inter-observer reliability
- Most cases require treatment with IV fluids
Question 6 of 10

6. Question
With regards to published evidence, which of the following statements is NOT correct?
- In infants, a lactose-free milk should be given to limit the effect of post-viral intolerance
- Probiotics may be useful in reducing stool frequency and duration of diarrhoea
- Anti-diarrheal agents should be avoided in children
- Antibiotics should not be given routinely
- A single dose oral ondansetron has been shown to reduce need for IV fluids
Question 7 of 10

7. Question
Which of the following is NOT an indication for antibiotics in cases of paediatric gastroenteritis?
- Suspected or confirmed septicaemia
- Extra-intestinal spread of bacterial infection
- Salmonella infection in a well toddler
- Pseudomembranous enterocolitis
- Dysenteric shigellosis
Question 8 of 10

8. Question
A 3-year-old child (weight 16 kg) presents with a 24-hour history of fever, diarrhoea and vomiting. His parents report a “tummy bug” has affected several of the children at nursery, they have not been overseas and his urine output is unchanged.

At triage he appears well and has normal observations. On examination he is pink, has warm extremities and moist mucous membranes.

According to NICE guidelines, which of the following management options is the most appropriate?
- Discharge home with verbal advice (encourage oral intake, return if symptoms or signs of dehydration develop)
- Prescribe a course of amoxycillin in case he has an infection elsewhere (i.e. ears, urine, throat)
- Oral rehydration (aim to replace 10 ml every 10mins)
- Oral rehydration (aim to replace a 50 ml/kg deficit and maintenance over 4 hours)
- Give 10ml/kg 0.9% saline followed by IV fluids to replace both deficit (100 ml/kg) and maintenance requirements
Question 9 of 10

9. Question
A 3-year-old child (weight 16 kg) presents with a 24-hour history of fever, diarrhoea and vomiting. His parents report a “tummy bug” has affected several of the children at nursery, they have not been overseas and his urine output is unchanged.

At triage he appears unwell and is tachycardic but normotensive. On examination he is pink, has warm extremities and a CRT of 2 seconds. His eyes appear sunken and he has a dry tongue.

According to NICE guidelines, which of the following management options is the most appropriate?
- Discharge home with verbal advice (encourage oral intake, return if symptoms or signs of dehydration develop)
- Prescribe a course of amoxycillin in case he has an infection elsewhere (i.e. ears, urine, throat)
- Oral rehydration (aim to replace 10 ml every 10 mins)
- Oral rehydration (aim to replace a 50 ml/kg deficit and maintenance over 4 hours)
- Give 10ml/kg 0.9% saline followed by IV fluids to replace both deficit (100 ml/kg) and maintenance requirements
Question 10 of 10

10. Question
A 3-year-old child (weight 16 kg) presents with a 24-hour history of fever, diarrhoea and vomiting. His parents report a “tummy bug” has affected several of the children at nursery, they have not been overseas and his urine output is unchanged.

At triage he appears lethargic, is tachycardic and hypotensive. On examination he is mottled, has cold extremities and a CRT of 5 seconds. His peripheral pulses are weak and thready.

According to NICE guidelines, which of the following management options is the most appropriate?
- Discharge home with verbal advice (encourage oral intake, return if symptoms or signs of dehydration develop)
- Prescribe a course of amoxycillin in case he has an infection elsewhere (i.e. ears, urine, throat)
- Oral rehydration (aim to replace 10 ml every 10 mins)
- Oral rehydration (aim to replace a 50 ml/kg deficit and maintenance over 4 hours)
- Give 10ml/kg 0.9% saline followed by IV fluids to replace both deficit (100 ml/kg) and maintenance requirements

Gastroenteritis in Children under 5 years of age – Post Test

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