Fluid and Electrolyte Disorders MCQs

Answer- A. 100 ml/Kg in 6 hour So total fluid to be given 100 ml/Kg in 6 hour.

Answer- B. 30 ml/kg in 30 min, 70 ml/kg in 2'/2 hours 12 Month - 5 year 30 ml/Kg in 30 min 70 ml/Kg in 2.30 hour

The history is very much suggestive of post viral lactose malabsorption. After the viral enteritis, the mucosal brush border cells are lost and these causes lactose malabsorption. Also , perianal excoriation is favorable to diagnosis of lactose intolerance. Other bacterial enteritis might show growth in culture or may have changes in stool routine like pus cells, occult blood. Though, they cannot be ruled out completely, likelihood of lactose malabsorption is more than bacterial. Celiac disease is a cause of chronic diarrhea and failure to thrive. Tags: Topic: DIARRHOEAL ILLNESS Difficulty level: GOOD TO KNOW PYQ: NEET PG 2022; AIIMS JULY 2020; FMGE DEC 2020;AUG 2020 Reference: Nelson textbook of pediatrics, 21 st ed, pg no: 2035

This child has acute watery diarrhea and no dysentery. Hence needs only ORS with Zinc. Remember that oral zinc for 14 days is recommended in all childhood diarrheas in age Antibiotics are indicated only in dysentery. Probiotics are not routinely recommended in childhood diarrhea and quality of evidence for their routine usage is very low. Reference: OP Ghai 10 th Edition, Pages 313-314.

Feeds/Fluids to be given in neonates Day 1 of life- For term babies, give 60 ml/kg/day and for preterm babies, give 80 ml/kg/day Increase daily at 10-15 ml/kg/day gradually Maximum fluid to be administered is about 150 to 160 ml/kg/day Maintenance Fluid used in 1 st 48 hr of life in neonates is generally sodium-free, e.g., 5% or 10% Dextrose Beyond 48 hours, Sodium-containing maintenance fluids can be safely used. Reference: OP Ghai 10 th Edition, Page 151

Explanation: Ringer's Lactate (RL) with 5% Dextrose is commonly used as the initial IV fluid in children with severe dehydration and malnutrition . It ensures rehydration, corrects electrolyte imbalance, and supplies energy through dextrose. Explanation of Other Options: ORS (Option A): Oral Rehydration Solution is the first choice for mild to moderate dehydration , but in severe dehydration, especially when the child is drowsy or unable to drink, ORS is not suitable. NS (Option B): Normal Saline is isotonic and can restore hydration, but it does not provide energy since it lacks dextrose. In malnourished children, the additional glucose is crucial. DNS (Option D): Dextrose Normal Saline contains glucose and helps in rehydration, but it does not offer the same balanced electrolytes as Ringer's Lactate, making it less ideal in severe cases.

The following may be present in hypernatremia dehydration, whereby proportionally more water than sodium is lost from the body: Jittery movements Increased muscle tone Hyperreflexia Convulsions Drowsiness or coma. KEY TAKEAWAYS: Hypernatremic dehydration occurs when there is a greater water loss relative to sodium loss, resulting in an increased plasma sodium concentration (serum sodium >145 mEq/L) . It is most commonly observed in settings of inadequate water intake, excessive water loss, or high solute intake. Tags: Topic: ELECTROLYTE DISTURBANCES Difficulty level: MUST KNOW Reference: Manual of paediatric emergencies & critical care, 2 nd ed., pg. 341

While treating the child with dehydration, we must promote intake of clear liquids like water, ORS, Lemonade, coconut water We must continue breastfeeding, formula feeds. We must completely avoid fruit juices and carbonated drinks. Tags: Topic: DIARRHOEAL ILLNESS Difficulty level: MUST KNOW PYQ: NEET PG 2022; AIIMS JULY 2020; FMGE DEC 2020;AUG 2020 Reference: Ghai essential pediatrics, 9 th ed, pg no: 291