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Chapter 76. Gastrointestinal Infections

A 2-month-old male child is brought to the hospital 2 days after onset of a very watery diarrhea. His weight is noted to be 12.5 lb (5.7 kg), which is decreased from his previous recorded weight of 15 lb (6.8 kg). His blood pressure is low and his heart rate is increased. His fontanelle and eye orbits are noted to be deeply sunken and tears are absent. His extremities are cool and mottled and his urine output is less than 1 mL/kg/h. He is noted to be lethargic upon presentation. Which one of the following therapies would be most appropriate for this patient:

A. ORT at 50 mL/kg over 2 to 4 hours

B. ORT at 100 mL/kg over 2to 4 hours

C. D5W at 100 mL/h for 2 hours; then reassess fluid status

D. Lactated Ringers at 250 mL/h for at least 6 hours

E. Lactated Ringers at 20 mL/kg over 15 to 20 minutes and repeat as necessary

A 4-year-old child with a 3-day history of viral gastroenteritis presents to his local medical clinic with signs of severe dehydration secondary to multiple vomiting episodes. Which one of the following antiemetic agents should be considered for the treatment of this child:

A. Aprepitant

B. Dexamethasone

C. Diphenhydramine

D. Dolasetron

E. Ondansetron

Which one of the following is least likely to be associated with shigellosis:

A. Bacteremia

B. Dysentery

C. Fractional Stools

D. Tenesmus

E. Vomiting

Antimicrobial agents are contraindicated in which of the following infections because they may induce the expression and release of toxin, which may predispose a patient to develop hemolytic-uremic syndrome (HUS):

A. Cholera

B. Cryptosporidiosis

C. Enterohemorrhagic E. coli

D. Enterotoxigenic E. coli

E. Salmonellosis

All of the following could be considered for the treatment of a patient with shigellosis except:

A. Azithromycin


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