Paediatric emergencies: fluid bolus caution: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Paediatric emergencies: fluid bolus caution

Sample item

A 3-year-old with severe febrile illness and no signs of shock or dehydration, with a capillary refill of 2 seconds, is being considered for a fluid bolus in a resource-limited hospital. What did the FEAST trial show?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Fluid boluses increased mortality in children with febrile illness without hypotension

The FEAST trial in African children with severe febrile illness found higher 48-hour mortality with fluid boluses compared with no bolus in those without hypotension. Boluses are therefore used cautiously and only for clear shock.

Option by option

  • A. Albumin boluses were superior to saline in every setting

    Albumin did not do better than saline.

  • B. Boluses had no effect and no risk

    Boluses carried measurable risk.

  • C. Boluses reduced mortality in all febrile children

    The trial did not show benefit from boluses.

  • D. Fluid boluses increased mortality in children with febrile illness without hypotension (correct)

    Correct. Excess mortality was seen with boluses.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Fluid boluses increased mortality in children with febrile illness without hypotension. The FEAST trial in African children with severe febrile illness found higher 48-hour mortality with fluid boluses compared with no bolus in those without hypotension.

Why is "Albumin boluses were superior to saline in every setting" not the answer?

Albumin did not do better than saline.

Why is "Boluses had no effect and no risk" not the answer?

Boluses carried measurable risk.

Why is "Boluses reduced mortality in all febrile children" not the answer?

The trial did not show benefit from boluses.

What concept does this question test?

It tests Paediatric emergencies: fluid bolus caution in Pediatrics. Boluses are therefore used cautiously and only for clear shock.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric emergencies: fluid bolus caution?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.