Paediatric emergencies: exertional heat stroke: 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: exertional heat stroke

Sample item

A 16-year-old collapses during a cricket match in hot humid weather. Rectal temperature is 41.8 degrees C, the skin is hot and dry, and he is confused. Which is the most important initial step?

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

The answer and the reasoning

B. Rapid whole-body cooling, ideally by cold water immersion

Heat stroke is a core temperature above 40 degrees C with central nervous system dysfunction. Outcome depends on how fast the temperature is lowered, so immediate active cooling, preferably cold water immersion, comes first, with airway support and fluids.

Option by option

  • A. Intravenous dantrolene sodium

    Dantrolene is not effective for heat stroke, and it is used for malignant hyperthermia.

  • B. Rapid whole-body cooling, ideally by cold water immersion (correct)

    Correct. Rapid active cooling limits organ damage, and the speed of cooling determines outcome.

  • C. Oral paracetamol and ibuprofen

    Antipyretics act on the hypothalamic set point and are ineffective in heat stroke.

  • D. Oral rehydration solution alone

    Oral fluids alone are inadequate for a confused patient with a core temperature above 40 degrees C.

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 B, Rapid whole-body cooling, ideally by cold water immersion. Heat stroke is a core temperature above 40 degrees C with central nervous system dysfunction.

Why is "Intravenous dantrolene sodium" not the answer?

Dantrolene is not effective for heat stroke, and it is used for malignant hyperthermia.

Why is "Oral paracetamol and ibuprofen" not the answer?

Antipyretics act on the hypothalamic set point and are ineffective in heat stroke.

Why is "Oral rehydration solution alone" not the answer?

Oral fluids alone are inadequate for a confused patient with a core temperature above 40 degrees C.

What concept does this question test?

It tests Paediatric emergencies: exertional heat stroke in Pediatrics. Outcome depends on how fast the temperature is lowered, so immediate active cooling, preferably cold water immersion, comes first, with airway support and fluids.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: exertional heat stroke?

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.