Paediatric emergencies: corrosive ingestion: 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: corrosive ingestion

Sample item

A 3-year-old swallowed a toilet cleaner 1 hour ago. She is drooling, refuses fluids and has hoarse cry with mild stridor. What is the correct initial management?

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

The answer and the reasoning

C. Keep nil by mouth, secure the airway, give fluids and plan early endoscopy

In corrosive ingestion, the priorities are the airway, nil by mouth, intravenous fluids, analgesia and early endoscopy within 24 to 48 hours to grade injury. Vomiting re-exposes the oesophagus, lavage risks perforation and neutralisation causes exothermic injury.

Option by option

  • A. Pass a wide-bore tube for gastric lavage

    Gastric lavage risks perforating the damaged oesophagus and stomach.

  • B. Give a neutralising agent by mouth immediately

    Neutralisation produces heat and further injury and is not recommended.

  • C. Keep nil by mouth, secure the airway, give fluids and plan early endoscopy (correct)

    Correct. Airway protection, nil by mouth and early endoscopy are the cornerstones of care.

  • D. Induce vomiting to remove the agent quickly

    Inducing vomiting re-exposes the oesophagus and airway to the corrosive and is contraindicated.

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 C, Keep nil by mouth, secure the airway, give fluids and plan early endoscopy. In corrosive ingestion, the priorities are the airway, nil by mouth, intravenous fluids, analgesia and early endoscopy within 24 to 48 hours to grade injury.

Why is "Pass a wide-bore tube for gastric lavage" not the answer?

Gastric lavage risks perforating the damaged oesophagus and stomach.

Why is "Give a neutralising agent by mouth immediately" not the answer?

Neutralisation produces heat and further injury and is not recommended.

Why is "Induce vomiting to remove the agent quickly" not the answer?

Inducing vomiting re-exposes the oesophagus and airway to the corrosive and is contraindicated.

What concept does this question test?

It tests Paediatric emergencies: corrosive ingestion in Pediatrics. Vomiting re-exposes the oesophagus, lavage risks perforation and neutralisation causes exothermic injury.

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: corrosive ingestion?

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.