Diarrhoea: severe dehydration fluids: 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 · Diarrhoea: severe dehydration fluids

Sample item

A 6-month-old with severe dehydration needs intravenous fluid. Which regimen is advised?

ADextrose 5 percent 100 ml/kg over 3 hoursBRinger lactate 100 ml/kg over 30 minutesCNormal saline 10 ml/kg onlyDRinger lactate 30 ml/kg over 1 hour, then 70 ml/kg over 5 hours

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

The answer and the reasoning

D. Ringer lactate 30 ml/kg over 1 hour, then 70 ml/kg over 5 hours

In infants under 12 months, 100 ml/kg of Ringer lactate (or normal saline) is given as 30 ml/kg in the first hour and 70 ml/kg over the next 5 hours. For older children it is 30 ml/kg in 30 minutes and 70 ml/kg over 2.5 hours. ORS is begun as soon as the child can drink.

Option by option

A. Dextrose 5 percent 100 ml/kg over 3 hours
Dextrose 5 percent lacks sufficient sodium.
B. Ringer lactate 100 ml/kg over 30 minutes
Giving the whole 100 ml/kg within 30 minutes risks fluid overload.
C. Normal saline 10 ml/kg only
Ten ml/kg is not enough to correct severe dehydration.
D. Ringer lactate 30 ml/kg over 1 hour, then 70 ml/kg over 5 hours (correct)
Correct. 30 ml/kg in 1 hour then 70 ml/kg over 5 hours.

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.

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Ringer lactate 30 ml/kg over 1 hour, then 70 ml/kg over 5 hours. In infants under 12 months, 100 ml/kg of Ringer lactate (or normal saline) is given as 30 ml/kg in the first hour and 70 ml/kg over the next 5 hours.

Why is "Dextrose 5 percent 100 ml/kg over 3 hours" not the answer?

Dextrose 5 percent lacks sufficient sodium.

Why is "Ringer lactate 100 ml/kg over 30 minutes" not the answer?

Giving the whole 100 ml/kg within 30 minutes risks fluid overload.

Why is "Normal saline 10 ml/kg only" not the answer?

Ten ml/kg is not enough to correct severe dehydration.

What concept does this question test?

It tests Diarrhoea: severe dehydration fluids in Pediatrics. For older children it is 30 ml/kg in 30 minutes and 70 ml/kg over 2.5 hours. ORS is begun as soon as the child can drink.

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 Diarrhoea: severe dehydration fluids?

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.