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Pyloric Stenosis Resuscitation — FRCA Final MCQ

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ModeratePaediatric AnaesthesiaPyloric Stenosis ResuscitationFRCA Final

6-week-old (4 kg) with pyloric stenosis. ABG: pH 7.52, pCO2 6.2, HCO3 38, K 2.9, Cl 88. Ready for surgery?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — No — resuscitate with 0.9% NaCl + KCl until Cl >100 and K >3.5

Pyloric stenosis: medical emergency (resuscitate first), NOT surgical emergency. Hypochloraemic hypokalaemic metabolic alkalosis from HCl vomiting. Resuscitate with 0.9% NaCl + KCl (20-40 mmol/L) until Cl >100, K >3.5, pH <7.45, adequate UO. Operating while alkalotic and hypokalaemic risks cardiac arrest.

Reference: APAGBI – 2023 – Anaesthesia for pyloric stenosis