Kawasaki disease — MCCQE Part 1 MCQ

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EasyChild With FeverKawasaki diseaseMCCQE Part 1

A 3-year-old has fever for 6 days, bilateral conjunctivitis, cracked lips, swollen hands and a polymorphous rash. Which of the following is the most appropriate next step?

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Correct answer: D — Give intravenous immunoglobulin and acetylsalicylic acid, and arrange echocardiography

Give intravenous immunoglobulin and acetylsalicylic acid, and arrange echocardiography is the single best answer because the age, timing, examination findings and investigations in the vignette fit Kawasaki disease better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to CPS Kawasaki disease statement, with attention to acuity, safety-netting and local provincial pathways.

Reference: CPS Kawasaki disease statement