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Measles — MCCQE Part 1 MCQ

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ModerateChild with FeverMeaslesMCCQE Part 1

8-year-old unimmunised child presents with fever, cough, coryza and conjunctivitis. A maculopapular rash began on the face and there are Koplik spots. Which of the following is the most appropriate next step?

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Correct answer: E — Isolate, notify public health and test for measles

Isolate, notify public health and test for measles is best because classic measles symptoms in an unimmunised child require public-health action. Use a United States screening schedule instead of Canadian guidance is suboptimal because MCCQE questions expect Canadian preventive-care guidance; Defer all preventive care until symptoms develop is suboptimal because screening and immunisation aim to prevent disease before symptoms; Order the most invasive test as routine first-line screening is suboptimal because screening should balance benefit, harm and resource use; Screen at every visit regardless of interval or prior results is suboptimal because over-screening causes avoidable false positives and harm. Measles is airborne and highly contagious.

Reference: Canadian Immunization Guide; provincial public health guidance