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Loperamide inappropriate child — GPhC CRA MCQ

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HardGastrointestinal TherapeuticsLoperamide inappropriate childGPhC CRA

A 3-year-old with acute diarrhoea has fewer wet nappies, dry mucous membranes and mild tachycardia but is alert, drinking and has no shock, blood in stool or bilious vomiting. What is the best initial management?

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

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Correct answer: D — Give low-osmolarity oral rehydration solution frequently in small amounts and arrange clinical assessment

Explanation lettering: D = shown as A · A = shown as B · B = shown as C · C = shown as D

A is wrong because antidiarrhoeals are not used in young children and fruit juice can worsen diarrhoea. B delays the priority of rehydration and antibiotics are not routine. C is correct: the child has signs of clinical dehydration but no shock, requiring ORS in small frequent amounts with assessment and monitoring; escalation is needed if oral therapy fails or red flags develop. D worsens dehydration. E is not an appropriate ORS strategy and delays review.

Reference: NICE CG84: Gastroenteritis in under 5s—recommendations. https://www.nice.org.uk/guidance/CG84/chapter/recommendations