skip to main content

Kawasaki disease — MCCQE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

HardRashKawasaki diseaseMCCQE Part 1

A 5-year-old has six days of fever, bilateral nonpurulent conjunctival injection, cracked lips, a polymorphous rash, swollen hands, and a 2-cm cervical node. Laboratory findings support inflammation, and no alternative diagnosis is evident. What is the most appropriate immediate management?

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

Reveal the answer and explanation

Correct answer: A — Give IVIG with antiplatelet therapy and arrange echocardiography without delaying treatment

This child meets clinical criteria for Kawasaki disease and is within the first 10 days of fever, when prompt treatment most effectively reduces coronary artery aneurysm risk. Give a single 2 g/kg dose of intravenous immunoglobulin and antiplatelet therapy according to bleeding risk and local paediatric or cardiology guidance. Echocardiography is essential at baseline and during follow-up, but a normal or delayed study must not postpone treatment when the diagnosis is established. Waiting for an aneurysm forfeits prevention. NSAIDs can interfere with aspirin's antiplatelet effect and are not sole therapy. Live vaccines are generally deferred after IVIG because passive antibody can reduce vaccine response; follow the Canadian immunization schedule and specialist advice.

Reference: Canadian Paediatric Society, Kawasaki Disease—Practical Guidance on Diagnosis and Management: https://cps.ca/en/documents/position/kawasaki-disease