MBBS viva · Paediatrics
Paediatric dehydration (AGE) — WHO Plans A/B/C viva
Viva on AGE dehydration: WHO clinical signs, ORS Plan B, IV Plan C, zinc, antibiotics only when indicated, SGLT1 mechanism.
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"A 10-month-old with diarrhoea is irritable with sunken eyes and drinks eagerly. Manage."
Q1: Assessment (2 min)
- WHO signs for none / some / severe dehydration.
- Some = ≥2 of irritable, sunken eyes, thirsty, slow skin pinch.
- Severe = ≥2 of lethargy, sunken eyes, cannot drink, very slow skin pinch.[1]
Q2: Fluid plans (3 min)
- Plan A home ORS; Plan B 75 mL/kg ORS/4 h; Plan C 100 mL/kg IV RL with age-specific timing. [1]
- Continue breastfeeding; replace ongoing losses.
- Ondansetron selectively; no loperamide in infants.
Q3: Adjuncts and antimicrobials (2 min)
- Zinc 10–20 mg daily for 10–14 days (WHO 2005, all children with diarrhoea); Cochrane: no benefit shown under 6 months. [1]
- Antibiotics for dysentery/cholera/selected invasive disease — not routine watery diarrhoea.
- Rotavirus vaccine prevention message.
Q4: Pitfalls (1 min)
- Malnutrition masks signs; hypoglycaemia risk; hypernatraemic dehydration needs careful correction; if radial pulse still very weak, WHO repeats the 30 mL/kg aliquot once, then complete Plan C. [1]
Key phrases
- "Seventy-five millilitres per kilogram ORS over four hours." [1]
- "Zinc ten to twenty milligrams daily for ten to fourteen days."
- "ORS works because SGLT1 still functions."
References1ShowHide
- [1]World Health Organization The treatment of diarrhoea: a manual for physicians and other senior health workers. 4th revision. World Health Organization, 2005.Source