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WorksheetsVomiting in Children - An ED Approach.
Total questions: 22
Worksheet time: 8mins
Which of the following is a surgical emergency in a vomiting child?
Bilious (green) vomiting
Non-bilious vomiting with diarrhoea
Vomiting after eating dairy/gluten
Vomiting that resolves with ondansetron
What is the most likely cause of projectile vomiting in a 6-week-old male?
Gastroenteritis
Appendicitis
Pyloric Stenosis
Diabetic Ketoacidosis
True or False: Vomiting without diarrhoea is reassuring?
TRUE
FALSE
Which of the following is NOT a red flag for vomiting in children?
Watery diarrhoea with vomiting
Bilious vomiting
Vomiting with altered consciousness
Projectile vomiting in an infant
What is the first-line treatment for mild dehydration in gastroenteritis?
Intravenous Fluids
Ondansetron
Nil by mouth
Oral rehydration solution (ORS)
Which investigation is MOST appropriate for suspected intussusception?
CT Abdomen
Abdomen Ultrasound
Contrast / Gas Enema
Stool MCS
A 4-year-old has green vomit, abdominal distension, and lethargy. What should you do FIRST?
Start IV fluids and escalate to surgery
Give oral ondansetron and observe
Trial of Fluids. Likely Discharge
Paracetamol / Supportive Cares and observe
Which statement about ondansetron in kids is TRUE?
It cures the underlying cause
It helps reduce vomiting and admissions
It should be avoided in gastroenteritis
It replaces the need for rehydration
Which of the following is an example of functional vomiting?
Vomiting due to intussusception
Bilious vomiting in neonate
Vomiting with fever and lethargy
Cyclical vomiting syndrome
Acute infectious gastroenteritis in children is most commonly caused by:
Viruses
Bacteria
Parasite
Fungi
Hypernatraemia in infants with gastroenteritis is most often caused by?:
IV fluid overload
Overuse of oral rehydration solution
Concentrated formula or home-made fluids
Sweat loss
Which of the following is NOT a red flag in gastroenteritis according to QPEC?
High-grade fever in >3 months old
Bilious vomiting
Severe lethargy
Localised abdominal pain
A risk factor for dehydration in gastroenteritis is:
Mild fever ~ 37.5'
Vomiting without fever
Age >5yrs
≥5 loose stools in 24 hours
For children >2 years with clinical dehydration, which route is preferred?
Subcutaneous fluid rehydration (0.9% saline)
IV fluids (0.9% saline + 5% glucose)
Nil by mouth
Trial of fluids (10mL/kg over 60 minutes)
Rapid rehydration volume over 4 hours is calculated as:
20 mL/kg
50 mL/kg
100 mL/kg
10 mL/kg
To prevent spread of viral gastro in childcare, children should be excluded for:
Completion of 5 day antibiotic course
24–48 hours after symptoms stop
One week minimum
Until cessation of vomiting
A 3-week-old male presents to ED with forceful, non-bilious vomiting after every feed for 3 days. He is hungry after vomiting and has lost weight. On exam, he appears slightly dehydrated. A small olive-shaped mass is palpated in the epigastric region. WHAT IS THE MOST LIKELY DIAGNOSIS?
Gastro-oesophageal reflux disease
Pyloric stenosis
Hirschsprung disease
Intussusception
A 2-month-old presents with sudden onset bilious vomiting, abdominal distension, and lethargy. Mum reports one episode of dark, bloody stool ("currant jelly"). The child is tachycardic with a distended abdomen. WHAT IS THE NEXT MOST APPROPRIATE STEP?
Oral rehydration and discharge
Immediate surgical referral
Trial of ondansetron
Abdominal X-ray and stool culture
A 2-year-old girl presents with vomiting and watery diarrhoea for 24 hours. She is alert, has mild dry lips, and her cap refill is <2 sec. She hasn’t kept down much fluid today. No blood in stool. WHAT IS THE MOST APPROPRIATE NEXT STEP?
IV fluids immediately
Antidiarrhoeal and antiemetic medications
Trial of oral rehydration solution
Discharge with safety netting advice + supportive cares
A 13-year-old boy presents with vomiting, abdominal pain, and increasing drowsiness over 6 hours. He is tachypnoeic with fruity-smelling breath. BGL is 18.6 mmol/L. WHAT IS THE LIKELY DIAGNOSIS?
Viral gastroenteritis
Appendicitis
Sepsis
Diabetic ketoacidosis (DKA)
A 4-year-old presents with recurrent episodes of vomiting every few weeks, lasting 24–48 hours. No associated fever, diarrhoea, or abdominal tenderness. Child is well between episodes. WHAT IS THE MOST LIKELY DIAGNOSIS?
Functional constipation
Gastroenteritis
Cyclical vomiting syndrome
Appendicitis
A 7-year-old boy presents with early morning vomiting, worsening headache, and blurred vision. Parents report he’s been more irritable and has had difficulty at school. On examination, he is bradycardic with elevated blood pressure and shows papilloedema on fundoscopy. WHAT IS THE MOST LIKELY UNDERLYING CAUSE OF HIS VOMITING?
Migraine
Viral Gastroenteritis
Raised intracranial pressure
Motion sickness
