Age 2 years with 1 day of watery diarrhea and lethargy. No vomiting. Temperature 36.8°C, HR 160/min, RR 42/min. Markedly sunken eyes, very dry oral mucosa, weak thready pulses, capillary refill 4–5 seconds, skin tenting, minimal urine for 10 hours, weight 11 kg. Which immediate step is most appropriate?

Age 18 months with 3 days of watery stools; afebrile, active. HR 110/min, RR 28/min, moist mucosa, normal skin turgor, capillary refill <3 seconds, normal urine output. Stool is greenish without blood. Which adjunct is recommended to shorten illness and reduce recurrence?

Age 4 years with high fever, abdominal cramps, and frequent small‑volume stools containing visible blood and mucus for 24 hours. Temperature 39.2°C, HR 132/min, signs of moderate dehydration. Stool microscopy: leukocytes (+6), mucus(+), blood (+2). Most appropriate empiric antibiotic is:

Age 7 years with 3 days of abdominal pain and bloody diarrhea after consuming street food; afebrile now. Stool microscopy shows trophozoites with ingested RBCs on fresh wet mount; no leukocytes. Liver and spleen normal. Best next step is:

A 7 month-girl was referred as she suffered from watery stool for more than 2 weeks. She has no fever nor cough. The baby looked active, BW 4.5 kg, HR 110 bpm, RR 30, temperature 37 C, normal peristaltic, good skin turgor, and no erythematous around anal area. What was your diagnosis for the case?

Age 6 weeks with progressive jaundice since week 3. Stools pale/acholic on several days, urine dark. Total bilirubin 10 mg/dL with conjugated 6.8 mg/dL; ALT/AST mildly elevated; GGT high. Abdomen soft, no splenomegaly. Most appropriate initial imaging to evaluate the cause is:

Age 8 weeks with persistent conjugated hyperbilirubinemia and repeated acholic stools. Ultrasound: absent/atrophic gallbladder, no choledochal cyst. Weight gain adequate; INR normal. Next best step in management is:

Newborn with delayed passage of meconium (>48 hours), progressive abdominal distension, and bilious vomiting at day 3. Plain abdominal radiograph shows dilated bowel loops without air in distal rectum. Digital rectal exam results in explosive stool. Most definitive diagnostic test is:

Age 2 years with chronic constipation since infancy, abdominal distension, intermittent vomiting, and failure to thrive. Recurrent episodes of fever and foul‑smelling diarrhea with lethargy. WBC 15,500/µL, CRP elevated. Most concerning complication that requires urgent recognition is:

Age 5 years with infrequent, painful hard stools, stool withholding, and occasional fecal smearing for 6 months. Growth parameters normal, abdominal exam benign, neurologic exam normal, perianal inspection unremarkable. Most appropriate first‑line pharmacologic therapy is:

Age 9 months with constipation. Which finding is a red flag suggesting an organic rather than functional cause?

Age 5 years with intense nocturnal perianal pruritus for 2 weeks and disturbed sleep. No weight loss. Perianal excoriations noted. Adhesive tape test planned in the morning. Most appropriate treatment regimen is:

Age 6 years with episodic abdominal colic and distension; one episode of vomiting a long, whitish worm. No fever; mild anemia (Hb 10.8 g/dL). Abdominal exam: hyperactive bowel sounds, no peritoneal signs. Ultrasound shows multiple tubular echogenic structures within the small bowel lumen. Most appropriate antiparasitic therapy once obstruction is excluded is:

A 2-year-old boy looked irritable when brought to ER due to abdominal pain and vomiting. Heart rate 120 bpm, RR 30 bpm, temperature 36.8 C. Abdominal distension with metallic sound upon auscultation was found. What is your most possible diagnosis for this case?

Age 4 years. Colicky pain accompanied by strong urge to defecate. Within 24 hours, 9 bowel movements with mucus and fresh red blood. Fever, nausea, vomiting. Signs of dehydration: sunken eyes, skin turgor >3 seconds. Fresh stool examination: mucus (+), blood (+2), leukocytes (+3), no parasites visible. No history of previous antibiotic use. Abdominal tenderness mild and diffuse without guarding. The most likely diagnosis is…

Age 2 years. History of delayed meconium passage >48 hours after birth. Since infancy, frequent constipation, recurrent abdominal distension, occasional green vomiting. Currently, enlarged abdomen, tympanic; on auscultation, loud bowel sounds with a “metallic sound.” Weight stagnant. Previous rectal examination triggered explosive stool passage. No history of inflammatory bowel disease. The most likely diagnosis is...

18 months old. Long-standing constipation. Delayed motor development, not yet walking independently; limited speech. Puffy face, dry-rough skin, large tongue, relatively short stature. Abdomen tends to be distended, bowel sounds normal. No rectal bleeding. Family history negative. The most important initial examination to establish the suspected etiology is...

Age 5 years. Three weeks after playing and swimming in a rural irrigation canal, the patient developed mucous diarrhea, mild fever, and lower abdominal pain. There was no severe vomiting. Microscopic examination of stool samples revealed small eggs with rudimentary spiny projections. Eosinophils were slightly elevated. The most likely causative agent is...