#june2020mccqe1
A 4-year-old boy was seen by his general practitioner with an acute otitis media of his right ear. He has a known allergy to penicillin and was started on erythromycin Suspension four times daily. Four days later he now presents with poor appetite, central abdominal pain and three to four loose bowel motions per day. On examination he is afebrile but still distressed, with some nonspecific generalised abdominal tenderness. There is no rebound tenderness. His otitis is settling well. Which one of the following is the most appropriate next step in management?
(A) Stop his antibiotic treatment
(B) Arrange an abdominal ultrasound
(C) Arrange a rotavirus screen of stool
(D) Ask a surgeon to review him to exclude acute appendicitis
(E) Check his faeces for giardia
A 4-year-old boy was seen by his general practitioner with an acute otitis media of his right ear. He has a known allergy to penicillin and was started on erythromycin Suspension four times daily. Four days later he now presents with poor appetite, central abdominal pain and three to four loose bowel motions per day. On examination he is afebrile but still distressed, with some nonspecific generalised abdominal tenderness. There is no rebound tenderness. His otitis is settling well. Which one of the following is the most appropriate next step in management?
(A) Stop his antibiotic treatment
(B) Arrange an abdominal ultrasound
(C) Arrange a rotavirus screen of stool
(D) Ask a surgeon to review him to exclude acute appendicitis
(E) Check his faeces for giardia
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