A 5-month old infant was brought by his mother to the health center because of diarrhea occurring 4 to 5 times a day. His skin goes back slowly affer a skin pinch and his eyes are sunken. Using the IMCI guidelines, you will classify this infant in which category?

Correct Answer: C

Rationale: The correct classification for this infant based on the symptoms described is severe dehydration. According to the Integrated Management of Childhood Illness (IMCI) guidelines, severe dehydration is characterized by skin pinch returning slowly, sunken eyes, and frequent diarrhea. These signs indicate significant fluid loss and the need for immediate intervention. No signs of dehydration (choice A) would not be accurate given the symptoms presented. Some dehydration (choice B) may not fully capture the severity of the infant's condition. The data being insufficient (choice D) is incorrect as the symptoms provided clearly indicate severe dehydration.

Correct Answer: D

Rationale: The correct answer is D: Conjunctival xerosis. This is the earliest sign of xerophthalmia as it indicates dryness and thickening of the conjunctiva due to lack of vitamin A. Keratomalacia (A) and corneal opacity (B) occur at later stages and are more severe manifestations. Night blindness (C) is a symptom of vitamin A deficiency but typically appears after conjunctival xerosis. Therefore, observing conjunctival xerosis during a physical examination of a young child would be the earliest sign of xerophthalmia.

Correct Answer: D

Rationale: Step 1: Lower conjunctival sac is the best area to examine for pallor as it is a mucous membrane that reflects the true color of blood vessels. Step 2: Anemia causes decreased hemoglobin levels, leading to paleness visible in lower conjunctival sac. Step 3: Palms, nailbeds, and around the lips may also show pallor, but they can be affected by other factors like skin pigmentation or lighting. Summary: Lower conjunctival sac is the best site for assessing pallor due to its direct reflection of blood vessel color, making it superior to other areas prone to external influences.

Correct Answer: C

Rationale: The correct answer is C: Instruct mothers to keep their babies at home to prevent disease transmission. This is the best course of action during a measles epidemic because keeping babies at home helps reduce their exposure to the virus and prevent its spread. Babies under 6 months are too young for the measles vaccine (choice A), and giving high doses of Retinol (choice B) is not a recommended treatment for measles. Adequate nutrition (choice D) is important for overall health but does not directly address preventing measles transmission.

Correct Answer: B

Rationale: The correct answer is B: Antibiotic to prevent pneumonia. Measles can lead to secondary bacterial infections like pneumonia, making antibiotics crucial to prevent complications. Choice A is incorrect as Gentian violet is not recommended for mouth lesions in measles. Choice C is incorrect as Tetracycline eye ointment is not indicated for corneal opacity in measles. Choice D is incorrect as giving Retinol capsules is not a standard management for measles. Antibiotics are essential to prevent and treat bacterial infections associated with measles.