A child weighing 36 kg is in moderate dehydration. Calculate the amount of ORS this child will need within 4 hours in mL. (Do not enter units)

The correct answer is b. Preadolescent growth spurt

Choice A reason:

Idiopathic scoliosis is not typically noticeable when a toddler begins to walk. At this stage, the spine is still developing, and any curvature is usually not significant enough to be detected. Idiopathic scoliosis most commonly becomes noticeable during periods of rapid growth, which occur later in childhood.

Choice B Reason:

The preadolescent growth spurt is the period when idiopathic scoliosis becomes most noticeable. This is because the rapid growth during this time can exacerbate the curvature of the spine. Idiopathic scoliosis often becomes apparent between the ages of 10 and 18 years, when children experience significant growth spurts.

Choice C Reason:

Late adolescence is not the period when idiopathic scoliosis becomes most noticeable. By this time, most children have completed their major growth spurts, and any scoliosis would likely have been detected earlier. The condition is typically identified during the preadolescent growth spurt.

Choice D Reason:

The newborn period is not associated with the development of idiopathic scoliosis. While congenital scoliosis can be present at birth, idiopathic scoliosis develops later in childhood, particularly during periods of rapid growth.

Choice A reason:

A low protein diet is not a therapeutic treatment for Hirschsprung disease. Hirschsprung disease is a congenital condition characterized by the absence of ganglion cells in the distal colon, leading to a lack of peristalsis and functional obstruction. Dietary modifications, such as a low protein diet, do not address the underlying issue of the absence of nerve cells in the bowel. Therefore, this choice is incorrect.

Choice B reason:

Surgical removal of the affected section of the bowel is the primary treatment for Hirschsprung disease. This procedure, known as a pull-through surgery, involves removing the aganglionic segment of the colon and connecting the healthy part of the intestine to the anus. This surgery restores normal bowel function by allowing the passage of stool through the healthy, innervated portion of the intestine. The pull-through procedure can be performed using minimally invasive techniques, resulting in shorter recovery times and fewer complications.

Choice C reason:

A permanent colostomy is not typically the first-line treatment for Hirschsprung disease. While a temporary colostomy may be performed in some cases to allow the bowel to heal before a pull-through surgery, a permanent colostomy is usually reserved for more severe cases or when other surgical options are not feasible. The goal of treatment is to restore normal bowel function, and a permanent colostomy is generally considered a last resort.

Choice D reason:

Daily enemas are not a definitive treatment for Hirschsprung disease. While enemas may be used temporarily to relieve symptoms and manage bowel movements, they do not address the underlying cause of the condition. The absence of ganglion cells in the bowel requires surgical intervention to restore normal bowel function. Therefore, daily enemas are not a long-term solution for Hirschsprung disease.