1 Week Of Progressively in Pediatrics — Case | Pediatric Emergency | SMLE Q#11271

SMLE Question #11271

Pediatrics Pediatric Emergency

Objective: OBJ-OPH-REFERRAL-001

Last updated: February 2026
A 5-week-old male infant is brought to the emergency department with 1 week of progressively worsening non-bilious vomiting after feeds. He has poor weight gain and decreased urine output. He appears lethargic and dehydrated with sunken eyes and dry mucous membranes. Abdominal examination shows a mildly distended epigastrium without peritonism. Electrolytes are consistent with hypochloremic metabolic alkalosis with hypokalemia, and hypertrophic pyloric stenosis is suspected; surgery is planned after stabilization. What is the most appropriate initial intravenous fluid?

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