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4. MCQ for Part 1 - Clinical scenario

A 8 year-old boy from the travelling community has presented to the paediatric emergency with 5 days history of fever, malaise, headache, anorexia and earache (since yesterday). On examination the left parotid gland appears swollen. 
His immunisation history is uncertain.
Based on your provisional diagnosis which of the following should not be the part of your management plan?
(You can choose more than one) --

1. Inform Public Health England (PHE)/Health protection
 
2. Supportive management - Fluid, rest, paracetamol
 
3. Avoid school for 5 days.
 
4. Arrange for oral fluid test
 
5. PO steroid
 
6. Aspirin

Answer: PO steroid and Aspirin.

Mumps is a notifiable disease (to Public Health England) on suspicion - it is a legal requirement.
PHE organises oral fluid testing for mumps. That is the recommended test. Although IgM can be tested in the local NHS laboratory, it is always recommended to arrange an oral fluid test via PHE.
The treatment for mumps is supportive - fluid, rest, paracetamol, ibuprofen.
Infection control - the patient should be asked to avoid school for five days from the onset of parotid swelling.

Aspirin is not recommended under 16 years of age (you can tell me why?)
PO steroid has no role.

Read this - https://cks.nice.org.uk/mumps

Additional reading:
Notifiable diseases (PHE)
UK vaccination - travelling community traditionally have low vaccination rate.
Oral fluid test.
Related diseases - Rubella, Measles