An adult with culture-confirmed cholera presents with severe dehydration: feeble pulse, sunken eyes, poor skin turgor and inability to drink. After assessing the airway, which intravenous fluid should be started immediately?

• A Ringer lactate ✓
• B Normal saline (0.9% NaCl)
• C 5% dextrose in normal saline
• D 5% dextrose in water

Explanation

Severely dehydrated cholera patients who cannot drink need rapid IV rehydration, and Ringer lactate is the fluid of choice because it replaces potassium and provides a bicarbonate precursor, correcting the hypokalaemia and metabolic acidosis characteristic of cholera. Plain normal saline expands volume but contains neither potassium nor buffer, thereby aggravating acidosis and potassium depletion despite restoring perfusion, and dextrose-based solutions deliver free water without meaningful electrolytes, making them unfit for shock correction.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.