This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Communicable diseases, Subject name: Social & Preventive Medicine
A child aged 24 months was brought to the Primary Health Centre with complains of cough and fever for the past 2 days. On examination, the child weighed 11 kg, respiratory rate was 38 per minute, chest in drawing was present. The most appropriate line of management for this patient is ? 
Select and explain. 
A. Classify as pneumonia and refer urgently to secondary level hospital, B. Classify as pneumonia, sta antibiotics and advise to repo after 2 days, C. Classify as severe pnemonia, sta antibiotics and refer urgently, D. Classify as severe pneumonia and refer urgently
C: Classify as severe pnemonia, sta antibiotics and refer urgently
Answer: C: Classify as severe pnemonia, sta antibiotics and refer urgently 
Explanation: The child has chest indrawing,but no fast breathing and hence classified as severe pneumonia. classification of pneumonia. Fast breathing is present when the respiratory rate is : 1. 60 breaths/min or more in child < 2 months of age. 2. 50 breaths/min or more in child aged 2-12 months. 3. 40 breaths/min or mote in child 12 months - 5 yrs. VERY SEVERE DISEASE:- 1. Not able to drink 2. Convulsions, abnormally sleepy/ difficult to wake. 3. Stridor in calm child 4. Severe malnutrition Treatment- Refer urgently to hospital. Give first fose of antibiotics. Treat fever and wheeze , if present. If cerebral malaria possible, give antimalarial. SEVERE PNEUMONIA Most impoant sign to consider when deciding if the child has pneumonia are the RR and chest indrawing. A child with chest indrawing may not have fast breathing if the child becomes exhausted. Then the breathing slows down. Un such cases chest indrawing may be the only sign in a child with severe pneumonia. Other signs: 1. Nasal flare 2. Grunting 3. Cyanosis 4. Wheezing Treatment:- Refer urgently to hospital. Give first dose antibiotics. Treat fever and wheeze if present. PNEUMONIA:- 1. Fast breathing 2. No chest indrawing Treatment:- Advice mother to give home care. Give an antibiotic. Treat fever and wheeze if present. Advice mother to return eith child in 2 days for reassessment, or earlier if child gets worse. No pneumonia:- 1. Simple cough or cold. Treatment:- Assess and treat ear problems or sore throat. Assess and treat other problems. Advice mother to give home care. Treat fever and wheeze if present. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.170}