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177.

A mother with her 5-year-old daughter came to see their family doctor. The daughter has been complaining of headache and she has occasionally vomited for some time. The symptoms usually occur in the morning hours. The doctor suspects a tumour of the central nervous system. However, the physical examination, including full neurological exam, did not reveal any abnormalities. The same refers to laboratory testing. What further measures should be taken?

A. paracetamol administration to control headache, at a dose based on kg body weight.
B. recommendation to avoid eating late, in order to prevent morning vomiting.
C. refer the patient to cancer centre for imagining diagnostics of the head.
D. refer the patient to gastro ward for imaging diagnostics of the abdomen.
E. refer the patient to psychology clinic, as most probably the child simulates the symptoms, which may be associated with impaired family relationships.

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