Dengue Fever Clinical Assessment Quiz

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Questions and Answers

Which clinical manifestation of dengue is most critical for hospital admission?

Vomiting

Diarrhea

Abdominal pain (correct)

Petechial rash

What is the preferred fluid management for a patient with dengue experiencing hypotension?

Oral rehydration solution

PNSS (1,500 mL + 20 mL/kg for each kg >20 kg) to run for 24 hours

PNSS at 5 to 7 mL/kg/h for the first 2 hours

PNSS to run at 20 mL/kg over the first 15 minutes then reassess (correct)

Which of the following is NOT a discharge criterion for managing dengue?

Increasing trend of platelet count

Stable hematocrit without intravenous fluids

No fever for 48 hours

Normal creatinine and liver enzymes (correct)

In a case of hypotensive shock from dengue where initial fluid resuscitation has failed, what is the next best step?

Transfuse packed red blood cells Signup and view all the answers

Which statement regarding the etiology of sepsis is incorrect?

The incidence of sepsis is equal across all demographics Signup and view all the answers

What initial management should be administered to a patient with respiratory distress and suspected pneumonia?

Intravenous antibiotics immediately Signup and view all the answers

What indicates a patient with dengue may require urgent intervention?

Decreasing platelet count Signup and view all the answers

Which of the following is an important diagnostic indicator for sepsis management?

Elevated lactate levels Signup and view all the answers

What defines resistance to MDR-TB?

Resistance to at least both Isoniazid and Rifampicin Signup and view all the answers

What is the next appropriate step for a patient with persistent diarrhea and tenesmus after oral rehydration therapy?

Routine fecalysis Signup and view all the answers

What is recommended in the latest regimen for newly diagnosed MDR-TB?

Bedaquiline, Pretomanid, Levofloxacin, and Moxifloxacin for 26 weeks Signup and view all the answers

What is the correct dosing regimen for prophylaxis in leptospirosis after exposure?

Doxycycline 100 mg/capsule, 2 capsules OD for 3 to 5 days Signup and view all the answers

In a patient suspected of severe leptospirosis, which finding is most indicative of the severity?

PaO2 of 68 mmHg on O2 at 10 LPM Signup and view all the answers

What treatment is preferred for a patient with leptospirosis presenting with severe symptoms?

Administer Methylprednisone Signup and view all the answers

Which organism is associated with an indolent type of endocarditis?

Tropheryma whipplei Signup and view all the answers

What clinical finding would most likely require immediate intervention in a patient with suspected leptospirosis?

Absence of urine output for 12 hours Signup and view all the answers

What is the initial fluid resuscitation volume recommended for a 58-year-old male with septic shock?

30 mL/kg Signup and view all the answers

In the case of a patient allergic to penicillin, which initial antimicrobial therapy is most appropriate?

Aztreonam plus Vancomycin Signup and view all the answers

Which vasopressor should be considered next if the patient's BP improves to 90/50 after receiving Norepinephrine?

Vasopressin Signup and view all the answers

What is the correct immediate action for diagnosing infective endocarditis in this patient?

If initial blood cultures remain negative after 48-72 hours, 2 to 3 blood culture sets should be obtained. Signup and view all the answers

What is the recommended threshold for red blood cell transfusion in septic patients?

When hemoglobin concentration falls below 8 mg/dL Signup and view all the answers

What is the most important step to take after a patient sustains a deep, dirty, contaminated wound to prevent tetanus?

Thorough wound cleaning. Signup and view all the answers

What is the most commonly involved site for extrapulmonary tuberculosis?

Lymph nodes Signup and view all the answers

What is the most common clinical manifestation of a first episode HSV-1 infection?

Fever. Signup and view all the answers

In the case of a cat bite leading to axillary lymphadenopathy, which treatment is appropriate?

Azithromycin. Signup and view all the answers

Which patient should be treated for latent tuberculosis based on their tuberculin reaction and exposure?

50/F living with her son who has bacteriologically confirmed PTB and a reaction size of 10 mm Signup and view all the answers

When is the optimal time to start antiretroviral treatment in a patient with TB meningitis recently diagnosed with HIV?

After 8 weeks Signup and view all the answers

For a patient with skin and soft tissue infection (SSTI) and first-time febrile neutropenia, what is the best empiric antibiotic therapy?

Vancomycin + ceftazidime. Signup and view all the answers

Which management step is NOT appropriate for a diabetic patient with symptoms indicating possible infection in the right leg?

Hyperbaric oxygen therapy. Signup and view all the answers

What defines multidrug-resistant tuberculosis (MDR-TB)?

Resistance to isoniazid and rifampicin Signup and view all the answers

What is the recommended prophylactic therapy for recurrent cellulitis?

Benzathine Penicillin every 2-4 weeks. Signup and view all the answers

In which situation is typhoid immunization NOT recommended?

A fully vaccinated individual from non-endemic regions. Signup and view all the answers

Study Notes

Dengue Management

Hospital admission is warranted for abdominal pain in dengue patients.
For a dengue case with hypotensive symptoms, fluid management includes PNSS at 5 to 7 mL/kg/h for the first 2 hours.
Discharge criteria for dengue include no fever for 48 hours, increasing platelet count, and stable hematocrit without IV fluids.

Sepsis Etiology & Management

Pneumonia is the most common source of sepsis among infections.
Blood cultures are positive in about half of sepsis cases.
Initial management of septic patients involves starting IV crystalloid fluids promptly.

Tuberculosis (TB) Considerations

The most commonly involved site for extrapulmonary TB is the lymph nodes.
Latent TB treatment is indicated for individuals in close contact with active TB patients.
In TB meningitis combined with recent HIV diagnosis, anti-retroviral treatment should start after 8 weeks of TB treatment.

Multidrug-Resistant TB

Multidrug-resistant TB (MDR-TB) is defined as resistance to both Isoniazid and Rifampicin.

Leptospirosis Management

Prophylaxis for leptospirosis involves doxycycline, 2 capsules taken once daily for 3 to 5 days after exposure.
In severe leptospirosis cases, indicators include PaO2 levels and other clinical signs.

Endocarditis Diagnostics

For suspected infective endocarditis, blood cultures should be performed if initial cultures remain negative after 48-72 hours.

Tetanus Prevention

Immediate wound cleaning is the most crucial step to prevent tetanus in contaminated wounds.

Herpes Simplex Virus (HSV-1) Infection

The most common clinical manifestation of first episode HSV-1 infection is fever.

Bite Wound Management

For cat bites with lymphadenopathy, azithromycin is the appropriate treatment.

SSTI & Neutropenia

Empiric antibiotic therapy for first-time febrile neutropenia should include vancomycin plus ceftazidime.

Management of Diabetic Patients with Infection

In diabetic patients presenting with lower extremity infections, immediate surgical referral when needed is vital, but hyperbaric oxygen therapy is not appropriate as an immediate treatment.

Recurrent Cellulitis Therapy

Benzathine penicillin administration every 2-4 weeks is recommended for recurrent cellulitis prevention.

Recurrent Skin Abscess Treatment

Drainage of the abscess and daily chlorhexidine wash are essential; procalcitonin levels should not guide antibiotic initiation.

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Description

Test your knowledge on the clinical manifestations and management of dengue fever. This quiz covers important signs that require hospital admission and fluid management protocols for patients. Ideal for medical students and healthcare professionals.