Podcast
Questions and Answers
What is the primary purpose of estimating NS1 antigens and IgM and IgG at the time of presentation?
What is the primary purpose of estimating NS1 antigens and IgM and IgG at the time of presentation?
- To confirm the presence of dengue virus
- To determine the required hospitalization level
- To achieve the best sensitivity in clinical practice (correct)
- To assess the need for molecular testing
Why are molecular tests not routinely indicated for diagnosing dengue fever?
Why are molecular tests not routinely indicated for diagnosing dengue fever?
- They are only effective during critical phases.
- NS1 antigen estimation typically suffices. (correct)
- They require specialized laboratory equipment.
- They have lower sensitivity than antibody tests.
What aspect of dengue in children emphasizes the need for continuous monitoring?
What aspect of dengue in children emphasizes the need for continuous monitoring?
- The effectiveness of outpatient management
- The rapid progression of the disease
- Minute-to-minute variation in clinical illness state (correct)
- The high rate of hospitalization
Which of the following describes the IgG antibody response during secondary dengue?
Which of the following describes the IgG antibody response during secondary dengue?
What classification method can help in determining the further care needed for children with dengue?
What classification method can help in determining the further care needed for children with dengue?
What is characteristic of the febrile phase in children suffering from dengue?
What is characteristic of the febrile phase in children suffering from dengue?
What occurs during the critical phase of dengue in children?
What occurs during the critical phase of dengue in children?
In which phase do children begin to experience clinical improvement after dengue fever?
In which phase do children begin to experience clinical improvement after dengue fever?
Which diagnostic test is preferred for detecting NS1 antigen in dengue?
Which diagnostic test is preferred for detecting NS1 antigen in dengue?
When do IgM antibodies typically become detectable in dengue patients?
When do IgM antibodies typically become detectable in dengue patients?
What is the duration of the convalescent phase in children with dengue?
What is the duration of the convalescent phase in children with dengue?
What is the key characteristic of IgG antibodies in primary dengue infection?
What is the key characteristic of IgG antibodies in primary dengue infection?
How long can IgM antibodies remain detectable in patients after dengue infection?
How long can IgM antibodies remain detectable in patients after dengue infection?
What is the focus of the National Guideline for Dengue Case Management during the COVID-19 Pandemic?
What is the focus of the National Guideline for Dengue Case Management during the COVID-19 Pandemic?
Which organization published comprehensive guidelines for the prevention and control of dengue?
Which organization published comprehensive guidelines for the prevention and control of dengue?
What is the primary target audience of the Clinical guidelines for the management of DF/DHF/DSS?
What is the primary target audience of the Clinical guidelines for the management of DF/DHF/DSS?
Which aspect of dengue management was emphasized in the National Guidelines for Management of Dengue Fever in Adults by Sri Lanka?
Which aspect of dengue management was emphasized in the National Guidelines for Management of Dengue Fever in Adults by Sri Lanka?
What is the primary purpose of the resources linked in the provided text?
What is the primary purpose of the resources linked in the provided text?
What occurs during recovery in a patient's white blood cell count?
What occurs during recovery in a patient's white blood cell count?
What should be assessed after 20 mL/kg crystalloid or colloid resuscitation in pediatric intensive care units for dengue shock?
What should be assessed after 20 mL/kg crystalloid or colloid resuscitation in pediatric intensive care units for dengue shock?
What is a key indicator of clinical recovery in platelet count?
What is a key indicator of clinical recovery in platelet count?
Which monitoring method is suggested for ensuring safe fluid therapy at the bedside?
Which monitoring method is suggested for ensuring safe fluid therapy at the bedside?
Which statement about C-reactive protein (CRP) is correct during the observed condition?
Which statement about C-reactive protein (CRP) is correct during the observed condition?
In what situation is it preferable to manage a child categorized as having dengue shock?
In what situation is it preferable to manage a child categorized as having dengue shock?
In severe disease, which of the following is true regarding liver function tests?
In severe disease, which of the following is true regarding liver function tests?
What is the potential consequence of aggressive fluid resuscitation in dengue management?
What is the potential consequence of aggressive fluid resuscitation in dengue management?
What is a typical finding in ferritin levels during dengue fever?
What is a typical finding in ferritin levels during dengue fever?
What is essential when advanced monitoring is not immediately available during fluid resuscitation for dengue?
What is essential when advanced monitoring is not immediately available during fluid resuscitation for dengue?
What renal function test abnormalities are seen in severe diseases?
What renal function test abnormalities are seen in severe diseases?
Which coagulation abnormalities are typical in severe diseases?
Which coagulation abnormalities are typical in severe diseases?
What conditions are indicated by elevated lactate levels during shock?
What conditions are indicated by elevated lactate levels during shock?
Study Notes
Phases of Dengue Fever in Children
- Febrile Phase: Duration of 2–5 days; children remain febrile throughout; possible biphasic temperature.
- Critical Phase: Occurs 3–4 days after fever onset; plasma leakage and hemoconcentration may lead to hypotensive shock and organ dysfunction.
- Convalescent Phase: Begins after 6–7 days of fever; extracellular fluid returns to circulation, leading to clinical improvement over 2–3 days.
Diagnostic Approach for Dengue Fever
- NS1 Antigen: Glycoprotein appearing at symptom onset, declines in subsequent days; ELISA preferred for its high sensitivity.
- Dengue IgM: Emerges after day 5; present in 70% by day 10 and 100% by day 14; can be detectable for up to a year, impacting diagnostic sensitivity.
- Dengue IgG: Appears in primary infections within 1–2 weeks; persists for life; early and robust response observed in secondary dengue.
- Molecular Tests: PCR options available but NS1 and antibody tests are usually sufficient for diagnosis; high sensitivity in early infections.
Management Principles for Dengue Fever
- Clinical Classification: Assess severity for appropriate management; continuous monitoring essential during critical illness.
- White Blood Cell Count: Typically low; recovery indicated by rise in white cell count preceding platelet increase.
- Platelet Count: Rapid decline during critical phase; recovery marked by platelet increase.
- Liver Function Tests: Mild elevation of SGOT/SGPT, low albumin, and coagulation abnormalities in severe cases.
- Ferritin Levels: Higher in dengue than other febrile illnesses; very high levels associated with severe disease and hemophagocytic lymphohistiocytosis.
- Renal Function Tests: Elevated creatinine and proteinuria indicate severe conditions; metabolic acidosis may present in shock.
Additional Monitoring and Care
- Advanced monitoring (e.g., lung ultrasonography) can aid in fluid therapy decisions.
- Proper management of dengue shock necessary in pediatric intensive care settings; echocardiography may assess hemodynamics after fluid resuscitation.
- Continuous clinical monitoring is crucial, particularly when advanced methods are unavailable.
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Description
This quiz focuses on the febrile and critical phases of illness in children. It covers symptoms, duration, and temperature patterns experienced during these phases. Test your knowledge about how illnesses progress in pediatric patients.
