Dengue Quiz

House Officer Dengue CME

3.0
Q1.
Which statement is true?
A. Febrile phase usually last up to 2 days
B. Critical phase only occur during defervescence phase
C. Earliest abnormality in FBC is sudden decrease in WCC, then Plt
count
D. “Isle of white in the sea of red” is a hallmark of critical phase
Q2
Compensated shock signs are as below EXCEPT:

A. Intense thirst
B. Narrowed pulse pressure
C. Prolonged CRT
D. Tachycardia
Q3
• 24 years old Malay lady, day 4 of illness. Dengue NS1 positive.
Presented with persistent diarrhea x 10 and vomiting.
BP: 108/90mmHg HR: 122 T: 37.8
CRT=2secs, Coolish peripheries
Creat: 140 FBC: Hb 11.8/ HCT- 47/ WCC- 3.9/ Plt- 25
ALT: 519/AST: 800

Write full diagnosis.

Q4-Q10: Write True or False
Q4. Presence of NS1 after day 5 may predict severe dengue

Q5. Dengue IgM maybe detected at day 3 of illness

Q6. Repeat dengue IgG is recommended if dengue IgM is still negative after day 7 with the negative dengue IgG n the
initial test sample.

Q7. Decrease in HCT is a sign of plasma leakage

Q8. Normal HCT levels for male aged 65 is 46%

Q9. Dengue virus is transmitted by Aedes albopictus

Q10. Secondary infection is a major risk for severe dengue

Q11.

In decompensated shock, initial management would be:

A. IV colloid 10cc/kg within 1 hour

B. IV crystalloid run at 20cc/kg over 1 hour
C. IV colloid run at 20cc/kg over 15 min
D. IV crystalloid 10cc/kg over 2-3 hours
Q12.
Which statement is true in Dengue shock syndrome?

A. Pulse pressure of <20mmHg and SBP<90mmHG are early signs of

shock
B. Crystalloid is preferred to colloids in patient with intractable shock
C. Patient could be in shock even with normal BP
D. Sodium bicarbonate is recommended in metabolic acidosis with pH
of 7.1.
Q13.
All are criteria for hospital admissions for dengue cases EXCEPT:

A. Patient aged 60 and above with no comorbidities

B. Pregnant patient with no-comorbidities
C. Patient with reduce urine output
D. Patient with recent MI
Q14-Q19
Write True of False
Q14. Clinical deterioration usually occur during critical phase

Q15. Plasma leakage occurs during late critical phase towards recovery phase

Q16. Low HCT during recovery phase is due to hemodilution

Q17. Patient commonly developed APO during critical phase, if IV fluids is continued

Q18. Dengue patients with mucosal bleeding should be transfused with packed cell

Q19. Prophylactic transfusion of platelets and FFP is indicated once platelets become less than 10
Q20
Which one is NOT a discharge criteria for dengue patient?

A. Patient feeling well

B. Afebrile less than 24 hours
C. Rising WCC followed by platelet count
D. Stable hematocrit