Dengue fever

What is the incubation period for dengue fever?

• 2 - 4 days

• 4 - 7 days

• 7 - 10 days

• 10 - 14 days

When is it useful to send a dengue PCR?

• Between day 1 to day 5 of illness

• Between day 6 to day 7 of illness

• After day 7 of illness

• It is not useful

A patient presents to you with 6 days of acute febrile illness. His dengue NS1 is negative. What would you do next?

• Resend dengue NS1, as you do not trust the 1st result

• Send dengue IgM

• Send dengue IgG

• Consult Dr Foong & Dr Siti

Which of the following will not cause a false positive dengue serology result?

• Malaria

• Leptospirosis

• Scrub typhus

• Japanese encephalitis

Which weight should be used to calculate the fluid requirement in a patient with BMI of 30?

• Actual body weight

• Ideal body weight

• Adjusted body weight

• Just "agak agak" (estimate) by looking at the patient

A dengue patient in your ICU in critical phase is on 2 ml/kg/hr IV drip. His latest BP is 98/83 (MAP 88), HR is 98 bpm, CRT > 2 sec. What is your immediate next step of action for the patient?

• Give 10 ml/kg/hr crystalloid for 1 hour and reassess

• Give 20 ml/kg/hr colloid within 30 mins and reassess

• Repeat the BP reading

• Call Dr Foong / Dr Siti stat even though they are on leave

Which of the following is not a common cause of shock in dengue?

• Cardiogenic shock

• Liver failure

• Cytokine storm

• Pulmonary embolism

Which of the following is not a warning sign in dengue?

• Diarrhea 3 times in the past 24 hours

• Tender liver on palpation

• Ascites from bedside ultrasound

• Gum bleeding after brushing teeth

A dengue patient in compensated shock did not respond to 1st bolus of 10 ml/kg/hr 0.9% NaCl, with increasing HCT. What would you do next?

• Give a 2nd bolus of crystalloid, but use Hartmann instead

• Give a bolus of colloid

• Transfuse packed cells 10 ml/kg

• Call all the ICU trainees to come manage (Intensivists on long leave)

You suspect HLH in a dengue patient. What would you do next to support your diagnosis?

• Refer to hematology team to save time and mental fatigue

• Subscribe to UpToDate to find out diagnostic criteria for HLH

• Send serum ferritin

• Send procalcitonin