Dengue Quiz for Interns

Which of the following is a key clinical feature of the critical phase in pediatric dengue infection?

• Persistent high-grade fever for more than 7 days

• Sudden rise in platelet count

• Plasma leakage and signs of circulatory shock

• Presence of IgG antibodies to dengue virus

What is the recommended initial intravenous fluid for a child with dengue decompensated shock during the critical phase?

• 5% Dextrose in Normal Saline (D5S)

• 0.9% Normal Saline Solution (NSS)

• Lactated Ringer’s Solution

• 10% Dextrose in water (D10W)

Which of the following is an indication for hospital admission in a child suspected of having dengue infection?

• Fever subsiding within 24 hours

• Good oral intake and hydration

• Persistent vomiting or severe abdominal pain

• Epistaxis

During the critical phase of dengue hemorrhagic fever without shock, how often should the platelet count typically be monitored?

• Every 24 hours

• Every 12 hours

• Every 6 hours

• Every 2 hours

Which of the following antipyretics should be avoided in children with dengue fever?

• Acetaminophen

• Ibuprofen

• Aspirin

• None of the above

A 10-year-old boy presents on day 4 of high-grade fever. He appears lethargic, has vomited three times in the past 6 hours, and complains of abdominal pain. His vital signs are as follows: BP 98/60 mmHg, pulse 100 bpm, capillary refill 2 seconds. His hematocrit (Hct) has increased from 36% yesterday to 42% today. Platelet count is 90,000/mm³. What is the most appropriate next step in management?

• Discharge with oral rehydration and close outpatient follow-up

• Begin oral antipyretics and advise strict fluid intake at home

• Admit for observation and initiate intravenous fluid therapy

• Start antibiotics to cover for sepsis

A 7-year-old girl with confirmed dengue is admitted on day 5 of illness. She develops cold extremities, tachycardia (HR 140 bpm), and delayed capillary refill (>3 sec). BP is 80/50 mmHg. Her hematocrit is 48% (baseline 38%), and platelet count is 25,000/mm³. She has no active bleeding. What is the most appropriate initial fluid resuscitation?

• 10 mL/kg of D5W over 1 hour

• 10 mL/kg of Normal Saline over 15 minutes

• 10 mL/kg of Dextran 40 over 1 hour

• 10 mL/kg of Lactated Ringer’s solution over 1 hour