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WorksheetsDengue workshop
Total questions: 16
Worksheet time: 9mins
How is dengue fever transmitted ?
Bite of an infected mosquito
Bite of an infected male Aedes mosquito
Bite of an infected female Anopheles mosquito
Bite of an infected female Aedes mosquito
Aedes aegypti is also vector for the following EXCEPT:
Zika
Yellow fever
Chikungunya
Malaria
Dengue fever incubation period ranges from :
1-12 days
3-14 days
14-28 days
28-32 days
45 years old lady, currently diagnosed as dengue fever day 4 of illness in defervescence phase 24 hours complaint to you minimal amount of hematemesis.
O/E, clinically pink, CRT < 2 sec, good pulse volume, not tacchypnoiec BP 101/ 70 PR 110 SP02 99% under RA
Lungs clear Abdomen tender at epigastrium , PR brownish
HB 10 / TWC 3.2/ PLT 30/ HCT 46 VBG, Lactate, Coag - in process
What is your next 1st step?
Refer surgical for urgent OGDS
Platelet transfusion , IV Nexium and refer surgical for OGDS
Fluid resuscitation as compensated shock protocol
IV Nexium infusion
You are the MO in district hospital, reviewing one case in ED. 35 years old female with u/l DM, complaint of fever for 4 days associated with myalgia, joint pain and retroorbital pain. Fever resolved this morning, however complaint of breathlessness
O/E CRT < 2 sec, good pulse volume, pink, RR 24
BP 101/70 PR 100 SP02 92% under RA, 98% under NP023l
Lungs- reduced breath sound with stony dullness bilaterally up to MZ , Abd soft, minimal ascites, no pedal edema
FBC Hb 12/ TWC 2.8/ PLT 50/ HCT 46 Dengue combo IgG - ve , IgM +ve, NS1 ag +ve , RTK ag -ve
CXR bilateral pleural effusion up to midzone
What is your next plan ?
Start IV lasix 40mg stat and refer tertiary hospital
Admit ward for observation
Start IVD 1.2cc/ kg/ hr and admit ward
Start IVD 5cc/ kg/ hr and refer tertiary hospital
28 years old technician, Male with NKMI complaint of fever, myalgia , joint pain and retroorbital pain for 2 days. He is still able to take orally.
O/E not in distress, CRT< 2 sec, good pulse volume, not tacchypnoiec, pink, hydration good
He lives with his wife and 2 children
Lungs clear, Abdomen soft
FBC Hb 12/ TWC 2.5/ PLT 101/ HCT 44 RTK ag -ve Dengue combo NS1 +ve, IgG and IgM negative
What is your plan ?
Admit medical ward dengue cubicle
Allow discharge with ibuprofen for joint pain
Allow discharge and verbal advise to come stat if developed warning sign
Discharge with MC and dengue card for blood taking cm , TCA stat if warning sign
Choose the correct statement (s)
plasma leakage is one of the feature of dengue hemorrhagic fever
there is no role for endoscopic intervention when patient had persistent UGIB with thrombocytopenia
we need to do baseline coagulation profile for patient admitted with dengue fever
Dengue patient who had petechiae and mucosal bleed warrants platelet transfusion if platelet counts less than 50k
What are the risk factor(s) of bleeding complications in dengue fever
prolong duration of shock
persistent vomiting
persistent thrombocytopenia during recovery phase of dengue fever
chronic use of NSAIDs
I will suspect occult bleeding in dengue fever if patient has..
refractory shock in severe dengue
unexplained lactate acidosis
plasma leakage with significant hemoconcentration
drop in hematocrit after patient stabilized with fluid resuscitation in plasma leakage
Treatment for dengue carditis :
Antiviral
IV immunoglobulin
IV Methylprednisolone
Supportive with just sufficient fluids therapy
These statements are false for dengue encephalitis EXCEPT:
Normal CSF
No features of high ICP
Treatment for dengue encephalitis is pulse IV MTP
Lumbar puncture is absolute contraindication
Below are the roles of Point of care ulltrasound ( POCUS) in the management of dengue EXCEPT :
Identifying the type of dengue virus
Predicting disease severity
Evaluate clinical parameters, especially plasma- leaking
Guiding fluid replacement therapy
These are the manifestations of hemophagocytosis :
I. Occur in early disease
II. Normal or low serum ferritin
III. Mimicking sepsis
IV. Fever
II, III, IV
I, II, IV
III, IV
All the above
In Algorithm C, Dengue Fluid Resuscitation include management of fluid in all these conditions EXCEPT
Decompensated shock
Compensated shock
Septicaemic shock
Cytokine storm
To prevent fluid overload, what type of diuretic should be given to the patient?
Loop diuretic
Potassium sparing diuretic
Osmotic diuretic
None of the above
Predictors of Severe Dengue in ultrasound may include the following except
Pericholecystic collection
Gallbladder wall thickness
Ascites
Pleural effusion
