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Pediatrics · Paediatric infections: dengue critical phase
Sample itemA 6-year-old with 4 days of fever now has defervescence, abdominal pain, persistent vomiting, rising haematocrit and falling platelets. Which management principle is correct?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Careful IV crystalloid with monitoring; avoid steroids and NSAIDs
The critical phase of dengue occurs around days 3 to 7 as fever settles, with plasma leakage evident as rising haematocrit and warning signs. Management is judicious fluid therapy, with paracetamol for fever, and avoidance of NSAIDs, aspirin and steroids.
Option by option
A. Careful IV crystalloid with monitoring; avoid steroids and NSAIDs (correct)
Correct. Fluids are guided by haematocrit and clinical status.
B. Give high-dose steroids
Steroids have no benefit in dengue.
C. Give aspirin for pain
Aspirin and NSAIDs increase bleeding risk.
D. Prophylactic platelet transfusion
Prophylactic platelet transfusion is not recommended without bleeding.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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