Infectious diseases: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Infectious diseases

Sample item

On day 5 of fever, a 20-year-old with confirmed dengue has persistent vomiting, abdominal pain and bleeding gums. His platelet count falls to 30,000 and haematocrit rises by 25% above baseline. What is the most appropriate step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Admit and give isotonic crystalloid cautiously, guided by haematocrit and vital signs

Warning signs of severe dengue, such as abdominal pain, persistent vomiting, mucosal bleeding and a rising haematocrit with falling platelets, indicate plasma leakage in the critical phase. Management is careful intravenous crystalloid titrated to haematocrit and haemodynamics, avoiding fluid overload. NSAIDs and aspirin are avoided, and platelet transfusion is not given prophylactically.

Option by option

  • A. Give high-dose steroids

    Steroids have no proven benefit in dengue.

  • B. Give prophylactic platelet transfusion

    Prophylactic platelet transfusion does not improve outcome and may cause fluid overload.

  • C. Admit and give isotonic crystalloid cautiously, guided by haematocrit and vital signs (correct)

    Correct. Careful fluid replacement guided by haematocrit treats plasma leakage.

  • D. Give aspirin for fever

    Aspirin and NSAIDs increase bleeding risk and are contraindicated.

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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Admit and give isotonic crystalloid cautiously, guided by haematocrit and vital signs. Warning signs of severe dengue, such as abdominal pain, persistent vomiting, mucosal bleeding and a rising haematocrit with falling platelets, indicate plasma leakage in the critical phase.

Why is "Give high-dose steroids" not the answer?

Steroids have no proven benefit in dengue.

Why is "Give prophylactic platelet transfusion" not the answer?

Prophylactic platelet transfusion does not improve outcome and may cause fluid overload.

Why is "Give aspirin for fever" not the answer?

Aspirin and NSAIDs increase bleeding risk and are contraindicated.

What concept does this question test?

It tests Infectious diseases in General Medicine. Management is careful intravenous crystalloid titrated to haematocrit and haemodynamics, avoiding fluid overload. NSAIDs and aspirin are avoided, and platelet transfusion is not given prophylactically.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infectious diseases?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.