Communicable diseases: dengue management: practice question

A PSM 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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PSM · Communicable diseases: dengue management

Sample item

A 22-year-old man has fever for 5 days that has just settled. He now has abdominal pain, persistent vomiting, cold extremities and bleeding gums. Haematocrit has risen by 25% from baseline, and platelet count is 38,000 per microlitre. What is the most appropriate next step?

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

The answer and the reasoning

B. Intravenous isotonic crystalloid with close haematocrit and vital monitoring

Defervescence with warning signs and a rising haematocrit marks the critical phase of dengue, in which plasma leakage can progress to shock. Intravenous isotonic crystalloid is given in carefully titrated amounts, and the haematocrit and vitals guide the rate. Platelet transfusion is not given prophylactically, and aspirin and other NSAIDs are avoided because of bleeding risk.

Option by option

  • A. Aspirin for fever and pain control

    Aspirin worsens bleeding and platelet dysfunction; paracetamol is the antipyretic of choice.

  • B. Intravenous isotonic crystalloid with close haematocrit and vital monitoring (correct)

    Correct. Fluid replacement guided by haematocrit treats plasma leakage in the critical phase.

  • C. Empirical broad-spectrum antibiotics with corticosteroids

    Dengue is viral, so antibiotics and steroids do not address plasma leakage.

  • D. Prophylactic platelet transfusion

    Prophylactic platelet transfusion does not prevent bleeding and can cause fluid overload; transfusion is reserved for significant 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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Questions about this PSM question

What is the answer to this PSM question?

The best answer is B, Intravenous isotonic crystalloid with close haematocrit and vital monitoring. Defervescence with warning signs and a rising haematocrit marks the critical phase of dengue, in which plasma leakage can progress to shock.

Why is "Aspirin for fever and pain control" not the answer?

Aspirin worsens bleeding and platelet dysfunction; paracetamol is the antipyretic of choice.

Why is "Empirical broad-spectrum antibiotics with corticosteroids" not the answer?

Dengue is viral, so antibiotics and steroids do not address plasma leakage.

Why is "Prophylactic platelet transfusion" not the answer?

Prophylactic platelet transfusion does not prevent bleeding and can cause fluid overload; transfusion is reserved for significant bleeding.

What concept does this question test?

It tests Communicable diseases: dengue management in PSM. Intravenous isotonic crystalloid is given in carefully titrated amounts, and the haematocrit and vitals guide the rate. Platelet transfusion is not given prophylactically, and aspirin and other NSAIDs are avoided because of bleeding risk.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Communicable diseases: dengue management?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM 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.