Dengue CPG 2017

Question 1

incubation period of dengue

Answer 1

3-14 days

Question 2

three phases of dengue

Answer 2

1. febrile
2. critical phase
3. recovery

Question 3

acute febrile phase of dengue

Answer 3

lasts 2-7 days
body ache, muscle and joint pains, headache, retro-orbital pain, facial flushing, sore throat, hyperemic pharynx, macular or maculopapular rashe, petechiae, mild mucosal bleeding

*(+) torniquet test and progressive decrease in WBC count

Question 4

marks the beginning of critical phase

Answer 4

during fever defervescence on days 3-7, an increase in capillary permeability in parallel with increasing hematocrit levels

Question 5

convalescent phase

Answer 5

gradual improvement and stabilization of hemodynamic status

Question 6

warning signs of progression to severe dengue occur in late febrile phase

Answer 6

persistent vomiting
mucosal bleeding
early signs of shock

Question 7

signs and symptoms that warrant admission

Answer 7

shortness of breath
irritability or drowsiness
abdominal pain
melena
elevated hematocrit
decreased or decreasing platelet count

Question 8

risk factors associated with mortality

Answer 8

hypotension on admission
narrow pulse pressure
DHF 3 and 4 (severe)
History of previous dengue
prolonged shock
respiratory failure
liver failure (AST elevation >200 and INR >1.3
Renal failure (BUN >20mg and serum crea >1mg)
significant bleeding including GI bleeding
severe plasma leakage in multiple sites

Question 9

laboratory findings that warrant hospital admission

Answer 9

decline in Hgb by >/=20%
thrombocytopenia with APC 40% or 20% increase in lowest and highest Hct
Creatinine >1mg
AST > 1000 u
acidosis

Question 10

True or False.

PT and PTT are recommended as routine tests for patients with dengue

Answer 10

False

Question 11

following signs and symptoms may be associated with significant bleeding

Answer 11

vomiting
abdominal pain
restlessness
pleural effusion
rash

Question 12

recommended fluids for dengue

Answer 12

isotonic solutions such as 0.9% saline or Ringer’s lactate

Question 13

Hypotonic IV fluids used as maintenance can cause

Answer 13

hyponatremia and monitoring plasma sodium level is needed

Question 14

In dengue patients with shock, what fluids are used for resuscitation?

Answer 14

either crystalloids or colloids

Question 15

There is insufficient evidence to say that use of citronella based repellents is more effective than DEET-based repellents in reducing dengue transmission