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dengue/ malaria Flashcards

1
Q 
A 3 years old boy presents with high grade fever x 3 days, persistent vomiting and abdominal pain. She was brought to the emergency room for epistaxis and gum bleeding. Tourniquet test was negative and blood pressure was normal. CBC revealed Hgb 10g/L and Hct 40, WBC 4500, Plt 95, Dengue IgM Positive. Based on the old classification of Dengue, this patient is to be diagnosed as:
A. DHF I
B. DHF II
C. DHF III
D. DHF IV
E. None of the above
A

B. DHF II

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2
Q 
Based on the new classification for Dengue, this patient is to be diagnosed as:
A. Dengue without warning signs
B. Dengue with warning signs
C. Severe Dengue
D. Dengue Fever
E. None of the above
A

B. Dengue with warning signs

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3
Q

What is the recommended initial IV fluid resuscitation for patient with compensated shock?
A. Plain isotonic crystalloid 20mL/kg over 15 mins
B. Plain isotonic crystalloid 20 mL.kg over 1 hour
C. Plain isotonic crystalloid 10-15 mL/kg over 15 mins
D. Plain isotonic crystalloid 10-15 mL/kg over 1 hour
E. None of the above

A

D. Plain isotonic crystalloid 10-15 mL/kg over 1 hour

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4
Q 
What is the recommended duration of IVF therapy for patients who went into shock?
A. Less than 24 hours
B. 24-48 hours
C. 48-72 hours
D. No limit
E. None of the above
A

B. 24-48 hours

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5
Q 
In the OLD Classification of Dengue, all should be present, EXCEPT:
A. Fever for 2-7 days
B. Hemorrhagic tendencies e.g. petechiae
C. Thrombocytopenia
D. Evidence of plasma leakage
E. None of the above
A

E. None of the above

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6
Q 
How long is the critical phase in Dengue?
A. Less than 24 hours
B. 24-48 hours
C. 48-72 hours
D. 3-5 days
E. None of the above
A

B. 24-48 hours

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7
Q 
What is the appropriate IV Fluid to be used initially during the critical period in Dengue
A. Hypotonic solution
B. Isotonic solution
C. Hypertonic solution
D. Colloid solution
E. None of the above
A

B. Isotonic solution

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8
Q 
8. Which IV fluid can result to hyperchloremic metabolic acidosis if left unchecked in patients with increase Cl levels in the blood?
A. PNSS
B. PLRS
C. D5 0.3NaCl
D. 0.45 NaCl
E. None of the above
A

A. PNSS

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9
Q 
This IV fluid solution is contraindicated in patients with liver failure or liver problem
A. PNSS
B. PLRS
D50.3NaCl
D. 0.45 NaCl
E. None of the above
A

B. PLRS

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10
Q 
The following are characteristic of patients with compensated shock, EXCEPT:
0/1
A. BP less than 5th percentile
B. Narrow pulse pressure
C. Clear and lucid
D. Cool extremities
E. None of the above
A

A. BP less than 5th percentile

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11
Q 
The initial CBC monitoring for Dengue patients who presents with shock should be done?
A. Pre resuscitation
B. Post resuscitation
C. Anytime
D. 6 hours post resuscitation
E. None of the above
A

A. Pre resuscitation

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12
Q 
The following should be anticipated in dengue patient during convalescent/recovery phase, EXCEPT:
A. Nosocomial infection
B. Fluid overload
C. Decreasing platelet count
D. Improved appetite
E. None of the above
A

C. Decreasing platelet count

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13
Q

The following are indications for IV colloid solutions, EXCEPT:
A. Signs of fluid overload
B. Continue rising Hct/persistent high Hct
C. Too much IV fluid
D. Shock
E. None of the above

A

E. None of the above

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14
Q 
The following blood products can be used in dengue patients, EXCEPT:
1/1
A. pRBC
B. FWB
C. Platelet concentrate
D. FFP
E. None of the above
A

E. None of the above

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15
Q

The following are causes of mortality in dengue patients, EXCEPT:
A. Prolonged shock
B. Bleeding
C. Fluid overload
D. Poor monitoring on the part of the doctors/nurses
E. None of the above

A

E. None of the above

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16
Q 
A 3 year old female presented with paroxysm of fever and chills, associated with diaphoresis, cough, body malaise and arthralgia who recently visited the Philippines. What is your diagnosis?
A. Dengue
B. Malaria
C. COVID 19
D. Influenza
E. None of the above
A

B. Malaria

17
Q 
What is the best test of choice for malaria?
A. Thick and thin smear
B. PCR of blood
C. ELISA for Malaria titers
D. CSF malaria PCR
E. None of the above
A

A. Thick and thin smear

18
Q 
Which of the following is not a complication of malaria
A. Prostration
B. Seizures
C. Severe anemia
D. Cognitive impairment
E. None of the above
A

E. None of the above

19
Q 
Which of the following is not a common symptom seen with malaria?
A. Fever
B. Sandpaper rash
C. Hepatosplenomegaly
D. Jaundice
E. None of the above
A

B. Sandpaper rash

20
Q 
20. Which of the following strain have a dormant form?
A. P. vivax 
B. P. falciparum
C. P. knowlesi
D. P. malariae
E. none of the above
A

A. P. vivax

21
Q 
Which of the following drugs is not used to treat malaria?
A. Chlordiazepoxide
B. Malarone
C. Quinine
D. Coartem
E. None of the above
A

A. Chlordiazepoxide

22
Q

Which of the following is NOT a strategy to prevent contracting malaria?
A. wearing insect repellant on the body during the day
B. Having a mosquito net over the bed at night
C. Anti-malaria vaccine
D. Covering the body with clothing
E. None of the above

A

C. Anti-malaria vaccine

23
Q 
Why does splenomegaly develop in patients infected with malaria?
A. Increase in prouction of RBC
B. Entrapment of RBC in the spleen
C. Increase in BP due to low RBC levels
D. Increase in growth hormone
E. None of the above
A

B. Entrapment of RBC in the spleen

24
Q 
What is the incubation period of P. falciparum?
0/1
A. 12-17 days
B. 16-18 days
C. 18-40 days
D. 9-14 days
E. None of the above
A

D. 9-14 days

25
Q 
Which organismis a vector of plasmodium that cause disease in humans?
A. Female Anopheles
B. Male Anopheles
C. Aedes aegypti
D. Sporothrix schenkii
E. None of the above
A

A. Female Anopheles

26
Q 
What is the mechanism of action of Chloroquine?
1/1
A. It blocks heme detoxification in RBC 
B. Blocks G6PD enzymes
C. Blocks dihydrofolate reduction
D. Blocks H2O2 production
E. None of the above
A

A. It blocks heme detoxification in RBC

27
Q 
Which of the following species of plasmodium does not cause malaria in humans?
A. P. vivax
B. P. sporozyte
C. P. ovale
D. P. falciparum
E. None of the above
A

B. P. sporozyte

28
Q 
Which cells in human blood are most affected by plasmodium?
A. Platelets
B. RBC
C. Macrophages
D. Lymphocytes
E. None of the above
A

B. RBC

29
Q 
What is the best way to prevent malarial infection during the night?
1/1
A. Bed nets
B. Primaquine as prophylaxis
C. UV night lamps
D. Methotrexate as prophylaxis
E. None of the above
A

A. Bed nets

30
Q 
How many types of malarial strains can be transmitted to humans by mosquitos?
0/1
A. 4
B. 5
C. 2
D. 3
E. None of the above
A

B. 5

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