DENGUE 1.2 (AB) Flashcards

Question

What is the treatment if HCT increases after initial bolus?

Answer 1

Give a second bolus of 10–20 mL/kg/hr for 1 hour.

Answer 2

Crystalloid or colloid solution at 20 mL/kg over 15 minutes.

Answer 3

Low HCT with instability or decreasing HCT suggesting bleeding.

Answer 4

5–10 mL/kg packed red cells or 10–20 mL/kg fresh whole blood.

Answer 5

Cold extremities

Answer 6

Give IV crystalloid fluids and refer urgently to hospital.

Answer 7

Use papaya leaf extract (weak recommendation); avoid tawa-tawa and guava due to lack of evidence.

Answer 8

Increases platelet count

Answer 9

Patients in Group A are able to tolerate adequate volumes of oral fluids, pass urine at least once every 6 hours, and do not have warning signs.

Answer 10

Full Blood Count (FBC) and Hematocrit (HCT).

Answer 11

4 grams maximum per day.

Answer 12

Adequate bed rest, adequate fluid intake, paracetamol (not more than 4 grams per day), tepid sponging, and look for mosquito breeding.

Answer 13

Oral rehydration solution (ORS) should be given based on weight, such as 100 mL/kg/day for >3-10 kg, 75 mL/kg/day for >10-20 kg, and so on.

Answer 14

Sports drinks should not be given due to high osmolarity.

Answer 15

Bleeding (e.g., red spots, bleeding from nose/gums), vomiting blood, black-colored stools, heavy menstruation, frequent vomiting, severe abdominal pain, drowsiness, mental confusion, pale cold hands and feet, and difficulty breathing.

Answer 16

Steroids have no role in treating dengue and are not recommended by WHO due to lack of efficacy and potential side effects like gastrointestinal bleeding and hyperglycemia.

Answer 17

Initial CBC should be requested to establish baseline hematocrit and platelet count. Daily CBC may be done as part of disease monitoring, and monitoring can be discontinued when the patient is in the recovery phase.

Answer 18

Yes, ORS should be given to prevent poor outcomes, though the evidence is of very low certainty.

Answer 19

Patients with co-existing conditions like pregnancy, diabetes, renal failure, and social circumstances such as living alone. Warning signs like vomiting, abdominal pain, lethargy, mucosal bleeding, and impaired consciousness also require in-hospital care.

Answer 20

Increase in hematocrit, decrease in platelet count, elevation of transaminases, impaired PT or PTT, and thrombocytopenia.

Answer 21

Start isotonic IV fluids like 0.9% saline or Ringer's Lactate at maintenance rate. Monitor HCT and clinical status to adjust fluid rates.

Answer 22

For patients weighing 0-10 kg, the total fluid requirement is 100 mL/kg. For 10-20 kg, it's 1,000 mL + 50 mL/kg for each kg over 10 kg, and for >20 kg, it's 1,500 mL + 20 mL/kg for each kg over 20 kg.

Answer 23

Initiate IV fluid resuscitation with isotonic crystalloid solutions at 5-10 ml/kg/hr over 1 hour, then adjust according to clinical response.

Answer 24

Give 5-10 ml/kg of fresh packed red cells or 10-20 ml/kg of fresh whole blood.

Answer 25

Cold, clammy extremities, prolonged capillary refill time, weak pulse, severe bleeding, and impaired consciousness.

Answer 26

Papaya leaf extract may be used as a supplement, but tawa-tawa and guava preparations should be avoided due to insufficient evidence.

Answer 27

Papaya leaf extract helps in increasing platelet counts, reducing illness duration, and lowering the risk of requiring platelet transfusions.

DENGUE 1.2 (AB) Flashcards

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