Table 6 Clinical Knowledge Questions
Question | Response Selected | n (%) |
|---|---|---|
1. An 8-year old male patient presents to your office with a 4 day history of fever, nausea, vomiting three times per day, and joint aches. He is accompanied by his mother, who reports that he has been less active over the past few days and seems to be getting more uncomfortable. You note the following abnormalities on physical exam: The patient has bleeding of the oral mucosa, a palpable mass on the right side 2 cm below the ribs, and winces when you palpate his abdomen. You do not observe fluid in the abdomen or difficulty breathing. Based on current WHO guidelines, this patient is best classified as: | (n = 73) | |
Dengue fever | 0 (0 %) | |
Dengue hemorrhagic fever | 5 (7 %) | |
Dengue shock syndrome | 0 (0 %) | |
Dengue without warning signs | 2 (3 %) | |
Dengue with warning signs (T) | 61 (83 %) | |
Severe dengue | 5 (7 %) | |
2. A 5-year-old girl patient presents to your office with a few days of fever and a distended, painful abdomen. Her mother states that she has been less active over the past 3 days. It is currently February and you have seen six patients in the past 3 weeks with dengue infections. The best course of action in managing this patient is to: | (n = 73) | |
Order dengue lab tests, tell the patient to get rest at home, and ask the patient to return to your office in 24 h | 10 (14 %) | |
Order dengue lab tests and admit the patient to the hospital for 24 h of observation (T) | 54 (74 %) | |
Order dengue lab tests and admit the patient to the Intensive Care Unit for close monitoring and access to emergency care | 9 (12 %) | |
3. A 27-year-old male patient presents to your office in February with two days of fever and complaints of muscle aches. He notes that he has had three episodes of non-bloody vomiting in the past two days. The patient notes that his younger sister has similar symptoms. You recall hearing numerous reports of dengue infection during the last month. The best course of action in managing this patient is to: | (n = 71) | |
Order dengue lab tests, tell the patient to get rest at home, and ask the patient to return to your office in 24 h (T) | 52 (73 %) | |
Order dengue lab tests and admit the patient to the hospital for 24 h of observation | 19 (27 %) | |
Order dengue lab tests and admit the patient to the ICU for close monitoring and access to emergency care | 0 (0 %) | |