21 S P M P On Short Febrile Illness
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A 25-year-old man presents with a 2-day history of fever. The document discusses the diagnosis and management of viral fevers like dengue, chikungunya, and others. It provides guidance on history taking, physical examination, investigations, and treatment of uncomplicated viral fevers as well as management of potential complications. Antibiotics are only indicated for secondary bacterial infections while supportive care with antipyretics and fluids are the mainstay of treatment. Admission is required for suspected severe illnesses or complications.
![SPMP on Short Febrile Illness Dr. S. Aswini Kumar. MD, A 25 year-old man is brought to the OP department with history of fever of two days duration XXI. 01. Diagnosis of viral fever can be arrived at from the following history EXCEPT: High grade fever of continuous nature Yellowish discoloration of eyes and urine Generalized aches and pains Non-specific headaches Running nose and throat pain XXI. 02. You will proceed with a physical examination to demonstrate the following: Temperature assessment by palpation Inspection of the upper respiratory tract Palpation of the abdomen for hepatosplenomegaly Auscultation of the chest for adventitious sounds all of the above XXI. 03. The diagnosis of Weil’s disease can be excluded, if the following clinical features are present EXCEPT: Icterus Sub-conjunctival hemorrhage Muscle tenderness Increased urine output History of possible exposure to rat’s urine XXI. 04. The diagnosis of Dengue fever can be considered clinically by the following: Retro-orbital pain Generalized maculopapular rash Positive tourniquet test Epidemic spread in the community All of the above XXI. 05. Chikungunya fever can be considered from the presence of the following: Epidemic outbreak Pain and swelling of medium sized joints Severe functional disability Leucopenia All of the above XXI. 06. Investigations that may be done routinely to exclude other causes of fever are the following: Total leukocyte count and differentials Peripheral smear Platelet counts Urine routine examination All of the above XXI. 07. The following general measures are to be taken in the case of uncomplicated viral fevers EXCEPT: All patients should be admitted Complete bed rest Plenty of oral fluids Light easily digestible diet Antipyretic medications SOS XXI. 08. If the temperature is more than 400C, It can be managed by the following: Tepid sponging Covering with thick blanket Oral acetaminophen tablets Good ventilation All of the above XXI. 09. The technique of giving tepid sponging includes all of the following EXCEPT: Luke warm water is to be used A large soft cotton cloth is preferred Ice cubes may be put in the water Whole body is to be wiped A slow current of air may be used XXI. 10. Mediations that may be routinely prescribed are the following EXCEPT: Acetaminophen Phenylephrine Chlorpheneramine Ibuprofen Saline nasal drops XXI. 11. Antibiotic therapy is indicated in the following circumstances EXCEPT: All patients with viral fever Secondary bacterial infection Extremes of age Immunocompromized Very ill patient ,[object Object],Tab Ranitidine 150mg BID Tab Domperidone 10mg TID Tab Ibuprofen 800mg TID Liquid antacids 2tsp TID Adequate oral intake XXI. 13. Indications for admission in a patient with suspected viral fever are the following EXCEPT: ,[object Object]](https://image.slidesharecdn.com/21spmponshortfebrileillness-090820020921-phpapp01/85/21-s-p-m-p-on-short-febrile-illness-1-320.jpg)
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21 S P M P On Short Febrile Illness
- 3. Old aged or debilitated patient
- 5. All referred casesXXI. 14. Life threatening complications of viral fever are the following EXCEPT: Myocarditis Bronchopneumonia Meningoencephalitis Thrombocytopenia Acute renal failure XXI. 15. The above complications can be suspected from the following EXCEPT: Tachycardia out of proportion to fever Tachypnoea out of proportion to lung signs Alteration in sensorium and seizures Bleeding manifestations Flapping tremor of hands XXI. 16. Viral Meinigoencephalitis should be managed by the following, EXCEPT: Inj. Mannitol 200mg IV q8hrly Inj. Acyclovir 800mg IV q8hrly Inj. Amiodorone 200mg IV q8hrly Inj. Dexamethazone 2mg q6hrly Inj. Dilantin Sodium 100mg q 6hrly XXI. 17. The following statements regarding Viral Myocarditis are true, EXCEPT: High index of suspicion is required for the diagnosis Blood pressure should be assessed serially ECG will show sinus tachycardia and ST- T changes If no hypotension Outpatient management is preferred Admission to MICU and close observation are mandatory