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  #1  
Old 03-23-2012
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Pediatrics Infant died in India!

NOTE: this is a USMLE Consult-"inspired" question, so look away if you plan on using USMLE Consult as a measure of your progress.


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A 1.5-month-old infant was admitted to the pediatric intensive care unit in a large hospital in India with a 2-day history of fever, inconsolable crying, and refusal to feed. On physical examination, his results were as follows:

Rectal temperature: 39C
Heart rate, 150 beats/min
Respiratory rate, 50 breaths/min

The laboratory findings included the following:
Hemoglobin, 13 g/dL
Complete blood count (CBC): 6,300/μL
26% neutrophils
68% lymphocytes
6% monocytes
Platelet count: 50,000/μL.

The next day, the baby's blood pressure dropped, and he developed melena, petechial rash, and circumoral cyanosis with cold clammy extremities:

Platelet count: 36,000/μL
Alanine aminotransferase (ALT), 1401 U/L
Aspartate aminotransferase (AST), 1799 U/L
Lactate dehydrogenase (LDH), 1999 U/L

The infant died despite aggressive fluid resuscitation and vasopressor therapy. The baby's serum tested positive for immunoglobulin G (IgG) and immunoglobulin M (IgM), whereas the mother's serum had IgG only directed against a flavivirus. What is the most likely diagnosis?

A. Yellow fever
B. Dengue shock syndrome
C. Ebola hemorrhagic fever
D. Malaria
E. African trypanosomiasis
F. Infant doesn't drink enough milk
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  #2  
Old 03-23-2012
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it's either yellow fever or dengue syndrome

but since the baby has a petichial rash.. it's dengue
yellow fever doesnt consist of a rach
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Old 03-23-2012
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Cold, clammy extremities --> also characteristic of dengue not yellow fever




are all the questions in this question bank this twisted?? :S
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Old 03-23-2012
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B. Dengue shock? (Chosing between Yellow fever and this, guessing)
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Old 03-23-2012
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Default answer = B

the answer is B. Dengue shock syndrome
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Old 03-23-2012
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It's B....dengue shock syndrome.....characteristic patechial rash thrombocytopenia hypotension....liver damage
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Old 03-23-2012
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Dengue fever, also known as breakbone fever, is an infectious tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to measles. In a small proportion of cases the disease develops into the life-threatening dengue hemorrhagic fever, resulting in bleeding, low levels of blood platelets and blood plasma leakage, or into dengue shock syndrome, where dangerously low blood pressure occurs.
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Old 03-23-2012
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Its dengue. Yellow fever is almost unheard of in India.

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