p.4
Dengue Fever Diagnosis and Management
When is the NS1 antigen detectable in dengue virus infection?
During the first 0-7 days of symptoms.
p.2
Malaria Transmission Vectors
What is the most common vector of malaria?
Female mosquitoes of the genus Anopheles.
p.4
Dengue Fever Diagnosis and Management
What does a positive IgM test result indicate?
Presumptive recent dengue virus infections.
p.7
Dengue Fever Diagnosis and Management
What is hemoconcentration in severe dengue primarily due to?
Recent evidence points to a key role for the dengue virus NS1 protein in the vascular leak phenomenon associated with severe dengue.
p.3
Malaria Life Cycle and Dormant Forms
What is the cause of the patient's relapse in malaria?
Dormant forms (hypnozoites) remain inert and eventually break out to cause symptoms.
p.14
Anaphylaxis and Its Management
What is the role of the newly recognized Mas-related G protein–coupled receptor (MRGPX2)?
It activates mast cells in an IgE-dependent manner.
p.4
Dengue Fever Diagnosis and Management
By when should nearly all immunocompetent individuals develop IgG antibodies to dengue virus after exposure?
By 3 weeks following exposure.
p.1
First-line Treatment for Malaria
What is the recommended first-line treatment for uncomplicated cases of P. falciparum?
Artemisinin-based combination therapy (ACT).
p.9
First-line Treatment for Malaria
What drug can be given for severe malaria infection?
Artesunate (2.4 mg/kg stat IV followed by 2.4 mg/kg at 12 and 24 h and then daily if necessary).
p.7
Enteric Fever Diagnosis and Treatment
What is the definitive diagnosis for enteric fever?
Isolation of the Salmonella Typhi bacterium through blood culture.
p.4
Dengue Fever Diagnosis and Management
What is the primary dengue test to request during the acute phase of illness?
Dengue NS1, which detects the nonstructural protein NS1 of the dengue virus.
p.2
Severe Malaria Manifestations
What symptoms occur during classic malarial paroxysms?
Fever spikes, chills, and rigors.
p.5
Dengue Fever Diagnosis and Management
What is true about the rash of dengue fever?
It appears near the time of defervescence on days 3–5.
p.18
Hypersensitivity Reactions
What is AGEP an example of?
A type of hypersensitivity reaction.
p.5
Dengue Fever Diagnosis and Management
What is the management for a patient with dengue fever showing WBC 4, Hct 50, Hgb 110, neutrophils 50%, lymphocytes 50%, and platelets 80?
B. Patient belongs to group B (dengue case with warning signs) and hydration is necessary.
p.20
Malaria Life Cycle and Dormant Forms
What type of information can be found on page 408 of Harrison’s Principles of Internal Medicine?
Detailed medical knowledge relevant to internal medicine.
p.6
Dengue Fever Diagnosis and Management
When does the rash appear in relation to the lysis of fever?
After the lysis of fever.
p.17
Hypersensitivity Reactions
What is the role of IL-5 in the immune response?
It stimulates the production of eosinophils in the marrow and activates eosinophils at sites of immune responses.
p.2
Severe Malaria Manifestations
Which of the following is NOT part of the classic malarial paroxysms?
None of the options provided (fever spikes, chills, rigors are all part of it).
p.9
First-line Treatment for Malaria
What is an alternative drug to Artesunate for severe malaria if unavailable?
Artemether (3.2 mg/kg stat IM followed by 1.6 mg/kg qd).
p.12
Histamine and Its Role in Allergic Reactions
What do mast cells release that is important in local inflammatory response?
Histamine, which promotes vascular permeability and smooth muscle contraction.
p.19
Hypersensitivity Reactions
What is Type IVd hypersensitivity?
It includes conditions such as Serum Sickness, AGEP, Contact Dermatitis, Drug Induced Thrombocytopenia, and Anaphylaxis.
p.17
Hypersensitivity Reactions
What are some symptoms of an anaphylactic reaction?
Hypotension, difficulty in breathing or hypoxia, and/or circulatory failure.
p.2
Malaria Transmission Vectors
How does temperature affect the biting rates of Anopheles mosquitoes?
Increasing temperature from 21 to 32°C almost doubles the biting rates.
p.4
Dengue Fever Diagnosis and Management
What does the presence of IgG antibodies to dengue virus indicate?
Exposure to the virus sometime in the past.
p.7
Enteric Fever Diagnosis and Treatment
What is the prominent symptom of enteric fever?
Fever and abdominal pain, with rose spots being variable.
p.10
Malaria Transmission Vectors
How does human infection with malaria begin?
When a female anopheline mosquito inoculates plasmodial sporozoites during a blood meal.
p.5
Dengue Fever Diagnosis and Management
What is the timing of the rash appearance in dengue fever?
Near the time of defervescence on days 3–5, a maculopapular rash begins on the trunk and spreads to the extremities and the face.
p.19
Hypersensitivity Reactions
What is AGEP in the context of Type IVd hypersensitivity?
Acute Generalized Exanthematous Pustulosis, a skin reaction.
p.11
Hypersensitivity Reactions
Which food allergies mostly resolve spontaneously during childhood?
Eggs, milk, wheat, and soy, except for nuts and shellfish.
p.14
Anaphylaxis and Its Management
What do human mast cells express receptors for?
Anaphylatoxins (C5a and C3a), toll-like receptors, and epithelial alarmins like TSLP and IL-33.
p.15
Hypersensitivity Reactions
Which leukotrienes are known as the most potent vasoactive and spasmogenic agents?
D. Leukotrienes C4 and D4.
p.10
Hypersensitivity Reactions
What do mast cells and basophils release upon activation?
Histamine, proteases, proteoglycans, and tumor necrosis factor-α.
p.6
Dengue Fever Diagnosis and Management
What is a positive tourniquet test indicative of?
Microvascular fragility associated with dengue.
p.6
Dengue Fever Diagnosis and Management
What constitutes a positive tourniquet test?
>10 petechiae in one square inch of the upper arm after a 5-min BP cuff inflation.
p.11
Hypersensitivity Reactions
What procedure induces temporary tolerance to a drug in sensitized patients?
Rapid drug desensitization (RDD).
p.13
Anaphylaxis and Its Management
What is the purpose of using a 1 mg/mL concentration for injections?
It allows a more appropriate volume to be injected.
p.5
Dengue Fever Diagnosis and Management
What should be done for a patient with dengue fever and low platelet count?
A. Transfuse platelet concentrate if necessary.
p.15
Hypersensitivity Reactions
Which of the following is NOT an immediate reaction on mast cell activation?
D. Leukocyte infiltration.
p.9
First-line Treatment for Malaria
What is another treatment option for severe malaria if Artesunate and Artemether are unavailable?
Quinine dihydrochloride (20 mg of salt/kg infused over 4 h, followed by 10 mg of salt/kg infused over 2-8 h q8h).
p.20
Malaria Life Cycle and Dormant Forms
What is the primary focus of Harrison’s Principles of Internal Medicine?
It serves as a comprehensive reference for internal medicine.
p.19
Hypersensitivity Reactions
Which condition related to Type IVd hypersensitivity is characterized by a reaction to drugs leading to low platelet counts?
Drug Induced Thrombocytopenia.
p.11
Anaphylaxis and Its Management
What is the simplest approach to long-term management of anaphylaxis?
Strict avoidance of known anaphylactic triggers.
p.16
Hypersensitivity Reactions
What are the major interleukins involved in immune responses?
IL-4, IL-5, IL-13, IL-17.
p.7
Dengue Fever Diagnosis and Management
What are common symptoms detected in milder cases of severe dengue?
Restlessness, lethargy, thrombocytopenia (<100,000 per μL), and hemoconcentration.
p.11
Anaphylaxis and Its Management
What is the first-line treatment for anaphylaxis?
Intramuscular administration of 0.3–0.5 mL of 1:1000 (1 mg/mL) epinephrine.
p.11
Anaphylaxis and Its Management
What is a risk factor for poor clinical outcomes in anaphylaxis?
Failure to use epinephrine within the first 20 minutes of symptoms.
p.19
Anaphylaxis and Its Management
What is Anaphylaxis?
A severe, potentially life-threatening allergic reaction.
p.19
Hypersensitivity Reactions
What is Serum Sickness?
A type of immune complex-mediated hypersensitivity reaction.
