Decreased platelet count is a typical manifestation of?

ESIC Nursing Officer 2016 (Shift -2)

Medical & Surgical Nursing

Easy

Appeared in: ESIC Nursing Officer 2016 (Shift -2)

Explanation

Thrombocytopenia (low platelet count) is a hallmark feature of Dengue fever, serving as a key diagnostic and prognostic indicator.
The dengue virus causes thrombocytopenia through two primary mechanisms: direct suppression of the bone marrow, which reduces platelet production, and immune-mediated destruction of circulating platelets.
A rapid and significant drop in the platelet count is a critical warning sign for the progression to severe dengue (Dengue Hemorrhagic Fever), which carries a high risk of bleeding and shock.

Option B: Anemia is incorrect because it is defined by a deficiency of red blood cells or hemoglobin, which are responsible for oxygen transport. It does not primarily involve platelets.
Option C: Typhoid fever is a bacterial infection characterized by sustained high fever and gastrointestinal symptoms. While minor hematological changes can occur, significant thrombocytopenia is not a typical or defining feature.
Option D: Scarlet fever is a bacterial infection whose hallmark signs are a sandpaper-like rash, a strawberry tongue, and pharyngitis. It is not associated with thrombocytopenia.

Visual 1: Infographic: A graph showing the typical course of dengue infection, plotting fever, platelet count, and hematocrit levels over time to illustrate the critical phase when platelets drop.
Visual 2: Image: Clinical photograph of petechiae on a patient's skin, demonstrating a common sign of bleeding caused by low platelet counts.
Visual 3: Flowchart: A diagram illustrating the pathophysiology of dengue, showing how the virus leads to both bone marrow suppression and immune-mediated platelet destruction.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Hematological manifestations of infectious diseases as background academic context rather than a clinical decision trigger.
In patients with suspected dengue, daily monitoring of the complete blood count (CBC), especially the platelet count and hematocrit, is a critical nursing responsibility to identify the onset of the critical phase.
Nurses play a vital role in educating patients and their families about bleeding precautions when thrombocytopenia is present. This includes avoiding NSAIDs (like aspirin or ibuprofen) which can increase bleeding risk.
What if? If a patient with dengue and thrombocytopenia also develops a rising hematocrit, it signals plasma leakage, the hallmark of severe dengue. This requires immediate escalation and initiation of intravenous fluid therapy to prevent shock.

How to Approach the Question

First, identify the key clinical finding in the question stem: 'decreased platelet count,' which is medically termed thrombocytopenia.
Next, analyze the options provided, which include three infectious diseases and one hematological condition.
Systematically recall the primary characteristics of each option. Anemia is defined by low red blood cells, not platelets, so it can be eliminated.
Compare the remaining infectious diseases. Consider which disease is most famously or typically associated with a significant drop in platelets.
Dengue fever is classically known to cause marked thrombocytopenia, which is a crucial part of its monitoring and management. Typhoid and Scarlet fever have other defining features (enteric symptoms and rash, respectively) and do not typically present with severe thrombocytopenia.
Conclude by selecting the disease for which a decreased platelet count is a hallmark manifestation.

Concept Tested & Keywords

Concept Tested: Hematological manifestations of infectious diseases
Stem keywords: Decreased platelet count, thrombocytopenia, typical manifestation
Lead-in keywords: is a typical manifestation of

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