Which is a common finding seen in dengue patients, except?

AIIMS Delhi NO - 2017

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Delhi NO - 2017

Explanation

Neutropenia, a low count of neutrophils (a type of white blood cell), is not considered a classic or hallmark finding in dengue fever.
While a general decrease in the total white blood cell count (leukopenia) is common in dengue, significant neutropenia is not as characteristic as the other listed symptoms.
Sources confirm that leukopenia is a feature, and neutropenia may occur later in the disease, but it is not a primary diagnostic sign like fever, pain, and thrombocytopenia.

Option A: This is incorrect because severe joint pain (arthralgia) is a classic symptom of dengue, giving it the colloquial name 'break-bone fever'.
Option B: This is incorrect because thrombocytopenia (a low platelet count) is a hallmark laboratory finding in dengue, crucial for diagnosis and for monitoring the risk of hemorrhagic complications.
Option D: This is incorrect because a sudden, high-grade fever is typically the first and most prominent symptom of dengue infection.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical manifestations of Dengue Fever as background academic context rather than a clinical decision trigger.
Recognizing the classic signs of dengue (fever, pain, thrombocytopenia) is critical for early diagnosis and management.
Nurses must monitor patients with suspected dengue for warning signs of severe disease, such as persistent vomiting, abdominal pain, and any signs of bleeding (e.g., petechiae, gum bleeding). This is directly linked to the drop in platelets (thrombocytopenia).
Patient education is vital. Nurses should advise patients to rest, maintain hydration, and avoid NSAIDs like aspirin or ibuprofen, which can increase bleeding risk in the context of thrombocytopenia.

How to Approach the Question

First, identify the core of the question. It asks for the finding that is NOT common in dengue. This is an 'except' question, meaning three options are common findings and one is not.
Recall the classic symptoms of dengue fever. Think about the common name 'break-bone fever' to remember the severe pain.
Consider each option: Is 'Fever' common in dengue? Yes, it's a primary symptom. Is 'Joint pain' common? Yes, it's the 'break-bone' feature. Is 'Thrombocytopenia' common? Yes, it's a key lab finding.
By elimination, you are left with 'Neutropenia'.
Confirm your thinking: While a general low white blood cell count (leukopenia) is seen, is a specific low neutrophil count (neutropenia) a hallmark? It's less characteristic than the other three.
Select 'Neutropenia' as the exception.

Concept Tested & Keywords

Concept Tested: Clinical manifestations of Dengue Fever
Stem keywords: dengue patients, common finding
Lead-in keywords: except
Negative lead-in flag: This is a negative-lead-in question asking for the exception.

QwEZ-T0bA9vujapHsg01y_

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 2076-2078

E6 Medicine Harrison 22e Part 1 p. 1709-1711

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 243-245