Which of the following diseases is accompanied by hydrophobia?

DSSSB -28 August 2019 (Shift-2)

Medical & Surgical Nursing

Easy

Appeared in: DSSSB -28 August 2019 (Shift-2)

Explanation

Hydrophobia, or 'fear of water', is a hallmark symptom of the encephalitic (furious) form of rabies.
It is caused by involuntary, intensely painful spasms of the muscles in the throat (pharynx) and voice box (larynx) when the person attempts to swallow liquids.
The mere sight, sound, or even the thought of water can trigger these excruciating spasms, causing the patient to avoid drinking despite being thirsty.
This symptom is considered pathognomonic, meaning it is a classic sign specifically characteristic of rabies infection in humans.

Option B: Rubella (German Measles) is a viral infection known for its characteristic maculopapular rash, fever, and swollen lymph nodes (especially postauricular). It does not cause neurological symptoms like hydrophobia.
Option C: Rickets is a skeletal disorder in children resulting from a deficiency of vitamin D, calcium, or phosphate. It leads to soft, weak bones and deformities like bowed legs. It is a nutritional deficiency, not an infection, and has no association with hydrophobia.
Option D: Dengue fever is a mosquito-borne viral illness. Its classic symptoms include high fever, severe headache, retro-orbital pain, and intense muscle and joint pain, often called 'breakbone fever'. It does not involve the specific neurological symptom of hydrophobia.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical manifestation of Rabies as background academic context rather than a clinical decision trigger.
Recognizing hydrophobia and aerophobia (fear of drafts of air) is critical for the late-stage diagnosis of rabies, prompting immediate implementation of isolation precautions and palliative care.
The nurse's most vital role is in rabies prevention through patient education and the prompt, correct administration of Post-Exposure Prophylaxis (PEP) after a potential exposure from an animal bite or scratch.
What if? If a patient is bitten by a healthy domestic dog or cat, the protocol may involve confining and observing the animal for 10 days. If the animal remains healthy, PEP is not necessary. However, if the animal was a stray or wild animal, PEP must be initiated immediately without delay.

How to Approach the Question

First, identify the key clinical sign in the question stem, which is 'hydrophobia'.
Recall the definition of hydrophobia: an extreme fear of water, specifically related to the inability to swallow.
Systematically review the options provided.
Associate the pathognomonic sign of hydrophobia with the correct disease. Rabies is classically known to cause this symptom due to viral encephalitis affecting the brainstem.
Eliminate the other options by recalling their primary characteristics: Rubella (rash), Rickets (bone disease), and Dengue fever (high fever and severe pain).
Confirm the selection of Rabies as the only disease on the list that presents with hydrophobia.

Concept Tested & Keywords

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E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) p. 140-142

E6 Medicine Harrison 22e Part 1 p. 1693-1695