MP NHM CHO-2024 (Shift-1)
Community Health Nursing
Easy
Which of the following is a common symptom of kala- azar, a disease targeted by the National Vector Borne Disease Control Programme?
Appeared in: MP NHM CHO-2024 (Shift-1)
Explanation
- Kala-azar (Visceral Leishmaniasis) is a systemic parasitic disease where prolonged fever is a cardinal symptom.
- The fever is typically intermittent, remittent, or continuous, lasting for weeks to months, and is often the first sign of the disease.
- A characteristic, though uncommon, pattern is a double-temperature spike within 24 hours (double quotidian fever).
- This persistent fever, along with splenomegaly and weight loss, forms the classic clinical triad for diagnosing kala-azar.
Why Other Options Were Wrong
- Option A: Cough is not a primary symptom of kala-azar. It may appear as a sign of a secondary respiratory infection due to the weakened immune system (leukopenia) caused by the disease.
- Option B: Significant joint pain is not a feature of kala-azar. It is a hallmark symptom of other vector-borne diseases.
- Option C: Kala-azar does not typically cause a rash. The characteristic skin finding is hyperpigmentation (darkening of the skin), especially on the face and hands, which gives the disease its name 'black fever'.
Related Visual
- Visual 1: Diagram - The life cycle of the Leishmania parasite, showing the sandfly vector and the human host, to help understand transmission.
- Visual 2: Illustration - A patient showing the clinical signs of kala-azar, such as emaciation and marked abdominal distension due to hepatosplenomegaly.
- Visual 3: Micrograph - Leishman-Donovan (LD) bodies (amastigotes) within a macrophage from a bone marrow aspirate, which is the definitive diagnostic finding.
Clinical Relevance
- Nursing practice connection: Knowing Clinical manifestations of Kala-azar (Visceral Leishmaniasis) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Nurses working in endemic areas (e.g., Bihar, Jharkhand, West Bengal) must maintain a high index of suspicion for kala-azar in any patient presenting with fever for more than two weeks and splenomegaly.
- Under the National Vector Borne Disease Control Programme (NVBDCP), early case detection and complete treatment are crucial. Nurses play a key role in patient screening, administering medications like liposomal amphotericin B, and monitoring for side effects.
- Patient education is a vital nursing function, focusing on personal protection measures against sandfly bites, such as using insecticide-treated bed nets and maintaining clean surroundings.
How to Approach the Question
- Step 1: Identify the core subject of the question, which is 'kala-azar' and its common symptoms.
- Step 2: Recall the key clinical features of kala-azar (also known as Visceral Leishmaniasis). Remember the classic triad: prolonged fever, splenomegaly (enlarged spleen), and weight loss.
- Step 3: Analyze each option in the context of kala-azar's known symptomatology.
- Step 4: Evaluate 'Cough'. Recognize it as a non-specific symptom that isn't a primary feature of this disease.
- Step 5: Evaluate 'Joint Pain'. Associate this symptom more strongly with diseases like Chikungunya or Dengue.
- Step 6: Evaluate 'Rash'. Differentiate a rash from the characteristic hyperpigmentation ('black fever') seen in kala-azar.
Concept Tested & Keywords
- Concept Tested: Clinical manifestations of Kala-azar (Visceral Leishmaniasis)
- Stem keywords: kala-azar, symptom, National Vector Borne Disease Control Programme
- Lead-in keywords: Which of the following
- Negative lead-in flag: false
Question ID
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Practise the full MP NHM CHO-2024 (Shift-1)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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