Which of the following is not a symptom of dengue?

Appeared in: MP CHO -2019 (Shift-1)

Explanation

Dengue fever is characterized by a sudden onset of high-grade fever, typically reaching 39-40°C (102-104°F).
Low-grade fever is not a characteristic feature of the initial, acute febrile phase of dengue.
The presence of a high fever is a key diagnostic criterion, making 'low-grade fever' the correct answer for what is NOT a symptom.

Option A: High fever is a hallmark symptom of the febrile phase of dengue. Its presence is expected in a typical case.
Option C: Pain behind the eyes, known as retro-orbital pain, is a classic and highly specific symptom of dengue fever.
Option D: Severe joint pain (arthralgia) is so characteristic of dengue that the illness is commonly nicknamed 'break-bone fever'.

Clinical Relevance

Nursing practice connection: Knowing Clinical Manifestations of Dengue Fever helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must be able to differentiate typical dengue symptoms from warning signs that indicate progression to severe dengue (Dengue Hemorrhagic Fever/Dengue Shock Syndrome).
Accurate symptom identification is crucial for patient triage, education on supportive care (hydration, paracetamol), and advising against NSAIDs which can increase bleeding risk.
What if? - If the patient presented with high fever for 5 days and now the fever has subsided but they have severe abdominal pain and lethargy, the priority shifts from managing fever to monitoring for signs of plasma leakage and shock, as this marks the entry into the critical phase.

How to Approach the Question

First, analyze the question stem. It asks you to identify which option is not a symptom of dengue. This is a negative-framing question, so you are looking for the outlier.
Next, recall the classic clinical presentation of dengue fever. Key features include a sudden high fever, severe headache, pain behind the eyes, and intense muscle and joint pain (hence the name 'break-bone fever').
Evaluate each option against your knowledge of dengue:
High fever: This is a hallmark of dengue. So, this is a symptom.
Eye pain: Retro-orbital pain is a classic symptom. So, this is a symptom.
Joint pain: Severe arthralgia is characteristic. So, this is a symptom.

Concept Tested & Keywords

Concept Tested: Clinical Manifestations of Dengue Fever
Stem keywords: symptom, dengue
Lead-in keywords: not
Negative lead-in flag: This question uses a negative lead-in ('not'), asking you to identify the option that is NOT a symptom of dengue.

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

E6 Medicine Davidson Principles Practice 24e p. 263-265

Practise the full MP CHO -2019 (Shift-1)

Attempt every question from this paper in a timed mock, then review the full solution for each one.