Which of the following is the main serious complication of measles?

NHM UP Staff Nurse-2023 Shift-2nd

Child Health Nursing (Pediatrics)

Easy

Appeared in: NHM UP Staff Nurse-2023 Shift-2nd

Explanation

Encephalitis is a severe inflammation of the brain that can occur as a complication of measles, typically developing 1-2 weeks after the rash.
It is a post-infectious, immunologically mediated process, not a direct effect of the virus on the brain in most cases.
While other complications like pneumonia are more common causes of death, encephalitis is one of the most serious due to the high risk of permanent neurological damage (20-40%) or death (approx. 15%).
The other options listed are characteristic signs and symptoms of the disease itself, not subsequent complications.

Option A: Red, watery eyes (conjunctivitis) are a classic symptom of the prodromal phase of measles, not a complication. It is part of the '3 Cs': Cough, Coryza, and Conjunctivitis.
Option B: This describes the characteristic maculopapular rash of measles. The rash is a hallmark sign of the eruptive phase of the disease, not a complication.
Option C: White spots inside the cheeks are Koplik's spots. They are a pathognomonic (uniquely characteristic) sign of measles that appears before the rash. They are a diagnostic feature, not a complication.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Measles as background academic context rather than a clinical decision trigger.
Nurses must monitor patients with measles for signs of neurological complications like altered consciousness, seizures, or severe headache, which could indicate encephalitis and require immediate escalation.
Patient and family education about the importance of the MMR (Measles, Mumps, Rubella) vaccine is a key nursing role in preventing measles and its devastating complications.
In a clinical setting, a patient with measles requires airborne isolation precautions to prevent nosocomial spread, as the virus is highly contagious.

How to Approach the Question

First, identify the keywords in the question: 'main serious complication' and 'measles'. This directs you to look for a severe adverse outcome, not a typical symptom.
Analyze each option to determine if it's a standard sign/symptom or a complication.
Recall the classic presentation of measles: the '3 Cs' (cough, coryza, conjunctivitis), Koplik's spots, and the maculopapular rash.
Recognize that 'red watery eyes,' 'white spots inside cheeks,' and a body rash are all part of this classic presentation.
Identify Encephalitis as an inflammation of the brain, a known severe complication of various viral illnesses, including measles.
Conclude that Encephalitis is the only option that represents a serious complication rather than a standard feature of the disease.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1966-1968

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart A (pp 26-201 of 604) p. 151-153

E6 Medicine Harrison 22e Part 1 p. 1682-1684