Enteric Fever – Board-Style Questions

What this deck covers

enteric fever in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Higher every evening
2. What pressing showed
3. Treated before arrival
4. A single titre
5. The count that surprises
6. Vaccinated last year
7. Still in the stool
8. The third week
9. Picking at the sheets
10. Home from Karachi
11. Resistant to everything
12. Why the tablets failed
13. Day four and still hot
14. Back two weeks later
15. Back to nursery
16. Nobody has been abroad
17. The trip to Lahore
18. Loose rather than hard

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Brucellosis, acquired from unpasteurised camel milk, Rose spots, bacterial emboli in the skin, A repeat Widal test, looking for a fourfold rise in titre, As diagnostic, since any titre above 1:80 confirms infection, A white cell count that is normal or low despite the illness, A non-typhoidal serovar causing simple gastroenteritis, The bone marrow, from which it repeatedly seeds the gut, Acute cholecystitis from infection of the gallbladder, High-dose dexamethasone for forty-eight hours, Oral ciprofloxacin, the usual first choice for adults, Chloramphenicol, an old drug now effective again, The isolate has become resistant to macrolides as well, Continue the course, as settling often takes five days, Reinfection, meaning his water supply is unsafe.

Clinical pearls from this deck

• Stepwise temperature, slow pulse: think enteric fever.
• Rose spots: small blanching crops on the trunk, week 2.
• Antibiotics given, cultures negative: sample the marrow.
• One Widal titre in an endemic area proves nothing.
• Enteric fever: a white cell count low for the illness.
• Vaccinated and still ill: think Paratyphi A.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Infectious Disease case decks · pediatric reference values.