Scarlet fever — PARA MCQ

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HardPaediatrics - InfectionScarlet feverPARA

A 9-week-old infant has a rectal temperature of 38.1°C but is feeding and appears alert. No focus is found on initial examination. How should this finding be risk-stratified?

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Correct answer: C — Classify as high risk and arrange urgent assessment

Explanation lettering: D = shown as A · A = shown as B · E = shown as C · B = shown as D · C = shown as E

E is correct. NICE classifies a temperature of 38°C or higher in a child younger than 3 months as a red, high-risk feature for serious illness, even when the infant initially appears well. A underestimates age-dependent risk. B confuses prolonged fever with the immediate young-infant threshold. C wrongly uses response to antipyretics as a severity test. D applies the 39°C threshold used for children aged 3 to 6 months to a much younger infant.

Reference: NICE NG143: fever in under 5s recommendations: https://www.nice.org.uk/guidance/ng143/chapter/recommendations GMC: PA registration assessment content map: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/pa-and-aa-prequalification-education-framework/pa-registration-assessment-content-map