A 3-year-old child presents with high fever, koplik spots on the buccal mucosa, and a maculopapular rash that started on the face and progressed downward. On which day of illness did the rash most likely appear?
- A Day 3-4 ✓
- B Day 1
- C Day 7-10
- D Day 14
Correct answer: A. Day 3-4
Explanation
Measles follows a predictable sequence: prodromal phase of fever, cough, coryza, conjunctivitis for 2-4 days, during which Koplik spots appear on day 2-3. The characteristic maculopapular rash appears on day 3-4 of illness, beginning on the face/forehead and spreading downward (cephalocaudal spread). Koplik spots fade as the rash appears. This pattern is pathognomonic and distinguishes measles from rubella and roseola.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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