Kawasaki Disease and Its Most Serious Complication – A High-Yield UKMLA/PLAB Exam Scenario 👶🔥
Essential Insights for Medical Licensing Exams: Kawasaki Disease in Children
This article breaks down a high-yield paediatric scenario from the February 2025 PLAB 1 exam, focusing on Kawasaki Disease (KD) — a commonly tested topic in UKMLA, PLAB, and international medical licensing exams. Understanding its presentation, diagnosis, and complications is crucial for exam success.
📚 PLAB 1 Exam Case Scenario
A 4-year-old boy is brought to the Emergency Department with a persistent fever lasting six days. His parents report red eyes, a rash, cracked lips, and irritability with reluctance to walk. Examination reveals:
Bilateral non-purulent conjunctivitis
Strawberry tongue
Erythematous palms and soles with periungual desquamation
Blood test results:
White cell count: 18 × 10⁹/L (4-11 × 10⁹/L)
CRP: 70 mg/L (<10 mg/L)
ESR: 50 mm/hr (0-20 mm/hr)
Platelets: 600 × 10⁹/L (150-450 × 10⁹/L)
ALT: 35 U/L (5-40 U/L)
What is the most serious long-term complication associated with this condition?
A) Rheumatic heart disease
B) Pulmonary embolism
C) Coronary artery aneurysm
D) Pericarditis
E) Aortic dissection
Answer with an explanation is provided below.
PLAB/UKMLA Resources
Recent Updates to PLAB 1 Exam Format: Is the exam tougher post-MLA content map changes? Find out here.
MedRevisions Success Stories: Hear from past candidates who passed on their first attempt. Learn more.
Free PLAB/UKMLA Sample Questions: Sign up today for 20 free questions with revision notes.
Follow us on telegram for more free questions
Exam Licence preparation groups
Find the 10% discount referral links in the groups
All about the UKMLA or PLAB exam:
Important update to the PLAB exam: Is the PLAB exam based on the MLA content map from August 2024 onward? Find out more about the change and how to prepare for it here.
Evolving Nature of PLAB 1 Exam Questions: Is the exam getting tougher? A Closer Look with examples
What Past PLAB 1 candidates say about us (with exam results)
✅ Correct Answer: C) Coronary Artery Aneurysm 🫀
Check out these updated study notes in the demo questions and in the library section and get access to the contraception note for FREE. These new study notes will soon replace the existing revision notes entirely.
Clinical Reasoning and Explanation
🩺 Key Diagnosis – Kawasaki Disease (KD)
This child’s presentation fits classic Kawasaki Disease, a medium-vessel vasculitis predominantly affecting children under 5 years old. The diagnosis is based on:
Fever lasting ≥5 days plus
4 out of 5 CRASH criteria:
Conjunctivitis (bilateral, non-purulent)
Rash (polymorphous, non-vesicular)
Adenopathy (cervical lymph node ≥1.5 cm, often unilateral)
Strawberry tongue, cracked lips, mucositis
Hands & feet changes (erythema, swelling, periungual peeling)
🔴 Why Coronary Artery Aneurysm is the Most Serious Complication
Kawasaki Disease can lead to immune-mediated inflammation of the coronary arteries, resulting in:
Coronary artery dilation and
Aneurysm formation, seen in up to 25% of untreated cases.
These aneurysms can trigger:
Myocardial infarction (MI) 😱
Thrombosis
Sudden cardiac death
💉 Preventing Coronary Complications
Early treatment with IV immunoglobulin (IVIG) and aspirin within the first 10 days significantly reduces the risk of coronary aneurysm development.
❌ Why the Other Options Are Incorrect
A) Rheumatic heart disease
Rheumatic heart disease results from untreated Group A Streptococcal infection, leading to valvular heart disease. KD does not cause rheumatic heart disease.
B) Pulmonary embolism
KD does not predispose to venous thromboembolism, though it can cause platelet abnormalities. PE is not a primary concern.
D) Pericarditis
KD can cause pericarditis, but it is not the most serious complication. Coronary artery aneurysms pose a greater risk.
E) Aortic dissection
Aortic dissection is seen in connective tissue disorders (Marfan syndrome, Ehlers-Danlos syndrome) and hypertension-related aortic disease, but it is not associated with Kawasaki disease.
Key Learning Points for PLAB 1 / UKMLA:
Diagnosis of Kawasaki Disease (Fever + "CRASH" criteria):
Conjunctivitis (bilateral, non-purulent)
Rash (polymorphous, non-vesicular)
Adenopathy (cervical lymphadenopathy >1.5 cm, unilateral)
Strawberry tongue, cracked lips, oral mucositis
Hands & feet (erythema, desquamation)
Serious complications → Coronary artery aneurysms (risk of MI, thrombosis, sudden death).
Management:
IV Immunoglobulin (IVIG) + Aspirin within 10 days of symptom onset to reduce CAA risk.
Echocardiogram to assess coronary involvement.
Prepare Smarter for PLAB 1 & UKMLA with MedRevisions
To excel in UKMLA and PLAB 1 and master more high-yield scenarios like this:
✔ Join our free study group – Connect with 50,000+ medical students for exam strategies and discussions.
✔ Get MedRevisions materials – 5,000+ exam-style questions, updated notes, and exam mocks tailored to UKMLA/PLAB 1 format.
✔ Stay Updated – Learn about recent PLAB 1 recalls, NICE guideline updates, and focused study tools.
🎓 New Study Essential Mode For PLAB 1/UKMLA exam
For Focused, efficient, targeted learning for PLAB and UKMLA exam
This update gives you the freedom to prepare for your exam in a short time and cover the syllabus with around 1800+ questions and our updated notes. Then leverage the remaining 3000+ exam-style questions and solidify your concepts. Know how to use it from the link below and get access to the most updated and reliable exam-like materials. Learn more about the Study Essential Mode
This is a high-yield exam PLAB 1/ UKMLA question-style question. At MedRevisions, We provide questions and not only explain the correct answer, we also explain the wrong answer so you will have a comprehensive understanding of the concepts that is commonly tested in the exam. On top of that, we also provide you PLAB 1 / UKMLA exam curated notes with no additional cost.
To discuss to more PLAB or UK-MLA exam questions, Join: PLAB 1 /UKMLA exam study group
At MedRevisions, we strive hard to provide the most up-to-date content available for PLAB Part 1. We constantly add exam-style questions derived from the most recent exam and also update the content to align with the latest NICE/CKS guidelines to ensure doctors pass PLAB Part 1 or UKMLA exam with ease in ONE attempt.
Past PLAB 1 candidates reviews about MedRevisions
How to use MedRevisions effectively for the PLAB 1 exam/ UKMLA exam preparation
Previous PLAB 1 or UKMLA exam guideline update
All MedRevisions recent updates
What we provide:
✅ 5000+ exam style questions
✅ Perfectly tailored exam style notes
✅ 30+ exam mocks
✅ Spaced repetition learning tool