This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
Typhoid perforation occurs during 
Select and explain. 
A. Ist week, B. 2nd week, C. 3rd week, D. 4th week
C: 3rd week
Answer: C: 3rd week 
Explanation: • Enteric fever is a potentially life - threatening systemic disease characterized by fever and abdominal pain.
• It is caused by Salmonella typhi or paratyphi.
• Typhoid is the MC cause of ileal perforation in tropical countries (India).
Pathology :
• Ulceration and necrosis of ileocecal Peyer’s patches.
• The ulcer is parallel to the long axis of the gut and is usually situated in the lower ileum (longitudinal ulcers).
• Perforation of a typhoid ulcer usually occurs during the third week and is occasionally the first sign of the disease.
Clinical Features :
• Fever and abdominal pain are hallmark symptoms.
• Non-specific symptoms : Headache, cough, sweating, myalgia, arthralgia, fatigue.
• Paralytic ileus is the MC complication of typhoid.
• Intestinal hemorrhage (2nd MC) may be the leading symptom.