Occupational Dermatoses Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Occupational Dermatoses. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Occupational Dermatoses Indian Medical PG Question 1: What is the primary condition for which calcitriol is used as a treatment?
- A. Pemphigus
- B. Secondary hyperparathyroidism (Correct Answer)
- C. Lichen planus
- D. Leprosy
Occupational Dermatoses Explanation: Secondary hyperparathyroidism
- Calcitriol is the active form of vitamin D (1,25-dihydroxyvitamin D₃), and it is crucial for regulating calcium and phosphate levels in the body [1].
- In secondary hyperparathyroidism, often seen in chronic kidney disease (CKD), the kidneys cannot convert vitamin D to its active form, leading to hypocalcemia and increased PTH secretion [1], [2].
- Calcitriol supplementation helps to increase calcium absorption from the gut and suppress the release of parathyroid hormone (PTH), thereby treating the underlying cause of secondary hyperparathyroidism [1], [2].
- This is the primary therapeutic indication for calcitriol in clinical practice.
Lichen planus
- This is a chronic inflammatory condition affecting the skin, hair, nails, and mucous membranes
- Typically treated with corticosteroids or other immunosuppressants
- Calcitriol has no primary role in the treatment of lichen planus; its therapeutic applications are predominantly related to calcium and bone metabolism
Pemphigus
- Pemphigus is a group of rare autoimmune blistering diseases that affect the skin and mucous membranes
- Primary treatment involves immunosuppressants like corticosteroids, often in high doses
- Calcitriol is not indicated for the treatment of pemphigus, as its mechanism of action is unrelated to the autoimmune processes characteristic of this disease
Leprosy
- Leprosy is a chronic infectious disease caused by the bacterium Mycobacterium leprae
- Treated with multi-drug therapy (MDT), which includes antibiotics like rifampicin, dapsone, and clofazimine
- Calcitriol is not an antibiotic and therefore has no role in treating the bacterial infection responsible for leprosy
Occupational Dermatoses Indian Medical PG Question 2: Which of the following burn cases requires IMMEDIATE referral to a specialized burn center?
- A. 25% superficial burn in adult
- B. Burn in palm
- C. 10% superficial burn in child
- D. 25% deep burn in adult (Correct Answer)
- E. 5% superficial scald in adult
Occupational Dermatoses Explanation: ***25% deep burn in adult***
- A **deep burn** (full thickness or deep partial thickness) covering **greater than 10% TBSA** is an **absolute criterion** for immediate referral to a specialized burn center per ABA guidelines.
- This is due to the high risk of **complications**, need for specialized **wound care**, and potential for **surgical intervention** like skin grafting.
- The **combination of depth and extent** makes this the most urgent scenario requiring immediate specialized care.
*25% superficial burn in adult*
- **Superficial burns** (first-degree) involve only the epidermis and typically heal within days without scarring.
- While 25% TBSA is extensive, **superficial burns** can often be managed with supportive care and do not meet the depth criterion for mandatory burn center referral.
*Burn in palm*
- **Burns involving hands** are considered **special areas** and typically require burn center evaluation for optimal functional outcomes.
- However, without specification of **depth and extent**, a small superficial palm burn may be managed locally initially, whereas the question asks for IMMEDIATE referral.
- The **25% deep burn** takes precedence due to its life-threatening nature and clear-cut indication.
*10% superficial burn in child*
- For children, burns greater than **10% TBSA** warrant consideration for burn center referral due to higher morbidity risk.
- However, **superficial burns** (first-degree) in children, while concerning, are less urgent than deep burns of significant extent.
- The depth of injury is a critical factor; superficial burns may be managed with close monitoring if appropriate expertise is available locally.
*5% superficial scald in adult*
- A **5% TBSA superficial burn** in an adult does not meet the threshold for mandatory burn center referral (typically >10% for partial thickness burns).
- **Superficial scalds** can usually be managed with outpatient care, wound dressing, and pain control.
- This would only require referral if other complicating factors were present (e.g., involvement of special areas, inhalation injury).
Occupational Dermatoses Indian Medical PG Question 3: In which of the following conditions is phototherapy, specifically ultraviolet light therapy, useful for treatment?
- A. Psoriasis (Correct Answer)
- B. Tinea corporis
- C. Pemphigus
- D. PMLE
Occupational Dermatoses Explanation: ***Psoriasis***
- **Phototherapy** (narrowband UVB, broadband UVB, or PUVA) is a **well-established first-line treatment** for **moderate-to-severe psoriasis**.
- It works by **suppressing overactive immune cells** in the skin, reducing inflammation and decreasing keratinocyte proliferation.
- **Direct therapeutic effect** on active psoriatic lesions makes this the primary indication for phototherapy in dermatology.
*Tinea corporis*
- **Tinea corporis** is a **superficial fungal infection** (dermatophytosis) of the skin.
- Requires **antifungal medications** (topical azoles or oral terbinafine/griseofulvin) for treatment.
- **Phototherapy has no antifungal activity** and is not used for this condition.
*Pemphigus*
- **Pemphigus** is an **autoimmune blistering disease** with intraepidermal acantholysis.
- Treatment requires **systemic immunosuppression** (corticosteroids, rituximab, azathioprine).
- **Phototherapy is not indicated** and could potentially worsen the condition.
*PMLE*
- **Polymorphous light eruption (PMLE)** is a common **photosensitivity disorder**.
- While **prophylactic photohardening** (gradual controlled UV exposure) can be used to build tolerance **before sun exposure season**, this is a **preventative desensitization strategy**, not treatment of active disease.
- Unlike psoriasis, phototherapy does **not treat active PMLE lesions** and can trigger flares if not done properly.
- The primary approach for active PMLE is **sun avoidance, sun protection, and topical corticosteroids**.
Occupational Dermatoses Indian Medical PG Question 4: A child has a rash. His family history is positive for asthma. What could be the most probable diagnosis?
- A. Seborrheic dermatitis
- B. Atopic dermatitis (Correct Answer)
- C. Allergic contact dermatitis
- D. Erysipelas
Occupational Dermatoses Explanation: ***Atopic dermatitis***
- The presence of a rash in a child with a family history of **asthma** strongly suggests atopic dermatitis, as it is part of the **atopic triad** (eczema, asthma, allergic rhinitis).
- Atopic dermatitis often presents with **erythematous, pruritic patches** and plaques, commonly affecting flexural areas like the antecubital and popliteal fossae, as well as the face and neck in younger children.
*Seborrheic dermatitis*
- This condition typically presents with **greasy, yellowish scales** on an erythematous base, often affecting areas rich in sebaceous glands such as the scalp, face (nasolabial folds), and chest.
- While it can occur in infants, it does not have the strong association with a family history of asthma seen in atopic dermatitis.
*Allergic contact dermatitis*
- This rash results from an **exposure to an allergen**, leading to a localized, erythematous, and pruritic eruption, often with vesicles or bullae, at the site of contact.
- The history does not provide information about a specific allergen exposure, and while it could produce a similar-looking rash, the family history of asthma points more strongly to atopic diathesis.
*Erysipelas*
- Erysipelas is a superficial skin infection, usually caused by *Streptococcus pyogenes*, presenting as a **well-demarcated, intensely erythematous, warm, and painful rash** with a raised border.
- This is an **acute bacterial infection** and would typically be accompanied by systemic symptoms like fever and chills, which are not mentioned in the child's presentation.
Occupational Dermatoses Indian Medical PG Question 5: Which of the following is not a feature of dermatomyositis?
- A. Salmon Patch (Correct Answer)
- B. Periungual telangiectasias
- C. Gottron's patch
- D. Mechanic's hands
Occupational Dermatoses Explanation: ***Salmon Patch***
- A **salmon patch** (also known as a nevus simplex or stork bite) is a common, benign vascular birthmark that presents as a flat, red or pink patch.
- It is **not associated with dermatomyositis** and has no pathogenic link to the condition.
*Gottron's patch*
- **Gottron's patches** are a classic cutaneous manifestation of dermatomyositis, characterized by erythematous, violaceous, or dusky red papules or plaques over the **extensor surfaces of the metacarpophalangeal and interphalangeal joints**.
- Their presence is highly suggestive of dermatomyositis, often preceding or co-occurring with muscle weakness.
*Periungual telangiectasias*
- **Periungual telangiectasias** are dilated capillaries around the nail folds and are a common skin manifestation of dermatomyositis.
- They represent small vessel vasculopathy, a histological feature, and suggest microvascular damage often seen in systemic connective tissue diseases like dermatomyositis.
*Mechanic's hands*
- **Mechanic's hands** are a cutaneous feature seen in dermatomyositis (and other inflammatory myopathies like antisynthetase syndrome).
- They are characterized by **hyperkeratosis**, fissuring, and scaling of the skin, particularly on the lateral and palmar aspects of the fingers, resembling the hands of a manual laborer.
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