11 extractive question-and-answer pairs built from ICMR Standard Treatment Workflow (STW) URTICARIA AND ANGIOEDEMA, published by icmr.gov.in. Every answer is a verbatim span of text the source prints, and each row carries the passage it sits in, its offset in that passage, the source quote, the page and the location in the document, so any row can be checked against the original. 5 of the 11 pairs (45.5%) are explanatory questions and 6 restate a figure. 100.00% of rows pass the corpus quality gate.
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import desidata
df = desidata.load("icmr-standard-treatment-workflow-for-urticaria-and-angioedema-question-and")
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Usable for analysis, but expect some cleaning before you rely on it.
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First 10 of 11 rows
| question | answer | context | answer_start | question_type | knowledge_quality_score | source_quote | source_page | source_location | confidence | validation_status |
|---|---|---|---|---|---|---|---|---|---|---|
| What is a wheal characterized by? | A sharply circumscribed superficial central swelling of variable size and shape, surrounded by reflex erythema | • Urticaria -sudden appearance of wheals, angioedema, or both • A wheal- A sharply circumscribed superficial central swelling of variable size and shape, surrounded by reflex erythema > Associated with itching / burning sensation and of fleeting nature- resolves within 1–24 hours > Chronic urticaria implies duration for more than 6 weeks • Angioedema > Sudden, pronounced, erythematous or skin-colored swelling of lower dermis and subcutis with frequent involvement of mucous membranes > Associated pain, rather than itching /resolution is slower and can take up to 72 hours • Time to onset • Frequency / duration • Diurnal variation • Associated angioedema • Associated pain, itch • Induction by physical agents or exercise • Family history • Previous allergies • Surgical implantations • Gastric / intestinal problem • Due to evanescent nature the examination may not show any lesions • Presence of wheals of various sizes and shapes • The lesions are non-scaly but show an intense erythema and a trailing clearing region in older areas which may lead to a target configuration in expanding plaques • Drug history • Correlation with food • Correlation with menses • Smoking • Work profile • Hobbies • Stress • Quality of life impact • Response to therapy | 73 | definition | 0.980 | • Urticaria -sudden appearance of wheals, angioedema, or both • A wheal- A sharply circumscribed superficial central swelling of variable size and shape, surrounded by reflex erythema > Associated with itching / burning sensation and of fleeting nature- resolves within 1–24 hours > Chronic urticaria implies duration for more than 6 weeks • Angioedema > Sudden, pronounced, erythematous or skin-colored swelling of lower dermis and subcutis with frequent involvement of mucous membranes > Associated pain, rather than itching /resolution is slower and can take up to 72 hours • Time to onset • | 1 | page=1,block=6 | 0.700 | valid |
| Why is long-term use of first-generation antihistamines discouraged? | due to risk of sedation and psychomotor impairment | Chlorphenamine, Hydroxyzine avoided if possible due to risk of sedation and psychomotor impairment • Avoid triggers including drugs such as NSAIDs, PCM, ACE inhibitors if history is suggestive of drug induced or exacerbated urticaria/ angioedema TREATMENT • Severe urticaria with respiratory distress- maintain airway; injectable Hydrocortisone and Pheniramine (Avil) may be required • Intra-muscular Adrenaline of 1:1000 dilution (1 mg in 1 mL), 0.2 to 0.5 mg (0.01 mg/kg in children; maximum dose: 0.3 mg) administered intramuscularly every 5 to 15 minutes if choking/respiratory distress/shock * Angioedema with respiratory or laryngeal symptom requires emergency management -refer to higher center after vital stabilization; oral Prednisolone may be initiated to take care of biphasic response | 48 | relationship | 0.970 | Chlorphenamine, Hydroxyzine avoided if possible due to risk of sedation and psychomotor impairment • Avoid triggers including drugs such as NSAIDs, PCM, ACE inhibitors if history is suggestive of drug induced or exacerbated urticaria/ angioedema TREATMENT • Severe urticaria with respiratory distress- maintain airway; injectable Hydrocortisone and Pheniramine (Avil) may be required • Intra-muscular Adrenaline of 1:1000 dilution (1 mg in 1 mL), 0.2 to 0.5 mg (0.01 mg/kg in children; maximum dose: 0.3 mg) administered intramuscularly every 5 to 15 minutes if choking/respiratory distress/shock * | ||||
| What steps should be taken for severe urticaria accompanied by respiratory distress? | maintain airway; injectable Hydrocortisone and Pheniramine (Avil) may be required | Chlorphenamine, Hydroxyzine avoided if possible due to risk of sedation and psychomotor impairment • Avoid triggers including drugs such as NSAIDs, PCM, ACE inhibitors if history is suggestive of drug induced or exacerbated urticaria/ angioedema TREATMENT • Severe urticaria with respiratory distress- maintain airway; injectable Hydrocortisone and Pheniramine (Avil) may be required • Intra-muscular Adrenaline of 1:1000 dilution (1 mg in 1 mL), 0.2 to 0.5 mg (0.01 mg/kg in children; maximum dose: 0.3 mg) administered intramuscularly every 5 to 15 minutes if choking/respiratory distress/shock * Angioedema with respiratory or laryngeal symptom requires emergency management -refer to higher center after vital stabilization; oral Prednisolone may be initiated to take care of biphasic response | 302 | summary | 0.970 | Chlorphenamine, Hydroxyzine avoided if possible due to risk of sedation and psychomotor impairment • Avoid triggers including drugs such as NSAIDs, PCM, ACE inhibitors if history is suggestive of drug induced or exacerbated urticaria/ angioedema TREATMENT • Severe urticaria with respiratory distress- maintain airway; injectable Hydrocortisone and Pheniramine (Avil) may be required • Intra-muscular Adrenaline of 1:1000 dilution (1 mg in 1 mL), 0.2 to 0.5 mg (0.01 mg/kg in children; maximum dose: 0.3 mg) administered intramuscularly every 5 to 15 minutes if choking/respiratory distress/shock * | ||||
| What are some examples of unusual symptoms associated with urticaria? | long lasting lesions >24-48 hours with bruising | • Patients whose urticaria is difficult to control with antihistamines despite fourfold higher dosage than the licensed doses of Cetirizine, Levocetirizine or Fexofenadine • Patients with polypharmacy • Unusual urticaria e.g. long lasting lesions >24-48 hours with bruising • Associate angioedema that is unresponsive or presents with choking/ dyspnoea • Investigations not available First Line: 2nd generation non-sedating antihistamines Second Line: Increase dosage (upto fourfold) of 2nd generation antihistamines Refer to higher centre If symptoms persist after 2 weeks If symptoms persist after 2–4 further weeks | 226 | list | 0.820 | • Patients whose urticaria is difficult to control with antihistamines despite fourfold higher dosage than the licensed doses of Cetirizine, Levocetirizine or Fexofenadine • Patients with polypharmacy • Unusual urticaria e.g. long lasting lesions >24-48 hours with bruising • Associate angioedema that is unresponsive or presents with choking/ dyspnoea • Investigations not available First Line: 2nd generation non-sedating antihistamines Second Line: Increase dosage (upto fourfold) of 2nd generation antihistamines Refer to higher centre If symptoms persist after 2 weeks If symptoms persist after | ||||
| Which antihistamines are noted as potentially ineffective even at increased doses? | Cetirizine, Levocetirizine or Fexofenadine | • Patients whose urticaria is difficult to control with antihistamines despite fourfold higher dosage than the licensed doses of Cetirizine, Levocetirizine or Fexofenadine • Patients with polypharmacy • Unusual urticaria e.g. long lasting lesions >24-48 hours with bruising • Associate angioedema that is unresponsive or presents with choking/ dyspnoea • Investigations not available First Line: 2nd generation non-sedating antihistamines Second Line: Increase dosage (upto fourfold) of 2nd generation antihistamines Refer to higher centre If symptoms persist after 2 weeks If symptoms persist after 2–4 further weeks | 129 | list | 0.740 | • Patients whose urticaria is difficult to control with antihistamines despite fourfold higher dosage than the licensed doses of Cetirizine, Levocetirizine or Fexofenadine • Patients with polypharmacy • Unusual urticaria e.g. | 1 | page=1,block=57 | 0.700 | valid |
| What are the key features of urticarial vasculitis? | painful, persist for 24-48 hours and fade to leave bruising; ± fever and arthralgia | (presenting with wheals, angioedema, or both) Inducible (mostly physical) • Spontaneous appearance of wheals, angioedema, or both for ≥6 weeks • Symptomatic dermographism • Delayed pressure urticaria • Cholinergic urticaria • Cold/Heat urticaria • Solar urticaria • Aquagenic urticaria • Contact urticaria • Insect /Bedbug bites • Urticarial vasculitis- painful, persist for 24-48 hours and fade to leave bruising; ± fever and arthralgia • Pre bullous phase of bullous pemphigoid • Maculopapular drug/ viral rash INVESTIGATIONS Generally, no investigations are needed to confirm the diagnosis • Skin biopsy may be indicated if other diagnoses are being suspected • C4 and C1 inhibitor quantitation to detect C1 inhibitor deficiency may be done in suspected hereditary angioedema (Angioedema without urticaria) • Tests for current or past viral, bacterial or parasitic infections should be guided by history and clinical findings • Lab tests may be needed if patient is planned for immunosuppressive treatment • Certain investigations that are often ordered, but are of limited utility > Thyroid function tests and antithyroid peroxidase (TPO) antibodies > Autologous serum skin test (ASST) > Skin prick / specific IgE test | 354 | factual | 0.570 | |||||
| What is the safety concern regarding extended use of long-acting, non-sedating antihistamines? | prolonged treatment with long-acting, non-sedating antihistamines is not harmful | • Reassure -remits spontaneously in 12-24 months in ~50% patients • Treat with antihistamines. Reassure that prolonged treatment with long-acting, non-sedating antihistamines is not harmful • Non-sedating antihistamines (e.g. Cetirizine 10mg, Levocetirizine 5mg, Loratadine 10mg, or Fexofenadine 180mg once daily) mainstay of treatment. Dose can be increased 4-fold safely if needed • Long-term first generation antihistamines e.g. | 109 | factual | 0.570 | Reassure that prolonged treatment with long-acting, non-sedating antihistamines is not harmful • Non-sedating antihistamines (e.g. | 1 | page=1,block=50 | 0.700 | valid |
| What is the recommended adjustment for second-line treatment of urticaria? | Increase dosage (upto fourfold) of 2nd generation antihistamines | • Patients whose urticaria is difficult to control with antihistamines despite fourfold higher dosage than the licensed doses of Cetirizine, Levocetirizine or Fexofenadine • Patients with polypharmacy • Unusual urticaria e.g. long lasting lesions >24-48 hours with bruising • Associate angioedema that is unresponsive or presents with choking/ dyspnoea • Investigations not available First Line: 2nd generation non-sedating antihistamines Second Line: Increase dosage (upto fourfold) of 2nd generation antihistamines Refer to higher centre If symptoms persist after 2 weeks If symptoms persist after 2–4 further weeks | 452 | factual | 0.570 | long lasting lesions >24-48 hours with bruising • Associate angioedema that is unresponsive or presents with choking/ dyspnoea • Investigations not available First Line: 2nd generation non-sedating antihistamines Second Line: Increase dosage (upto fourfold) of 2nd generation antihistamines Refer to higher centre If symptoms persist after 2 weeks If symptoms persist after 2–4 further weeks | 1 | page=1,block=57 | 0.700 | |
| What is the primary treatment for urticaria? | Non-sedating antihistamines (e.g. Cetirizine 10mg, Levocetirizine 5mg, Loratadine 10mg, or Fexofenadine 180mg once daily) | • Reassure -remits spontaneously in 12-24 months in ~50% patients • Treat with antihistamines. Reassure that prolonged treatment with long-acting, non-sedating antihistamines is not harmful • Non-sedating antihistamines (e.g. Cetirizine 10mg, Levocetirizine 5mg, Loratadine 10mg, or Fexofenadine 180mg once daily) mainstay of treatment. Dose can be increased 4-fold safely if needed • Long-term first generation antihistamines e.g. | 192 | factual | 0.530 | Reassure that prolonged treatment with long-acting, non-sedating antihistamines is not harmful • Non-sedating antihistamines (e.g. Cetirizine 10mg, Levocetirizine 5mg, Loratadine 10mg, or Fexofenadine 180mg once daily) mainstay of treatment. | 1 | page=1,block=50 | 0.700 | valid |
| What is the primary treatment option for urticaria? | 2nd generation non-sedating antihistamines | • Patients whose urticaria is difficult to control with antihistamines despite fourfold higher dosage than the licensed doses of Cetirizine, Levocetirizine or Fexofenadine • Patients with polypharmacy • Unusual urticaria e.g. long lasting lesions >24-48 hours with bruising • Associate angioedema that is unresponsive or presents with choking/ dyspnoea • Investigations not available First Line: 2nd generation non-sedating antihistamines Second Line: Increase dosage (upto fourfold) of 2nd generation antihistamines Refer to higher centre If symptoms persist after 2 weeks If symptoms persist after 2–4 further weeks | 396 | factual | 0.490 | long lasting lesions >24-48 hours with bruising • Associate angioedema that is unresponsive or presents with choking/ dyspnoea • Investigations not available First Line: 2nd generation non-sedating antihistamines Second Line: Increase dosage (upto fourfold) of 2nd generation antihistamines Refer to higher centre If symptoms persist after 2 weeks If symptoms persist after 2–4 further weeks | 1 | page=1,block=57 | 0.700 | valid |
Read straight from the file — download or use the API URL for the full dataset.
| 1 |
| page=1,block=50 |
| 0.700 |
| valid |
| 1 |
| page=1,block=50 |
| 0.700 |
| valid |
| 1 |
| page=1,block=57 |
| 0.700 |
| valid |
| (presenting with wheals, angioedema, or both) Inducible (mostly physical) • Spontaneous appearance of wheals, angioedema, or both for ≥6 weeks • Symptomatic dermographism • Delayed pressure urticaria • Cholinergic urticaria • Cold/Heat urticaria • Solar urticaria • Aquagenic urticaria • Contact urticaria • Insect /Bedbug bites • Urticarial vasculitis- painful, persist for 24-48 hours and fade to leave bruising; ± fever and arthralgia • Pre bullous phase of bullous pemphigoid • Maculopapular drug/ viral rash INVESTIGATIONS Generally, no investigations are needed to confirm the diagnosis • Skin |
| 1 |
| page=1,block=34 |
| 0.700 |
| valid |
| valid |