| What are the symptoms of bullous systemic lupus erythematosus? | Appearance of fluid-filled, itchy or painful blisters (either flaccid or tense) on skin, over a normal or erythematous base | WHEN TO SUSPECT? • Pemphigus vulgaris/ variants • Pemphigus foliaceus/ variants • Bullous pemphigoid • Pemphigoid gestationis • Mucous membrane pemphigoid • Linear IgA bullous diseases/ chronic bullous disease of childhood • Dermatitis herpetiformis • Epidermolysis bullosa acquisita • Bullous systemic lupus erythematosus CORRECT DIAGNOSIS; PREVENTION/ TREATMENT OF SEPSIS; AND REGULARITY OF TREATMENT BRINGS BEST RESULTS Appearance of fluid-filled, itchy or painful blisters (either flaccid or tense) on skin, over a normal or erythematous base Appearance of raw, erythematous erosions ± crusting on skin Appearance of erosions/ blisters inside oral cavity, eyes, nose and genitals | 423 | definition | 1.000 | https://www.icmr.gov.in/icmrobject/custom_data/pdf/downloadable-books/STW_Vol_3_2022.pdf | WHEN TO SUSPECT? • Pemphigus vulgaris/ variants • Pemphigus foliaceus/ variants • Bullous pemphigoid • Pemphigoid gestationis • Mucous membrane pemphigoid • Linear IgA bullous diseases/ chronic bullous disease of childhood • Dermatitis herpetiformis • Epidermolysis bullosa acquisita • Bullous systemic lupus erythematosus CORRECT DIAGNOSIS; PREVENTION/ TREATMENT OF SEPSIS; AND REGULARITY OF TREATMENT BRINGS BEST RESULTS Appearance of fluid-filled, itchy or painful blisters (either flaccid or tense) on skin, over a normal or erythematous base Appearance of raw, erythematous erosions ± crusting | 16 | page=16,block=0 | 0.700 | valid |
| What birth weight is considered small for gestational age (SGA)? | birth weight < 10th percentile | • Preterm infants (< 37 weeks gestational age) • Low birth weight Infants (< 2500 g) • Small for gestation age (SGA): birth weight < 10th percentile • Large for gestation age (LGA): birth weight > 90th percentile • Infant of diabetic mother (IDM) • Sick infants (eg: sepsis, asphyxia, respiratory distress, shock,polycythemia, seizure) • Post exchange blood transfusion • Infants on intravenous fluids and parenteral nutrition • Stupor, lethargy, limpness • Jitteriness, tremors, convulsions • Episodes of cyanosis, apnea or tachypnea • Weak and high-pitched cry • Difficulty in feeding AGA : Appropriate for Gestational Age EBM : Expressed breast milk IV : Intravenous IM: Intramuscular PO : Per oral SC : Subcutaneous IUGR: Intra uterine growth retardation • Hydrocortisone: 5 mg/kg/day IV in two divided doses • Diazoxide: 10-25 mg/kg/day PO in three divided doses • Glucagon: 300 μg/kg SC or IM • Octreotide: 2-10 μg/kg/day SC SYMPTOMATIC AS WELL AS ASYMPTOMATIC HYPOGLYCEMIA CAN LEAD TO PERMANENT BRAIN DAMAGE BG ≥ 45 mg/dL | 118 | definition | 1.000 | https://www.icmr.gov.in/icmrobject/custom_data/pdf/downloadable-books/STW_Vol_3_2022.pdf | • Preterm infants (< 37 weeks gestational age) • Low birth weight Infants (< 2500 g) • Small for gestation age (SGA): birth weight < 10th percentile • Large for gestation age (LGA): birth weight > 90th percentile • Infant of diabetic mother (IDM) • Sick infants (eg: sepsis, asphyxia, respiratory distress, shock,polycythemia, seizure) • Post exchange blood transfusion • Infants on intravenous fluids and parenteral nutrition • Stupor, lethargy, limpness • Jitteriness, tremors, convulsions • Episodes of cyanosis, apnea or tachypnea • Weak and high-pitched cry • Difficulty in feeding AGA : |
| What diagnostic imaging techniques are abbreviated as OCT and OCTA? | Optical coherence tomography OCTA: Optical coherence tomography angiography | Proliferative Diabetic Retinopathy Microaneurysm Mild Diabetic retinopathy (Mild NPDR) Soft exudate Intraretinal hemorrhages Hard exudates Moderate NPDR Severe NPDR with severe macular edema Hard exudates and edema within foveal centre Proliferative Diabetic Retinopathy- Advanced Premacular hemorrhage BCVA: Best corrected visual acuity DME: Diabetic macular edema OCT: Optical coherence tomography OCTA: Optical coherence tomography angiography FFA: Fundus fluorescein angiography IOP: Intra ocular pressure | 371 | definition | 1.000 | https://www.icmr.gov.in/icmrobject/custom_data/pdf/downloadable-books/STW_Vol_3_2022.pdf | Proliferative Diabetic Retinopathy Microaneurysm Mild Diabetic retinopathy (Mild NPDR) Soft exudate Intraretinal hemorrhages Hard exudates Moderate NPDR Severe NPDR with severe macular edema Hard exudates and edema within foveal centre Proliferative Diabetic Retinopathy- Advanced Premacular hemorrhage BCVA: Best corrected visual acuity DME: Diabetic macular edema OCT: Optical coherence tomography OCTA: Optical coherence tomography angiography FFA: Fundus fluorescein angiography IOP: Intra ocular pressure |
| What distinguishes a wheal in terms of its appearance and associated symptoms? | 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 |
| What does LOPS refer to in medical terms? | Diabetic peripheral neuropathy with loss of protective sensation | July/ 2022 EUSOL: Edinburgh university solution of lime FBS: Fasting blood sugar LOPS: Diabetic peripheral neuropathy with loss of protective sensation PAD: Peripheral arterial disease PPBS: Post prandial blood sugar SIRS: Systemic inflammatory response syndrome | 87 | definition | 1.000 | https://www.icmr.gov.in/icmrobject/custom_data/pdf/downloadable-books/STW_Vol_3_2022.pdf | July/ 2022 EUSOL: Edinburgh university solution of lime FBS: Fasting blood sugar LOPS: Diabetic peripheral neuropathy with loss of protective sensation PAD: Peripheral arterial disease PPBS: Post prandial blood sugar SIRS: Systemic inflammatory response syndrome | 38 | page=38,block=85 | 0.700 | valid |
| What does a negative oral drug challenge test indicate? | that the patient is not allergic to the drug at the time of challenge | In the absence of any reliable in vitro test in clinical setting, oral drug challenge is the only way to detect the responsible drug Usually undertaken when drug avoidance is impractical, especially in case of polypharmacy or life saving medicines (e.g. antituberculous therapy) • Take a written consent prior to challenge • Contraindicated in active illness or pregnancy • Assess the risk benefit ratio • Caution: patients on antihistamines, oral steroids and tricy- clic antidepressants may have a modified response to the challenge • A negative test only indicates that the patient is not allergic to the drug at the time of challenge • The dose of drug for challenge depends on the severity of the previous reaction and the pharmacokinetic profile • Drug provocation should always be done - After admission/ under observation except in cases with FDE - Usually in the daytime so that the faintest erythema is appreciated - It should be treated immediately and aggressively with an appropriate dose of systemic corticosteroid which may be required for only 1-2 days - Drug provocation in cases with DRESS has to be avoided or if provoked, a prolonged retreatment is required - In case of SJS-TEN drug provocation should be done only if the drug cannot be avoided. | 568 | definition |
| What is a characteristic feature of chronic palmoplantar psoriasis? | Chronic erythematous well defined plaques symmetrically on palms and soles, and occassional nail involvement | CLINICAL FEATURES • Shower of numerous erythematous papules < 1 cm on the trunk and extremities • Seen more commonly in younger patients Primary health centre/Level • Antibiotics for streptococcal infection Secondary Level • Same as primary level care • Psoralen ultraviolet A Solar (PUVAsol) Tertiary Level • Same as primary level care • Narrow band UVB • Refractory cases- consider systemic treatments including novel small molecules Chronic erythematous well defined plaques symmetrically on palms and soles, and occassional nail involvement to be differentiated from palmoplantar eczema | 436 | definition | 1.000 | https://www.icmr.gov.in/icmrobject/custom_data/pdf/downloadable-books/STW_Vol_3_2022.pdf | CLINICAL FEATURES • Shower of numerous erythematous papules < 1 cm on the trunk and extremities • Seen more commonly in younger patients Primary health centre/Level • Antibiotics for streptococcal infection Secondary Level • Same as primary level care • Psoralen ultraviolet A Solar (PUVAsol) Tertiary Level • Same as primary level care • Narrow band UVB • Refractory cases- consider systemic treatments including novel small molecules Chronic erythematous well defined plaques symmetrically on palms and soles, and occassional nail involvement to be differentiated from palmoplantar eczema |
| What is a visible feature of psoriasis plaques? | Erythematous plaques with silvery white scales | • Continue emollients • Avoid irritants & prolonged use of topical steroids • Systemic treatment- refer to treatment overview • If these fail or are contraindicated, refer to tertiary level for combination or rotational therapy/ novel small molecules/ biologicals Scalp- Tar based shampoo and topical steroids +/- salicylic acid lotions Erythematous plaques with silvery white scales | 337 | definition | 1.000 | https://www.icmr.gov.in/icmrobject/custom_data/pdf/downloadable-books/STW_Vol_3_2022.pdf | • Continue emollients • Avoid irritants & prolonged use of topical steroids • Systemic treatment- refer to treatment overview • If these fail or are contraindicated, refer to tertiary level for combination or rotational therapy/ novel small molecules/ biologicals Scalp- Tar based shampoo and topical steroids +/- salicylic acid lotions Erythematous plaques with silvery white scales | 17 | page=17,block=25 | 0.700 | valid |
| What is infertility defined as in women under 35 years of age? | the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse in women < 35 years of age | WHAT IS INFERTILITY? • Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse in women < 35 years of age or within 6 months in women > 35 years of age • Affects up to 15% of couples | 101 | definition | 1.000 | https://www.icmr.gov.in/icmrobject/custom_data/pdf/downloadable-books/STW_Vol_3_2022.pdf | WHAT IS INFERTILITY? • Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse in women < 35 years of age or within 6 months in women > 35 years of age • Affects up to 15% of couples | 44 | page=44,block=11 | 0.700 | valid |
| What is the nature of the treatment algorithms being formulated for patient management? | scientific, robust and locally contextual | To formulate treatment algorithms for common and serious medical & surgical conditions for both outdoor & indoor patient management at primary, secondary and tertiary levels of India’s healthcare system that are scientific, robust and locally contextual. • Participation also from Public Health Specialists Search Strategists Graphic Designers • Review by Editorial Board • Approval by Advisory Committee • Prevalence studies • Global burden of diseases studies • HBP of AB-PMJAY Output ADVISORY COMMITTEE ICMR STW Team Speciality wise Expert Committees Editorial Board Book Web Portal Mobile Apps | 212 | definition | 1.000 | https://www.icmr.gov.in/icmrobject/custom_data/pdf/downloadable-books/STW_Vol_3_2022.pdf | To formulate treatment algorithms for common and serious medical & surgical conditions for both outdoor & indoor patient management at primary, secondary and tertiary levels of India’s healthcare system that are scientific, robust and locally contextual. | 7 | page=7,block=11 | 0.700 | valid |