DSSSB 6 September 2024
Medical & Surgical Nursing
Easy
All stages of rashes are simultaneously seen in which the following conditions?
Appeared in: DSSSB 6 September 2024
Explanation
- Chickenpox, caused by the varicella-zoster virus, is defined by a pleomorphic rash.
- Pleomorphism means that lesions in all stages of development—macules, papules, vesicles, and crusts—are present on the body at the same time.
- This occurs because the rash appears in successive crops over several days, with new lesions forming as old ones heal.
- The rash typically starts on the trunk (centripetal distribution) and spreads outwards.
Why Other Options Were Wrong
- Option A: The rash in Chikungunya is typically maculopapular (a mix of flat and raised spots) and does not progress through vesicular and crusting stages. Therefore, all stages are not seen simultaneously.
- Option B: Typhoid fever is characterized by 'rose spots,' which are faint, salmon-colored macules on the trunk. This rash is not vesicular or pleomorphic.
- Option D: The rash in Dengue fever is typically a diffuse maculopapular rash that can become petechial, sometimes described as 'islands of white in a sea of red.' It does not feature the simultaneous multiple stages (vesicles, crusts) seen in chickenpox.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The key concept tested is the identification of diseases based on the specific characteristics of their associated rash, particularly the phenomenon of pleomorphism as background academic context rather than a clinical decision trigger.
- Accurate identification of a pleomorphic rash is crucial for the prompt diagnosis of chickenpox, which allows for timely initiation of supportive care and, in high-risk patients, antiviral therapy.
- Chickenpox is highly contagious. Early diagnosis based on the rash is essential for implementing infection control measures, such as isolating the patient (especially in a hospital setting) to prevent transmission to immunocompromised individuals, pregnant women, and newborns.
- Patient education is vital. Nurses must advise patients/parents on managing itching to prevent secondary bacterial infections from scratching, maintaining hydration, and monitoring for complications like pneumonia or encephalitis.
How to Approach the Question
- First, identify the core question: It asks for a condition where all stages of a rash are seen at the same time.
- Recognize that 'all stages simultaneously' is the definition of a 'pleomorphic' rash. This is a key medical term.
- Recall or deduce the characteristics of the rashes associated with each option.
- Chickenpox is the classic textbook example of a pleomorphic rash (macules, papules, vesicles, crusts all at once).
- Eliminate the other options by recalling their typical rash presentations: Chikungunya and Dengue (maculopapular), and Typhoid (rose spots).
- Confirm that Chickenpox is the only option that fits the description of a pleomorphic rash.
Concept Tested & Keywords
- Concept Tested: The key concept tested is the identification of diseases based on the specific characteristics of their associated rash, particularly the phenomenon of pleomorphism.
- Stem keywords: rashes, all stages, simultaneously
- Lead-in keywords: which of the following
- Negative lead-in flag: false
Question ID
QB3u6R-RiOI7KOiEbNx18m
Reference Book
E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart A (pp 26-201 of 604) p. 147-149
Practise the full DSSSB 6 September 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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