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General Medicine · Dermatology: erythema multiforme and SJS
Sample itemAfter starting a high-risk medication, a patient develops fever, painful widespread erythematous rash, mucosal erosions, and skin detachment. What is the most appropriate immediate action?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Stop the suspected drug and arrange urgent specialist supportive care
Mucosal involvement and epidermal detachment after a new medication raise concern for Stevens-Johnson syndrome or toxic epidermal necrolysis. Immediate drug withdrawal and urgent hospital-based supportive care are essential.
Option by option
A. Treat as uncomplicated urticaria only
Simple urticaria does not cause mucosal erosions and skin detachment.
B. Start a cosmetic skin-lightening agent
Cosmetic treatment is inappropriate in an acute severe drug reaction.
C. Stop the suspected drug and arrange urgent specialist supportive care (correct)
Correct. Removing the culprit exposure and escalating care are critical.
D. Continue the drug and add topical emollient
Continuing a possible culprit can worsen a life-threatening reaction.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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