Metabolic skin signs: calciphylaxis: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Metabolic skin signs: calciphylaxis

Sample item

A dialysis patient has intensely painful retiform purpura progressing to black necrotic ulcers on the thighs and abdomen, with raised calcium-phosphate product. Which treatment is commonly used?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Sodium thiosulfate with wound care and correction of mineral metabolism

Calciphylaxis (calcific uremic arteriolopathy) is calcification and thrombosis of dermal and subcutaneous arterioles in end-stage renal disease, carrying high mortality. Management includes sodium thiosulfate, wound care, pain control and optimisation of calcium, phosphate and parathyroid status, while warfarin is stopped.

Option by option

  • A. Topical clobetasol

    Topical steroids do not treat the arteriolar disease.

  • B. Oral warfarin to improve perfusion

    Warfarin is a known risk factor and is avoided.

  • C. Sodium thiosulfate with wound care and correction of mineral metabolism (correct)

    Correct. Sodium thiosulfate and metabolic correction are the mainstay.

  • D. Surgical debridement alone without addressing cause

    Debridement alone does not address the vascular calcification.

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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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Sodium thiosulfate with wound care and correction of mineral metabolism. Calciphylaxis (calcific uremic arteriolopathy) is calcification and thrombosis of dermal and subcutaneous arterioles in end-stage renal disease, carrying high mortality.

Why is "Topical clobetasol" not the answer?

Topical steroids do not treat the arteriolar disease.

Why is "Oral warfarin to improve perfusion" not the answer?

Warfarin is a known risk factor and is avoided.

Why is "Surgical debridement alone without addressing cause" not the answer?

Debridement alone does not address the vascular calcification.

What concept does this question test?

It tests Metabolic skin signs: calciphylaxis in Dermatology. Management includes sodium thiosulfate, wound care, pain control and optimisation of calcium, phosphate and parathyroid status, while warfarin is stopped.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Metabolic skin signs: calciphylaxis?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.