Urticaria: refractory chronic spontaneous urticaria: 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.

Try it

Dermatology · Urticaria: refractory chronic spontaneous urticaria

Sample item

A woman has daily wheals for 5 months. They persist despite cetirizine at four times the standard dose, and routine tests are normal. Which add-on drug is recommended next?

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

The answer and the reasoning

A. Omalizumab

In guideline stepwise care, refractory chronic spontaneous urticaria after up-dosed second-generation antihistamines receives omalizumab, an anti-IgE antibody. Cyclosporine follows if omalizumab fails. Chronic oral steroids are discouraged.

Option by option

  • A. Omalizumab (correct)

    Correct. Omalizumab is the recommended next step after up-dosed antihistamines.

  • B. Long-term oral prednisolone

    Long-term oral steroids carry unacceptable adverse effects.

  • C. Dapsone as the first escalation

    Dapsone is a minor off-label option, not the guideline escalation.

  • D. Oral isotretinoin

    Isotretinoin has no role in urticaria.

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.

More Dermatology questions

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is A, Omalizumab. In guideline stepwise care, refractory chronic spontaneous urticaria after up-dosed second-generation antihistamines receives omalizumab, an anti-IgE antibody.

Why is "Long-term oral prednisolone" not the answer?

Long-term oral steroids carry unacceptable adverse effects.

Why is "Dapsone as the first escalation" not the answer?

Dapsone is a minor off-label option, not the guideline escalation.

Why is "Oral isotretinoin" not the answer?

Isotretinoin has no role in urticaria.

What concept does this question test?

It tests Urticaria: refractory chronic spontaneous urticaria in Dermatology. Cyclosporine follows if omalizumab fails. Chronic oral steroids are discouraged.

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 Urticaria: refractory chronic spontaneous urticaria?

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.