Urticaria: cold 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.

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Dermatology · Urticaria: cold urticaria

Sample item

A young woman develops wheals and facial swelling after swimming in cold water, and an ice cube applied to the forearm for 5 minutes produces a wheal on rewarming. What safety advice is vital?

AUse topical steroids before swimmingBNo special precautions are neededCAvoid swimming alone in cold water because of the risk of systemic reaction and drowningDTake cold baths to desensitise

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

The answer and the reasoning

C. Avoid swimming alone in cold water because of the risk of systemic reaction and drowning

Cold urticaria is confirmed by the ice cube test. Extensive cold exposure such as swimming can cause generalised mediator release with hypotension and collapse, so patients must avoid cold water immersion alone and may carry adrenaline. Antihistamines are the treatment, and secondary causes such as cryoglobulins should be sought.

Option by option

A. Use topical steroids before swimming
Topical steroids do not prevent the reaction.
B. No special precautions are needed
Precautions are needed.
C. Avoid swimming alone in cold water because of the risk of systemic reaction and drowning (correct)
Correct. Cold water swimming can cause systemic reactions and drowning.
D. Take cold baths to desensitise
Deliberate cold exposure is dangerous.

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.

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Avoid swimming alone in cold water because of the risk of systemic reaction and drowning. Cold urticaria is confirmed by the ice cube test.

Why is "Use topical steroids before swimming" not the answer?

Topical steroids do not prevent the reaction.

Why is "No special precautions are needed" not the answer?

Precautions are needed.

Why is "Take cold baths to desensitise" not the answer?

Deliberate cold exposure is dangerous.

What concept does this question test?

It tests Urticaria: cold urticaria in Dermatology. Extensive cold exposure such as swimming can cause generalised mediator release with hypotension and collapse, so patients must avoid cold water immersion alone and may carry adrenaline. Antihistamines are the treatment, and secondary causes such as cryoglobulins should be sought.

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: cold 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.