Papulosquamous disorders: nephrogenic systemic fibrosis: 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 · Papulosquamous disorders: nephrogenic systemic fibrosis

Sample item

A patient with end-stage kidney disease on haemodialysis develops woody induration and tightening of the skin of the legs and forearms with joint contractures, a few weeks after an MRI study. Which exposure is implicated?

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

The answer and the reasoning

A. Gadolinium-based contrast agent

Nephrogenic systemic fibrosis occurs in patients with severely reduced renal function after gadolinium-based MRI contrast, with thickened, fibrotic skin and contractures. The face is usually spared. Avoiding certain linear agents in advanced kidney disease is the key prevention measure.

Option by option

  • A. Gadolinium-based contrast agent (correct)

    Correct. Gadolinium in severe renal impairment is the established trigger.

  • B. Technetium-99m

    Technetium-99m is a nuclear imaging isotope and is not linked to skin fibrosis.

  • C. Oral barium sulphate

    Barium sulphate is not absorbed from the gut and is not linked to this condition.

  • D. Iodinated contrast medium

    Iodinated contrast causes contrast nephropathy and hypersensitivity but not this fibrosing disease.

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 A, Gadolinium-based contrast agent. Nephrogenic systemic fibrosis occurs in patients with severely reduced renal function after gadolinium-based MRI contrast, with thickened, fibrotic skin and contractures.

Why is "Technetium-99m" not the answer?

Technetium-99m is a nuclear imaging isotope and is not linked to skin fibrosis.

Why is "Oral barium sulphate" not the answer?

Barium sulphate is not absorbed from the gut and is not linked to this condition.

Why is "Iodinated contrast medium" not the answer?

Iodinated contrast causes contrast nephropathy and hypersensitivity but not this fibrosing disease.

What concept does this question test?

It tests Papulosquamous disorders: nephrogenic systemic fibrosis in Dermatology. The face is usually spared. Avoiding certain linear agents in advanced kidney disease is the key prevention measure.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Papulosquamous disorders: nephrogenic systemic fibrosis?

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.