Papulosquamous disorders: nailfold capillaroscopy in Raynaud phenomenon: 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: nailfold capillaroscopy in Raynaud phenomenon

Sample item

A 35-year-old woman with cold-induced digital colour change wants to know whether it is primary or secondary Raynaud phenomenon. Which finding favours a secondary process from systemic sclerosis?

ADilated nailfold capillaries with areas of dropoutBSymmetrical attacks beginning in the teenage yearsCAbsence of digital pitting scarsDNormal ESR and negative antinuclear antibody

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

The answer and the reasoning

A. Dilated nailfold capillaries with areas of dropout

Abnormal nailfold capillaroscopy, with giant loops and capillary loss, together with a positive antinuclear antibody or digital ulcers, favours secondary Raynaud phenomenon. Primary disease has a normal capillary pattern and no systemic features.

Option by option

A. Dilated nailfold capillaries with areas of dropout (correct)
Correct. Enlarged capillaries and dropout suggest microvascular disease from systemic sclerosis.
B. Symmetrical attacks beginning in the teenage years
Symmetric attacks from the teens are typical of primary Raynaud.
C. Absence of digital pitting scars
Absent digital pitting scars point away from a scleroderma process.
D. Normal ESR and negative antinuclear antibody
A normal ESR with negative antinuclear antibody is more typical of primary 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.

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is A, Dilated nailfold capillaries with areas of dropout. Abnormal nailfold capillaroscopy, with giant loops and capillary loss, together with a positive antinuclear antibody or digital ulcers, favours secondary Raynaud phenomenon.

Why is "Symmetrical attacks beginning in the teenage years" not the answer?

Symmetric attacks from the teens are typical of primary Raynaud.

Why is "Absence of digital pitting scars" not the answer?

Absent digital pitting scars point away from a scleroderma process.

Why is "Normal ESR and negative antinuclear antibody" not the answer?

A normal ESR with negative antinuclear antibody is more typical of primary disease.

What concept does this question test?

It tests Papulosquamous disorders: nailfold capillaroscopy in Raynaud phenomenon in Dermatology. Primary disease has a normal capillary pattern and no systemic features.

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 Papulosquamous disorders: nailfold capillaroscopy in Raynaud phenomenon?

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.