Repeated Medical PG Question- 71

#MEDICINE (NEET- PG)

Q- A 16 year old girl was on antiepileptic for treatment of seizure episodes while asleep. She had no seizure since 6 months. What is further management?

A. Stop treatment

B. Continue for minimum 2 years

C. Life long treatment

D. Stop treatment and follow up with 6 monthly EEG

Answer is B. Continue for minimum 2 years

▪️It is very difficult to determine when to stop therapy. Therapy may be stopped if the patient has been free of  seizures for 2–3 years.

▪️Most guidelines recommend treatment with AED’s for at least 2-5 years of seizure free interval before discontinuing (minimum of 2 years of seizure free period must be documented).Taper the dose of Anti Epileptic drugs rather than abrupt cessation.

▪️Sleep-deprivation EEG may be done first to determine if  the patient is at low risk of  a recurrence.  A normal sleep- deprivation EEG means there is a lower likelihood of  seizures.

Q-  A mechanic comes with fever, body ache and joint pains, he was given NSAIDS. A few days later he developed pigmentations over nose, his diagonis is?

A. Melasma

B. Chickengunia 

C. Dengue

D. Fixed drug erruption

Answer is  B. Chickengunia

▪️Skin hyperpigmentation is the commonly encountered finding in case of chickengunia.

▪️ It occurs in the form of centrofacial pigmentation as shown in picture predominantly involving the nose (Chick sign)

▪️It is the most commonly described pigmentation developing during the acute phase of the disease and helps in the retrospective diagnosis of CHK infectio

▪️Vascular response in the form of facial flushing, erythema and edema of ear lobules resembling Milian's ear sign.

CHIK SIGN: Classical presentation on and around nose in chickengunia