Varicella | Chickenpox | HHV3 | Varicella-Zoster Virus | Immunosuppression Cyclosporine CNIs |

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Hello strands myself dr imagination was certified dermatologist discussing dharma related topics in my youtube channel so if you’re new to this i would suggest and request you to please subscribe to my youtube channel this is the today’s mcq a 35 year old man so whenever a mcq is given you should read all the important clues in the question very very carefully so

The age is also very important and what medications the patient is on that also is very very important clue which the examiner will try to mention in the question so this patient was on cyclosports in few months okay since few months now he presented with four days history of fever four days history of fever cough and shortness of breath is there one day prior to

The above symptoms that is before the appearance of fever cough and shortness of breath there was appearance of some skin rash and what was the type of skin rash pluritic vesicular rash periodic vesicular rash was present on face trunk and limbs and justice findings are mentioned they were suggestive of pneumonia so with all these clues the examiner is asking the

Diagnosis of this and if you have marked the answer as option b disseminated virusel infection absolutely correct answer so uh why why is this virus lie infection decimator viral cell infection the answer here because usually you might have heard the varicella that is chickenpox which is caused by varicella zoster virus virusella’s osteovirus which is human herpes

Virus it is caused by this hhv3 this is you usually seen in the childhood where the presentation is going to be discrete vesicular lesions over the body mainly involving the central portions of the body that is the distribution is mainly centripetal and the spread is centrifugal and the classical description of the lesions is dew drop on rose petal appearance

You might have heard of all these things okay childhood with complaints of the this kind of a vesicular rash but here the patient is a adult so why we are getting uh into this diagnosis of viruses lies because the important clue which is mentioned that is cyclosporine which is a calcium inhibitor and it is basically a immunomodulator amino modulator or we can

Say it can also suppress the immunity in the individuals okay because of this what will happen this uh hhv3 which usually presents in the childhood it can or it can be a complication of this immunosuppression in the adult adult because of which the manifestations are going to be in the form of severe varicella infection that is severe chickenpox in adults is

The presentation in which we can see of course this vesicular rash which are able to see over the body and it is almost involving entire body and along with that even patients can have the physical findings that is the fever malaise the shortness of breath and on chest x-ray they can have these features of pneumonia which is classically uh described as varicella

Pneumonia which will give star sky appearance to the chest x-ray or if that were to be mentioned so uh and some students uh have answered it as anaphylaxis cyclosporine please remember if it was anaphylaxis to cyclosporine because of which these presentations uh were seen it would be immediate okay it would be immediate but the patient is taking cyclosporine

Since few months so it is not option d it is not option day and after option a there would have been some mention of some features which about suggest october closely like for example there would be a mention of mantos test or they would be a mention of afb on sputum so they were they are all not present so it is not tuberculosis and kaposi’s sarcoma it is going to

Present in the form of erythematous blocks but not vesicular lesions as given in this case so it is not capacitor so you can even rule out the options and come to the diagnosis uh for this particular question and i’m very happy uh almost all the students have answered this right if you are not yet the member of this telegram group which is free for all check out

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Channel and please do pause this video and try to guess what is the answer for this mcq mcq number 398 followed by your answer so post this as your comment if the answer is correct i would give a heart to your comment so always remember to think positive way always believe in yourself i can do it should be your belief system and thank you so much uh friends

Happy learning myself dr madness recreational survey channel