Q.1 Which of the following is the most common systemic cause of generalized pruritus without skin lesions?
Chronic kidney disease
Liver cirrhosis
Iron deficiency anemia
Hodgkin’s lymphoma
Explanation - Uremic pruritus is commonly seen in patients with chronic kidney disease, especially those on dialysis.
Correct answer is: Chronic kidney disease
Q.2 Which nerve fibers primarily transmit the sensation of pruritus?
A-delta fibers
C fibers
B fibers
A-beta fibers
Explanation - Itch is transmitted predominantly by unmyelinated C fibers, which are slow-conducting.
Correct answer is: C fibers
Q.3 Pruritus in cholestatic liver disease is primarily mediated by accumulation of:
Urea
Bile salts
Histamine
Keratin
Explanation - In cholestasis, accumulation of bile salts in the skin causes intense pruritus.
Correct answer is: Bile salts
Q.4 Which systemic malignancy is classically associated with pruritus?
Non-Hodgkin’s lymphoma
Hodgkin’s lymphoma
Breast carcinoma
Lung carcinoma
Explanation - Pruritus is a well-known systemic symptom in patients with Hodgkin’s lymphoma.
Correct answer is: Hodgkin’s lymphoma
Q.5 Which dermatological condition is most strongly associated with nocturnal pruritus?
Atopic dermatitis
Scabies
Psoriasis
Seborrheic dermatitis
Explanation - Scabies typically presents with intense nocturnal pruritus due to mite activity at night.
Correct answer is: Scabies
Q.6 Which cytokine plays a central role in chronic pruritus associated with atopic dermatitis?
IL-2
IL-4
IL-31
TNF-alpha
Explanation - IL-31 is a key cytokine mediating itch in atopic dermatitis.
Correct answer is: IL-31
Q.7 Which type of pruritus is often worsened by hot showers?
Uremic pruritus
Cholestatic pruritus
Aquagenic pruritus
Iron deficiency pruritus
Explanation - Aquagenic pruritus is provoked by contact with water, especially warm or hot water.
Correct answer is: Aquagenic pruritus
Q.8 Which receptor is the main mediator of histamine-induced itch?
H1 receptor
H2 receptor
H3 receptor
H4 receptor
Explanation - Histamine binds to H1 receptors on sensory nerves, triggering pruritus.
Correct answer is: H1 receptor
Q.9 Which antipruritic medication works by antagonizing opioid receptors?
Naltrexone
Hydroxyzine
Cetirizine
Gabapentin
Explanation - Naltrexone is an opioid receptor antagonist effective in refractory pruritus.
Correct answer is: Naltrexone
Q.10 Which of the following is the best initial treatment for uremic pruritus?
Topical steroids
Antihistamines
Emollients and phototherapy
Oral antibiotics
Explanation - Moisturizers and phototherapy are effective supportive treatments for uremic pruritus.
Correct answer is: Emollients and phototherapy
Q.11 Generalized pruritus without primary skin lesions is most commonly associated with:
Diabetes mellitus
Hypothyroidism
Chronic renal failure
Psoriasis
Explanation - In systemic diseases, pruritus is often generalized and without primary lesions, especially in renal failure.
Correct answer is: Chronic renal failure
Q.12 Which condition is characterized by pruritus after contact with water without visible rash?
Cholinergic urticaria
Aquagenic pruritus
Scabies
Contact dermatitis
Explanation - Aquagenic pruritus causes severe itching after water exposure without skin changes.
Correct answer is: Aquagenic pruritus
Q.13 In polycythemia vera, pruritus is particularly triggered by:
Heat exposure
Cold exposure
Water contact
Friction
Explanation - Aquagenic pruritus is a classic symptom of polycythemia vera.
Correct answer is: Water contact
Q.14 Which of the following neurotransmitters is most directly involved in the sensation of pruritus?
Acetylcholine
Substance P
Dopamine
Serotonin
Explanation - Substance P is a neuropeptide involved in neurogenic inflammation and itch transmission.
Correct answer is: Substance P
Q.15 Chronic pruritus in elderly patients without skin lesions should raise suspicion of:
Drug allergy
Underlying malignancy
Fungal infection
Sun exposure
Explanation - Elderly patients with unexplained chronic pruritus should be evaluated for internal malignancies.
Correct answer is: Underlying malignancy
Q.16 Which systemic condition is least likely to cause pruritus?
Chronic renal failure
Cholestasis
Hodgkin’s lymphoma
Hypertension
Explanation - Hypertension does not typically cause pruritus, unlike the other listed conditions.
Correct answer is: Hypertension
Q.17 Which vitamin deficiency can be associated with pruritus?
Vitamin A
Vitamin B12
Vitamin C
Vitamin D
Explanation - Vitamin B12 deficiency can rarely cause generalized pruritus.
Correct answer is: Vitamin B12
Q.18 Neuropathic pruritus is often associated with:
Hepatitis
Diabetes mellitus
Chronic kidney disease
Iron deficiency anemia
Explanation - Diabetes mellitus can cause neuropathic pruritus due to peripheral nerve involvement.
Correct answer is: Diabetes mellitus
Q.19 Which treatment is most effective for histamine-mediated pruritus?
Opioid antagonists
Antihistamines
Gabapentin
Phototherapy
Explanation - Antihistamines target histamine-mediated itch effectively.
Correct answer is: Antihistamines
Q.20 Which topical agent is most effective in providing symptomatic relief in localized pruritus?
Topical steroids
Capsaicin cream
Oral antihistamines
Phototherapy
Explanation - Capsaicin depletes substance P and is effective in neuropathic and localized pruritus.
Correct answer is: Capsaicin cream
Q.21 Pruritus in obstructive jaundice is due to accumulation of:
Bilirubin
Bile salts
Uric acid
Ammonia
Explanation - Deposition of bile salts in the skin leads to pruritus in jaundice.
Correct answer is: Bile salts
Q.22 Which psychiatric condition is frequently associated with psychogenic pruritus?
Depression
Schizophrenia
Obsessive-compulsive disorder
Anxiety disorders
Explanation - Psychogenic pruritus is strongly linked to anxiety and somatoform disorders.
Correct answer is: Anxiety disorders
Q.23 Which of the following is NOT a common cause of pruritus?
Chronic kidney disease
Liver disease
Iron deficiency anemia
Hypertension
Explanation - Hypertension is not a direct cause of pruritus, unlike renal or liver disorders.
Correct answer is: Hypertension
Q.24 Which ion channel is a therapeutic target in pruritus management?
Sodium channel
Calcium channel
TRPV1 channel
Potassium channel
Explanation - TRPV1 (transient receptor potential vanilloid 1) channels are important in itch signaling pathways.
Correct answer is: TRPV1 channel
Q.25 Which of the following conditions often causes localized pruritus around the anus?
Diabetes mellitus
Pinworm infection
Hepatitis C
Chronic kidney disease
Explanation - Enterobius vermicularis (pinworm) infection often causes perianal pruritus.
Correct answer is: Pinworm infection