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Welcome to your Quiz
Name
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Email
Phone
City
IADVL / SES membership number
Which ceramide subclass is covalently bound to involucrin on the cornified envelope to establish the cornified lipid envelope (CLE) scaffold?
Cer[NP]
Cer[EOS]
Cer[AS]
Cer[NS]
None
In the stratum granulosum, which tight junction protein is directly downregulated by IL-4 and IL-13, leading to enhanced antigen penetration?
Claudin-1
Claudin-5
Desmoglein-1
Corneodesmosin
None
Which epidermal-specific ceramide synthase is suppressed by Th2 cytokines (IL-4/IL-13), impairing the synthesis of very long-chain ceramides (C24–C32)?
CerS1
CerS2
CerS3
CerS6
None
Which cytokine acts predominantly through the IL-31RA/OSMR complex on sensory neurons to serve as the primary mediator of pruritus in AD?
IL-22
IL-31
IL-17A
IL-10
None
How does elevated stratum corneum pH secondary to filaggrin deficiency alter enzymatic barrier homeostasis?
Inhibits kallikrein-5 and activates LEKTI
Activates acid sphingomyelinase and beta-glucocerebrosidase
Inhibits beta-glucocerebrosidase and promotes unrestrained KLK5/KLK7 activity
Upregulates ABCA12 lipid loading
None
In lipidomic analysis of AD stratum corneum, which shift in ceramide chain length distribution is typically observed?
Selective increase in C24–C26 ceramides with depletion of C16–C18 ceramides
Selective reduction in long-chain ceramides (C24–C26) with a relative increase in short-chain ceramides (C16–C18)
Uniform elevation of all ceramide chain lengths
Complete loss of short-chain ceramides only
None
What distinguishes intrinsic AD from extrinsic AD immunologically and clinically?
Intrinsic AD shows high total serum IgE with purely Th1-mediated inflammation
Intrinsic AD presents with normal serum IgE levels and mixed Th2/Th1/Th17 cytokine activation
Intrinsic AD accounts for 70–80% of all atopic dermatitis cases
Intrinsic AD exhibits intact filaggrin expression and zero TEWL elevation
None
According to the "bricks and mortar" model of the stratum corneum, what proportion of total intercellular lipid mass is comprised of ceramides?
Roughly 10%
Roughly 25%
Roughly 50%
Roughly 85%
None
In the sphingomyelin hydrolysis pathway, which enzyme hydrolyzes lamellar body-derived sphingomyelin into ceramide in the stratum corneum extracellular space?
Serine palmitoyltransferase (SPT)
Acid sphingomyelinase (aSMase)
Beta-glucocerebrosidase (GBA)
Transglutaminase-1
None
In pediatric AD patients with loss-of-function FLG mutations, barrier disruption is characterized by which immune polarization in the stratum corneum compared to adult AD?
Th1-predominant environment
Th17-enriched environment
Pure Th22 environment without Th2 involvement
Complete suppression of all adaptive immune axes
None
1 out of 2
Which diagnostic presentation is recognized as the most distinctive phenotypic manifestation of AD in Fitzpatrick IV–VI Indian patients?
Confluent, bright salmon-pink erythema over extensor surfaces
Follicular papules centered on hair follicles, often misdiagnosed as keratosis pilaris or folliculitis
Severe generalized bullous eruptions
Pitted keratolysis with geographic erythema
None
Why do non-sedating H1 antihistamines consistently fail to control chronic pruritus in atopic dermatitis?
AD itch is primarily non-histaminergic, mediated by mediators such as IL-31, TSLP, and PAR-2 activation
H1 receptors are absent in dark skin phenotypes
Histamine is neutralized by stratum corneum proteases before receptor binding
Mast cells undergo apoptosis in chronic AD lesions
None
What is the scientifically validated physiological molar ratio of ceramides to cholesterol to free fatty acids required for barrier repair therapy (BRT)?
1:1:1
3:1:1
1:3:1
5:2:1
None
In the IADVL STAND AD 2024 consensus, which agent is recommended as the first-line conventional systemic immunosuppressant for moderate-to-severe AD in India?
Azathioprine
Methotrexate
Cyclosporine (2.5–5 mg/kg/day)
Mycophenolate mofetil
None
Which screening test is preferred prior to initiating targeted biologics or JAK inhibitors in BCG-vaccinated Indian patients?
Tuberculin skin test (Mantoux)
Interferon-Gamma Release Assay (IGRA / QuantiFERON-TB Gold)
Serum IgE level
Patch testing with PPD
None
Which biological mechanism explains why topical emollient application within 3 minutes of bathing provides rapid itch relief prior to anti-inflammatory onset?
Direct competitive inhibition of H1 receptors on mast cells
Immediate suppression of keratinocyte alarmin TSLP release, blocking TRPA1+ sensory nerve activation
Cleavage of neuronal IL-31RA receptors
Selective degradation of substance P
None
What dual therapeutic benefit does niacinamide provide in advanced emollient formulations for Indian patients with AD?
Upregulates filaggrin/ceramide synthesis and inhibits melanosome transfer to reduce PIH
Inhibits Janus kinase-1 and replaces free fatty acids directly
Acts as an occlusive wax while bleaching normal skin tones
Destroys S. aureus cell walls and prevents sweat production
None
Which traditional oil is supported by RCT evidence for reducing SCORAD and S. aureus colonization in pediatric AD, contrasting with barrier-disruptive mustard and olive oils?
Pure Mustard oil
Refined Olive oil
Virgin Coconut oil
Castor oil
None
What is the recommended emollient quantity that should be prescribed weekly for an adult patient with atopic dermatitis?
50–100 g/week
100–200 g/week
250–500 g/week
750–1000 g/week
None
Which targeted agent holds CDSCO approval for Indian AD patients aged 6 months and older and demonstrated a 68% EASI-75 response at 6 months in Indian real-world data?
Upadacitinib
Abrocitinib
Tralokinumab
Dupilumab
None
2 out of 2
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