All are true about stillbih, except: Maharashtra 08, 09, 11
**Question:** All are true about Still's Disease, except Maharashtra 08, 09, 11.
**Core Concept:** Still's Disease, also known as adult-onset Still's disease (AOSD), is a rare, inflammatory disorder that affects adults. It is characterized by fever, arthritis, rash, and systemic involvement. Maharashtra is a state in India, but the question refers to specific years (08, 09, 11). These years are unrelated to the disease itself and serve as unrelated details in this context.
**Why the Correct Answer is Right:** The correct answer is "D" because the question asks for the exception to the true statements about Still's Disease. Maharashtra 08, 09, 11 are unrelated to the disease itself, and their inclusion in the statement is irrelevant and misleading. These years are not clinical, pathological, or therapeutic aspects of Still's Disease.
**Why Each Wrong Option is Incorrect:**
A. Maharashtra 07: Incorrect because the question specifically mentions Maharashtra 08, 09, 11, which makes 07 irrelevant and does not address the true statements about Still's Disease.
B. Clinical features: Still's Disease presents with high-grade fever, arthralgia, polyarthritis, evanescent salmon-pink rash, hepatosplenomegaly, lymphadenopathy, and elevated acute phase reactants (C-reactive protein, erythrocyte sedimentation rate, ferritin). This option addresses the clinical features of Still's Disease but omits the year details (Maharashtra 08, 09, 11).
C. Pathogenesis: Still's Disease is characterized by a cytokine storm (increased levels of IL-1, IL-6, and TNF-alpha) and is caused by a viral infection, typically secondary to H. Pylori or Streptococcus pyogenes infection. This option addresses the pathogenesis of Still's Disease but omits the year details (Maharashtra 08, 09, 11).
D. Treatment: Treatments for Still's Disease include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs). This option addresses the treatment aspect of Still's Disease without including the year details (Maharashtra 08, 09, 11).
**Clinical Pearl:** Maharashtra is a state in India, not directly related to the disease itself or its clinical features, pathogenesis, or treatment. The question specifically mentions Maharashtra 08, 09, and 11, which are unrelated to the core aspects of Still's Disease.
**Why Each Wrong Option is Right:**
A. Maharashtra 07: This option addresses the year details (Maharashtra 08, 09, 11) and is therefore unrelated to the