Leprosy

Topics in this chapter

• Classification and Immunology
• Clinical Features and Nerve Involvement
• Histopathology and Diagnostic Tests
• Reactions and Complications
• Treatment and Drug Side Effects

Practice questions

1. Question 1Q-2D33DC

   A 35-year-old male presents with multiple hypopigmented, anesthetic patches over his trunk and extremities. Skin slit smear is positive for acid-fast bacilli with a Bacteriological Index (BI) of 3+ and Morphological Index (MI) of 0%. According to the Ridley-Jopling classification, which is the most likely diagnosis?

   1. A.Indeterminate leprosy
   2. B.Borderline tuberculoid leprosy
   3. C.Borderline borderline leprosy
   4. D.Borderline lepromatous leprosy
   See the answer and solution
2. Question 2Q-A31A87

   A patient with lepromatous leprosy on Multi-Drug Therapy (MDT) develops painful subcutaneous nodules on the extremities, accompanied by fever, arthralgia, and iridocyclitis. Biopsy of a nodule shows intense neutrophilic infiltrate in the deep dermis and subcutis with leukocytoclastic vasculitis. What is the most appropriate initial management for this severe reaction?

   1. A.Increase the dose of Rifampicin
   2. B.Start Thalidomide or systemic corticosteroids
   3. C.Stop all anti-leprosy drugs permanently
   4. D.Administer Clofazimine in low daily doses only
   See the answer and solution
3. Question 3Q-52CB7B

   Which of the following nerves is classically known to be the most commonly affected peripheral nerve in leprosy?

   1. A.Ulnar nerve
   2. B.Great auricular nerve
   3. C.Common peroneal nerve
   4. D.Median nerve
   See the answer and solution
4. Question 4Q-2FBEB6

   According to the World Health Organization (WHO) guidelines, what is the standard duration of Multi-Drug Therapy (MDT) for a patient diagnosed with multibacillary (MB) leprosy in adults?

   1. A.6 months
   2. B.12 months
   3. C.24 months
   4. D.Lifelong
   See the answer and solution
5. Question 5Q-A982D6

   A 28-year-old male treated for borderline tuberculoid leprosy 3 months ago presents with acute swelling, redness, and tenderness of pre-existing skin lesions, along with acute tenderness and loss of function in the right ulnar nerve. Skin smear is negative. What is the diagnosis and mechanism?

   1. A.Type 1 reaction; Delayed-type hypersensitivity (Cell-mediated)
   2. B.Type 2 reaction; Immune complex-mediated
   3. C.Type 3 reaction; Immediate hypersensitivity
   4. D.Lucio phenomenon; Thrombotic vasculopathy
   See the answer and solution