Leprosy: silent neuropathy: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Leprosy: silent neuropathy

Sample item

A multibacillary leprosy patient on MDT has gradually developed weakness of finger abduction and reduced sensation in the little finger over 6 weeks, without pain, tenderness or new skin lesions. What is the appropriate step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Treat as silent neuropathy with oral prednisolone and protect the hand

Silent neuropathy is nerve function impairment without pain or tenderness, and it can progress unnoticed unless nerve function is tested regularly with monofilaments and voluntary muscle testing. It is managed as a reaction-related neuropathy with oral corticosteroids and splinting, while MDT continues. Early treatment improves recovery.

Option by option

  • A. Reassure, as no pain means no nerve damage

    Absence of pain does not exclude nerve damage.

  • B. Stop MDT and observe

    MDT should continue because the bacilli remain a risk.

  • C. Treat as silent neuropathy with oral prednisolone and protect the hand (correct)

    Correct. Silent neuropathy needs steroids and protection while MDT continues.

  • D. Start thalidomide

    Thalidomide is for ENL, not for neuropathy.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Treat as silent neuropathy with oral prednisolone and protect the hand. Silent neuropathy is nerve function impairment without pain or tenderness, and it can progress unnoticed unless nerve function is tested regularly with monofilaments and voluntary muscle testing.

Why is "Reassure, as no pain means no nerve damage" not the answer?

Absence of pain does not exclude nerve damage.

Why is "Stop MDT and observe" not the answer?

MDT should continue because the bacilli remain a risk.

Why is "Start thalidomide" not the answer?

Thalidomide is for ENL, not for neuropathy.

What concept does this question test?

It tests Leprosy: silent neuropathy in Dermatology. It is managed as a reaction-related neuropathy with oral corticosteroids and splinting, while MDT continues. Early treatment improves recovery.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Leprosy: silent neuropathy?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.