Leprosy: management of type 1 reaction: 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: management of type 1 reaction

Sample item

A woman with borderline tuberculoid leprosy develops swollen erythematous existing plaques and a tender, thickened ulnar nerve with new weakness of finger abduction. What is the most appropriate treatment?

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

The answer and the reasoning

B. Oral prednisolone, with continued multidrug therapy and nerve rest

Type 1 reaction with nerve function impairment is a medical emergency, and a tapering course of prednisolone given over several months protects nerve function. Antileprosy therapy continues. Thalidomide is effective for ENL but not for type 1 reactions.

Option by option

  • A. Antihistamines alone

    Antihistamines will not save nerve function.

  • B. Oral prednisolone, with continued multidrug therapy and nerve rest (correct)

    Correct. Steroids with continued MDT and nerve rest are standard.

  • C. Oral thalidomide

    Thalidomide does not control type 1 reactions and is teratogenic.

  • D. Stopping multidrug therapy until the reaction settles

    Stopping MDT is not advised, since reactions are not drug allergy.

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 B, Oral prednisolone, with continued multidrug therapy and nerve rest. Type 1 reaction with nerve function impairment is a medical emergency, and a tapering course of prednisolone given over several months protects nerve function.

Why is "Antihistamines alone" not the answer?

Antihistamines will not save nerve function.

Why is "Oral thalidomide" not the answer?

Thalidomide does not control type 1 reactions and is teratogenic.

Why is "Stopping multidrug therapy until the reaction settles" not the answer?

Stopping MDT is not advised, since reactions are not drug allergy.

What concept does this question test?

It tests Leprosy: management of type 1 reaction in Dermatology. Antileprosy therapy continues. Thalidomide is effective for ENL but not for type 1 reactions.

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: management of type 1 reaction?

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.