Leprosy: cytokine profile at the lepromatous pole: 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: cytokine profile at the lepromatous pole

Sample item

A patient has widespread symmetric skin infiltration with a bacteriological index of 5+ and a negative lepromin test. Which cytokine profile is expected in the lesions?

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

The answer and the reasoning

D. Th2 pattern with interleukin-4 and interleukin-10

The lepromatous pole is characterised by a Th2-type response with IL-4 and IL-10, which suppresses macrophage activation and allows unchecked bacillary multiplication. The tuberculoid pole has a Th1 response with interferon gamma and IL-2.

Option by option

  • A. Th1 pattern with interferon gamma and interleukin-2

    A Th1 profile with interferon gamma characterises the tuberculoid pole.

  • B. Th17 pattern with interleukin-17 and interleukin-22

    A Th17 profile is not the defining pattern of the lepromatous pole.

  • C. Dominant natural killer cell pattern with perforin

    A dominant natural killer cell pattern does not define either pole of the spectrum.

  • D. Th2 pattern with interleukin-4 and interleukin-10 (correct)

    Correct. A Th2 profile accompanies the poor cell-mediated immunity of lepromatous disease.

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 D, Th2 pattern with interleukin-4 and interleukin-10. The lepromatous pole is characterised by a Th2-type response with IL-4 and IL-10, which suppresses macrophage activation and allows unchecked bacillary multiplication.

Why is "Th1 pattern with interferon gamma and interleukin-2" not the answer?

A Th1 profile with interferon gamma characterises the tuberculoid pole.

Why is "Th17 pattern with interleukin-17 and interleukin-22" not the answer?

A Th17 profile is not the defining pattern of the lepromatous pole.

Why is "Dominant natural killer cell pattern with perforin" not the answer?

A dominant natural killer cell pattern does not define either pole of the spectrum.

What concept does this question test?

It tests Leprosy: cytokine profile at the lepromatous pole in Dermatology. The tuberculoid pole has a Th1 response with interferon gamma and IL-2.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: cytokine profile at the lepromatous pole?

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.