Neurology: painful diabetic neuropathy: practice question

A General Medicine 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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General Medicine · Neurology: painful diabetic neuropathy

Sample item

A 58-year-old with diabetes has burning pain in both feet at night. Which drug has first-line evidence for neuropathic pain?

APrednisoloneBStrong opioids as first choiceCParacetamol aloneDPregabalin

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

The answer and the reasoning

D. Pregabalin

Painful diabetic peripheral neuropathy is managed with duloxetine, pregabalin, gabapentin or amitriptyline alongside glycaemic control and foot care. Simple analgesics and NSAIDs are generally ineffective for neuropathic pain. Opioids are not recommended first line because of dependence.

Option by option

A. Prednisolone
Steroids are not indicated.
B. Strong opioids as first choice
Opioids carry risk and are not first-line.
C. Paracetamol alone
Paracetamol has little effect on neuropathic pain.
D. Pregabalin (correct)
Correct. Gabapentinoids are first-line for neuropathic pain.

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.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Pregabalin. Painful diabetic peripheral neuropathy is managed with duloxetine, pregabalin, gabapentin or amitriptyline alongside glycaemic control and foot care.

Why is "Prednisolone" not the answer?

Steroids are not indicated.

Why is "Strong opioids as first choice" not the answer?

Opioids carry risk and are not first-line.

Why is "Paracetamol alone" not the answer?

Paracetamol has little effect on neuropathic pain.

What concept does this question test?

It tests Neurology: painful diabetic neuropathy in General Medicine. Simple analgesics and NSAIDs are generally ineffective for neuropathic pain. Opioids are not recommended first line because of dependence.

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 Neurology: painful diabetic neuropathy?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.