Leprosy: leprosy and diabetic 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: leprosy and diabetic neuropathy

Sample item

A diabetic man has painless plantar ulcers and a stocking pattern of sensory loss, but also a thickened, tender posterior tibial nerve and a hypopigmented anaesthetic patch on the thigh. What should be done in addition to diabetic care?

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

The answer and the reasoning

D. Evaluate for leprosy with slit-skin smear and nerve assessment

Diabetes and leprosy can co-exist and both cause painless plantar ulcers. A thickened nerve and an anaesthetic hypopigmented patch require a leprosy work-up, since treating leprosy prevents more nerve damage.

Option by option

  • A. Attribute everything to diabetic neuropathy

    Attributing all signs to diabetes would miss a treatable infection.

  • B. Plan amputation immediately

    Immediate amputation is not justified before assessing and treating the underlying causes.

  • C. Start antifungal therapy

    An antifungal does not treat nerve-involving mycobacterial disease.

  • D. Evaluate for leprosy with slit-skin smear and nerve assessment (correct)

    Correct. The nerve thickening and anaesthetic patch need a leprosy work-up.

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, Evaluate for leprosy with slit-skin smear and nerve assessment. Diabetes and leprosy can co-exist and both cause painless plantar ulcers.

Why is "Attribute everything to diabetic neuropathy" not the answer?

Attributing all signs to diabetes would miss a treatable infection.

Why is "Plan amputation immediately" not the answer?

Immediate amputation is not justified before assessing and treating the underlying causes.

Why is "Start antifungal therapy" not the answer?

An antifungal does not treat nerve-involving mycobacterial disease.

What concept does this question test?

It tests Leprosy: leprosy and diabetic neuropathy in Dermatology. A thickened nerve and an anaesthetic hypopigmented patch require a leprosy work-up, since treating leprosy prevents more nerve damage.

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: leprosy and diabetic 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.