Leprosy: risk factors for ENL: 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: risk factors for ENL

Sample item

Which patient is at highest risk of developing erythema nodosum leprosum?

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

The answer and the reasoning

B. A lepromatous patient with a bacteriological index of 4 or more

ENL occurs in lepromatous and borderline lepromatous patients, and the risk rises with a high bacillary load, such as a bacteriological index of 4 or more. It may appear before, during or after treatment, and pregnancy and infection are triggers. Tuberculoid and indeterminate disease do not develop ENL.

Option by option

  • A. A tuberculoid patient with a single patch

    Tuberculoid disease has few bacilli and does not cause ENL.

  • B. A lepromatous patient with a bacteriological index of 4 or more (correct)

    Correct. High bacillary load in lepromatous disease carries the highest ENL risk.

  • C. A pure neuritic leprosy patient

    Pure neuritic leprosy is paucibacillary.

  • D. An indeterminate leprosy patient

    Indeterminate disease has very low bacillary load.

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, A lepromatous patient with a bacteriological index of 4 or more. ENL occurs in lepromatous and borderline lepromatous patients, and the risk rises with a high bacillary load, such as a bacteriological index of 4 or more.

Why is "A tuberculoid patient with a single patch" not the answer?

Tuberculoid disease has few bacilli and does not cause ENL.

Why is "A pure neuritic leprosy patient" not the answer?

Pure neuritic leprosy is paucibacillary.

Why is "An indeterminate leprosy patient" not the answer?

Indeterminate disease has very low bacillary load.

What concept does this question test?

It tests Leprosy: risk factors for ENL in Dermatology. It may appear before, during or after treatment, and pregnancy and infection are triggers. Tuberculoid and indeterminate disease do not develop ENL.

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: risk factors for ENL?

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.