Leprosy: reversal reaction spectrum: 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: reversal reaction spectrum

Sample item

Which group of patients is most prone to type 1 (reversal) lepra reaction?

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

The answer and the reasoning

C. Borderline leprosy (BT, BB, BL)

Type 1 reactions occur in the unstable borderline spectrum, when cell-mediated immunity changes, and they upgrade (reversal) or downgrade the disease. Polar tuberculoid and polar lepromatous forms are immunologically stable. ENL is the reaction of lepromatous and borderline lepromatous disease.

Option by option

  • A. Polar lepromatous leprosy

    Polar lepromatous disease is mainly liable to ENL.

  • B. Polar tuberculoid leprosy

    Polar tuberculoid disease is stable and rarely reacts.

  • C. Borderline leprosy (BT, BB, BL) (correct)

    Correct. Borderline forms are immunologically unstable.

  • D. Indeterminate leprosy only

    Indeterminate leprosy is not the usual setting for type 1 reactions.

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 C, Borderline leprosy (BT, BB, BL). Type 1 reactions occur in the unstable borderline spectrum, when cell-mediated immunity changes, and they upgrade (reversal) or downgrade the disease.

Why is "Polar lepromatous leprosy" not the answer?

Polar lepromatous disease is mainly liable to ENL.

Why is "Polar tuberculoid leprosy" not the answer?

Polar tuberculoid disease is stable and rarely reacts.

Why is "Indeterminate leprosy only" not the answer?

Indeterminate leprosy is not the usual setting for type 1 reactions.

What concept does this question test?

It tests Leprosy: reversal reaction spectrum in Dermatology. Polar tuberculoid and polar lepromatous forms are immunologically stable. ENL is the reaction of lepromatous and borderline lepromatous disease.

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: reversal reaction spectrum?

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.