Leprosy: secondary amyloidosis: 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: secondary amyloidosis

Sample item

A man with lepromatous leprosy of 20 years and repeated ENL has oedema and heavy proteinuria. Renal biopsy shows amorphous deposits that stain with Congo red, and the apple-green birefringence is lost after potassium permanganate treatment. Which protein is deposited?

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

The answer and the reasoning

C. Serum amyloid A

Chronic inflammation in lepromatous leprosy can lead to reactive systemic AA amyloidosis, a recognised cause of renal failure in neglected cases. AA amyloid is the permanganate-sensitive type, while AL amyloid is permanganate-resistant.

Option by option

  • A. Immunoglobulin light chain

    AL amyloid arises from plasma cell dyscrasias and resists permanganate.

  • B. Beta-2 microglobulin

    Beta-2 microglobulin amyloid occurs in long-term dialysis.

  • C. Serum amyloid A (correct)

    Correct. Serum amyloid A derived deposits fit chronic inflammation and permanganate sensitivity.

  • D. Transthyretin

    Transthyretin amyloid is hereditary or senile and also resists permanganate.

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, Serum amyloid A. Chronic inflammation in lepromatous leprosy can lead to reactive systemic AA amyloidosis, a recognised cause of renal failure in neglected cases.

Why is "Immunoglobulin light chain" not the answer?

AL amyloid arises from plasma cell dyscrasias and resists permanganate.

Why is "Beta-2 microglobulin" not the answer?

Beta-2 microglobulin amyloid occurs in long-term dialysis.

Why is "Transthyretin" not the answer?

Transthyretin amyloid is hereditary or senile and also resists permanganate.

What concept does this question test?

It tests Leprosy: secondary amyloidosis in Dermatology. AA amyloid is the permanganate-sensitive type, while AL amyloid is permanganate-resistant.

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: secondary amyloidosis?

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.