If a person is having _____ skin patches with definite sensory deficit and/or more than one definite thickened and tender peripheral nerves then it is a case of Multibacillary (MB) leprosy?

1. A

   One

2. B

   Two

3. C

   Three

4. D

   Five

Appeared in: AIIMS Rishikesh & Jodhpur NO - 2017

Explanation

• The WHO and NLEP classify leprosy for treatment purposes based on the number of skin lesions and nerves involved.
• Paucibacillary (PB) leprosy is defined as having 1 to 5 skin lesions and/or involvement of a single nerve trunk.
• Multibacillary (MB) leprosy is defined as having six or more skin lesions and/or involvement of more than one nerve trunk.
• The number 'five' is the critical threshold separating the two categories. Having up to five lesions is PB, while having more than five is MB.
• Therefore, in the context of the given options, 'five' represents the boundary value tested in the classification criteria.

Why Other Options Were Wrong

• Option A: Having one skin patch falls definitively under the classification of Paucibacillary (PB) leprosy, which is defined by 1-5 lesions.
• Option B: Having two skin patches is clearly within the definition of Paucibacillary (PB) leprosy (1-5 lesions).
• Option C: Having three skin patches is also classified as Paucibacillary (PB) leprosy, as the range is 1-5 lesions.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain WHO/NLEP classification of leprosy based on clinical signs as background academic context rather than a clinical decision trigger.
• Correctly classifying leprosy as PB or MB is the most critical step in management, as it determines the specific combination of drugs and the duration of Multi-Drug Therapy (MDT).
• MB leprosy requires a longer and more intensive drug regimen (typically 12 months) compared to PB leprosy (typically 6 months) to prevent relapse and drug resistance.
• Nursing care involves educating patients on the importance of treatment adherence and teaching self-care techniques for anesthetic areas (hands, feet, eyes) to prevent injuries and disabilities.

How to Approach the Question

• First, identify the core concept being tested, which is the clinical classification of leprosy.
• Recall the WHO/NLEP definitions for Paucibacillary (PB) and Multibacillary (MB) leprosy.
• Focus on the key numerical criteria: the number of skin lesions and the number of involved nerves.
• Remember the threshold: 1-5 lesions for PB, and 6 or more for MB. The number '5' is the boundary.
• Analyze the options. Note that 1, 2, and 3 are clearly within the PB range. 'Five' represents the upper limit of PB, making it the critical threshold number.
• Select the option that represents this clinical classification boundary, even if the question's wording is slightly ambiguous.

Concept Tested & Keywords

• Concept Tested: WHO/NLEP classification of leprosy based on clinical signs.
• Stem keywords: leprosy, Multibacillary (MB), skin patches, sensory deficit, thickened nerves
• Lead-in keywords: If a person is having

Question ID

QMbdndxOFqkg_u2WdX_Xuc

Copy ID

Reference Book

E6 Medicine Harrison 22e Part 1 p. 1447-1449

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) p. 182-184