Leprosy MCQs With Answer

Leprosy MCQs With Answer offers B.Pharm students a concise, exam-focused review of epidemiology, microbiology, clinical features, diagnosis and pharmacotherapy of leprosy. This Student-friendly post highlights essential keywords like leprosy diagnosis, multidrug therapy, dapsone, rifampicin, clofazimine, nerve involvement, and leprosy reactions to help students find targeted study material quickly. Each question emphasizes practical pharmacological and public health aspects, dosing, adverse effects and monitoring relevant to pharmacy practice. The set is designed to deepen conceptual understanding rather than rote recall, preparing students for exams and clinical decision-making. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. What is the causative organism of leprosy?

• Mycobacterium tuberculosis
• Mycobacterium leprae
• Mycobacterium avium
• Mycobacterium kansasii

Correct Answer: Mycobacterium leprae

Q2. Which organism characteristic explains the long incubation period of leprosy?

• Rapid replication rate
• Obligate intracellular parasitism and slow growth
• Spore formation
• High mutation rate

Correct Answer: Obligate intracellular parasitism and slow growth

Q3. Which classification is used clinically to guide treatment duration in WHO programs?

• Ridley-Jopling five-group classification
• WHO paucibacillary and multibacillary classification
• Gram stain classification
• Acid-fast index classification

Correct Answer: WHO paucibacillary and multibacillary classification

Q4. Which of the following stains is typically weakly positive for Mycobacterium leprae?

• Gram stain
• Ziehl-Neelsen (acid-fast) stain
• Giemsa stain
• India ink

Correct Answer: Ziehl-Neelsen (acid-fast) stain

Q5. Which animal model has been historically important for cultivating M. leprae?

• Mouse footpad and nine-banded armadillo
• Rabbit intestine
• Guinea pig skin
• Non-human primate lungs

Correct Answer: Mouse footpad and nine-banded armadillo

Q6. The primary target tissue in leprosy leading to disability is:

• Cardiac muscle
• Peripheral nerves
• Liver parenchyma
• Renal glomeruli

Correct Answer: Peripheral nerves

Q7. Which immune response is associated with tuberculoid leprosy?

• Dominant humoral (Th2) response
• Strong cell-mediated (Th1) response
• Predominant allergic response
• Weak inflammatory response without granulomas

Correct Answer: Strong cell-mediated (Th1) response

Q8. Which drug is the cornerstone bactericidal agent in WHO MDT for leprosy?

• Dapsone
• Clofazimine
• Rifampicin
• Minocycline

Correct Answer: Rifampicin

Q9. Dapsone primarily acts by inhibiting which bacterial process?

• Cell wall synthesis
• Folate synthesis
• Protein synthesis at 30S ribosome
• DNA gyrase function

Correct Answer: Folate synthesis

Q10. A major adverse effect of dapsone that requires monitoring is:

• Hepatotoxicity causing jaundice
• Hemolytic anemia, especially in G6PD deficiency
• Nephrotoxicity with proteinuria
• Ototoxicity leading to hearing loss

Correct Answer: Hemolytic anemia, especially in G6PD deficiency

Q11. Clofazimine causes which characteristic adverse effect important for counseling patients?

• Black discoloration of teeth
• Skin discoloration and ichthyosis
• Photosensitivity blisters
• Cataract formation

Correct Answer: Skin discoloration and ichthyosis

Q12. Standard WHO MDT duration for paucibacillary (PB) leprosy is:

• 1 month
• 6 months
• 12 months
• 24 months

Correct Answer: 6 months

Q13. Standard WHO MDT duration for multibacillary (MB) leprosy is:

• 6 months
• 9 months
• 12 months
• 24 months

Correct Answer: 12 months

Q14. Which test provides a quantitative measure of bacillary load used in monitoring therapy?

• Serum antibody titer
• Slit-skin smear bacterial index
• Complete blood count
• Urine culture

Correct Answer: Slit-skin smear bacterial index

Q15. What is the mechanism of rifampicin action?

• Inhibition of DNA gyrase
• Inhibition of RNA polymerase
• Disruption of cell membrane
• Inhibition of peptidoglycan cross-linking

Correct Answer: Inhibition of RNA polymerase

Q16. Which leprosy reaction is mediated by immune complex deposition and systemic features like fever?

• Type 1 (reversal) reaction
• Type 2 reaction (erythema nodosum leprosum)
• Type 3 hypersensitivity reaction
• Delayed type hypersensitivity only in skin

Correct Answer: Type 2 reaction (erythema nodosum leprosum)

Q17. Management of severe erythema nodosum leprosum (ENL) commonly includes:

• High-dose antibiotics only
• Systemic corticosteroids and thalidomide when indicated
• Topical antifungals
• Immediate discontinuation of MDT

Correct Answer: Systemic corticosteroids and thalidomide when indicated

Q18. Which drug is teratogenic and must be avoided in pregnant women with ENL?

• Prednisone
• Thalidomide
• Clofazimine
• Dapsone

Correct Answer: Thalidomide

Q19. Single-dose rifampicin is used in leprosy control programs as:

• Post-exposure prophylaxis for contacts
• Treatment for multibacillary cases
• Replacement for MDT in pregnancy
• Vaccine adjuvant

Correct Answer: Post-exposure prophylaxis for contacts

Q20. The Ridley-Jopling classification includes which of the following categories?

• Paucibacillary and multibacillary only
• Tuberculoid, borderline and lepromatous spectrum
• Acute and chronic leprosy only
• Cutaneous and visceral leprosy only

Correct Answer: Tuberculoid, borderline and lepromatous spectrum

Q21. Histopathology of lepromatous leprosy typically shows:

• Well-formed granulomas with few bacilli
• Diffuse infiltration with numerous foamy macrophages and many bacilli
• Vasculitis with lymphocyte predominance
• Necrotizing granulomas with caseation

Correct Answer: Diffuse infiltration with numerous foamy macrophages and many bacilli

Q22. Which diagnostic method is most specific for detecting M. leprae DNA?

• Skin smear microscopy
• Polymerase chain reaction (PCR)
• Serology for anti-PGL-1 antibodies
• Complete blood count

Correct Answer: Polymerase chain reaction (PCR)

Q23. A key pharmacy counseling point for rifampicin is:

• It causes hypoglycemia and requires dose increase of insulin
• It colors body fluids orange and can reduce oral contraceptive effectiveness
• It causes immediate severe hepatotoxicity in all patients
• It should be taken with dairy products only

Correct Answer: It colors body fluids orange and can reduce oral contraceptive effectiveness

Q24. When treating a pregnant woman with leprosy, which drug is relatively safe and commonly continued?

• Thalidomide
• Rifampicin
• Clofazimine due to teratogenicity
• Dapsone always contraindicated in pregnancy

Correct Answer: Rifampicin

Q25. Which laboratory parameter should be monitored during dapsone therapy?

• Serum creatinine only
• Complete blood count for hemolysis and methemoglobinemia
• Blood glucose levels weekly
• Urine ketones monthly

Correct Answer: Complete blood count for hemolysis and methemoglobinemia

Q26. Primary resistance to dapsone in leprosy may occur due to mutations in:

• rpoB gene
• folP1 gene
• gyrA gene
• katG gene

Correct Answer: folP1 gene

Q27. Rifampicin resistance is commonly associated with mutations in which gene?

• rpoB gene
• folP1 gene
• gyrA gene
• inhA gene

Correct Answer: rpoB gene

Q28. For a child contact of a leprosy patient, the recommended chemoprophylaxis is:

• Daily dapsone for 6 months
• Single-dose rifampicin where appropriate
• Monthly clofazimine for 12 months
• No intervention is ever recommended

Correct Answer: Single-dose rifampicin where appropriate

Q29. Type 1 (reversal) reactions are characterized by:

• Immune complex mediated systemic vasculitis
• Sudden increase or decrease in cell-mediated immunity causing inflammation of existing lesions and nerves
• Purely neuropathic pain without inflammation
• Opportunistic infections due to immunosuppression

Correct Answer: Sudden increase or decrease in cell-mediated immunity causing inflammation of existing lesions and nerves

Q30. Which of the following is the most important immediate treatment to prevent nerve function impairment in reversal reaction?

• High-dose systemic corticosteroids
• Topical emollients
• Antihistamines only
• Immediate surgical nerve decompression in all cases

Correct Answer: High-dose systemic corticosteroids

Q31. Clofazimine has which additional therapeutic effect beyond antibacterial action?

• Antiviral activity
• Anti-inflammatory effect useful in ENL
• Potent anticoagulant action
• Hypoglycemic effect

Correct Answer: Anti-inflammatory effect useful in ENL

Q32. A significant pharmacokinetic property of clofazimine is:

• Rapid renal excretion
• Long tissue half-life and accumulation in fatty tissues
• Extensive hepatic metabolism to inactive volatile products exhaled
• Poor oral absorption making it intravenous only

Correct Answer: Long tissue half-life and accumulation in fatty tissues

Q33. Which clinical sign is most suggestive of early peripheral nerve involvement in leprosy?

• Sharp central chest pain
• Loss of sensation in a glove-and-stocking distribution
• Severe headache relieved by analgesics
• Persistent cough for months

Correct Answer: Loss of sensation in a glove-and-stocking distribution

Q34. In the context of leprosy control, MDT stands for:

• Maximum Drug Therapy
• Multidrug Therapy
• Minimal Dose Treatment
• Monotherapy Dose Technique

Correct Answer: Multidrug Therapy

Q35. Why is multidrug therapy used in leprosy?

• To shorten treatment to one week
• To prevent resistance by using drugs with different targets
• Because single drugs are universally toxic
• To avoid monitoring of adverse effects

Correct Answer: To prevent resistance by using drugs with different targets

Q36. Which monitoring is essential during long-term clofazimine therapy?

• Regular ophthalmic examinations for cataracts only
• Monitoring for skin discoloration and gastrointestinal intolerance
• Frequent audiometry tests for hearing loss
• Daily ECG monitoring due to arrhythmias

Correct Answer: Monitoring for skin discoloration and gastrointestinal intolerance

Q37. A negative slit-skin smear rules out leprosy in a patient with clinical signs.

• True, it definitively excludes leprosy
• False, smear can be negative in paucibacillary disease
• True, because M. leprae is always detectable
• False, because smear is irrelevant in diagnosis

Correct Answer: False, smear can be negative in paucibacillary disease

Q38. Which nerve is most commonly affected in leprosy leading to claw hand?

• Median nerve
• Ulnar nerve
• Femoral nerve
• Optic nerve

Correct Answer: Ulnar nerve

Q39. Which vaccination strategy is proven to prevent leprosy effectively?

• Bacillus Calmette-Guérin (BCG) gives partial protection but is not fully preventive
• MMR vaccine is highly protective against leprosy
• Influenza vaccine prevents leprosy
• No vaccine has ever shown any effect

Correct Answer: Bacillus Calmette-Guérin (BCG) gives partial protection but is not fully preventive

Q40. When suspecting drug-resistant leprosy, which action is appropriate?

• Continue the same regimen without changes
• Perform molecular testing for resistance mutations and consult specialist for regimen change
• Stop all drugs and observe
• Increase dapsone dose only

Correct Answer: Perform molecular testing for resistance mutations and consult specialist for regimen change

Q41. Methemoglobinemia is a known adverse effect of which antileprosy drug?

• Rifampicin
• Dapsone
• Clofazimine
• Penicillin

Correct Answer: Dapsone

Q42. For laboratory confirmation, slit-skin smears are typically taken from:

• Areas of normal skin far from lesions
• Active margin of skin lesions, earlobes and cooler sites
• Only from oral mucosa
• Only from the scalp

Correct Answer: Active margin of skin lesions, earlobes and cooler sites

Q43. Which clinical feature helps distinguish lepromatous from tuberculoid leprosy?

• Multiple poorly defined symmetric skin lesions with high bacillary load in lepromatous type
• Single well-demarcated anesthetic patch in lepromatous type
• Rapid spontaneous healing in lepromatous type
• Absence of nerve involvement in lepromatous type

Correct Answer: Multiple poorly defined symmetric skin lesions with high bacillary load in lepromatous type

Q44. What is the role of patient education in leprosy management?

• Minimal, since drugs cure disease without self-care
• Critical for adherence, stigma reduction, wound care and nerve protection
• Only to warn about colored urine from rifampicin
• Optional, provided contacts are treated

Correct Answer: Critical for adherence, stigma reduction, wound care and nerve protection

Q45. Which blood test is recommended before starting dapsone therapy in populations at risk?

• HIV antibody test only
• G6PD deficiency screening
• Fasting lipid profile
• Serum amylase

Correct Answer: G6PD deficiency screening

Q46. Which of the following is a contraindication for thalidomide use?

• Female patient of childbearing potential without strict contraception
• Male patients
• Patients with anemia only
• Patients with skin discoloration from clofazimine

Correct Answer: Female patient of childbearing potential without strict contraception

Q47. Which antibiotic has been studied as an alternative or adjunct in leprosy MDT regimens?

• Amoxicillin
• Minocycline
• Ciprofloxacin only
• Gentamicin

Correct Answer: Minocycline

Q48. A patient on MDT develops high fever, erythematous nodules and neuritis after starting therapy. This presentation most likely indicates:

• Type 1 reaction due to reduced immunity
• Type 2 reaction (ENL) due to immune complex formation
• Drug allergy to rifampicin causing Stevens-Johnson syndrome
• Viral exanthem unrelated to leprosy

Correct Answer: Type 2 reaction (ENL) due to immune complex formation

Q49. Which public health measure is essential to control leprosy transmission?

• Isolation of all diagnosed patients indefinitely
• Early diagnosis, prompt MDT, contact screening and prophylaxis
• No intervention is effective; disease is self-limiting
• Complete cessation of BCG vaccination programs

Correct Answer: Early diagnosis, prompt MDT, contact screening and prophylaxis

Q50. Long-term follow-up after completion of MDT is important because:

• Relapse and late reactions can occur and nerve damage may progress
• Patients will always be infectious for life
• MDT causes irreversible organ damage needing constant surveillance
• There is no reason for follow-up after treatment ends

Correct Answer: Relapse and late reactions can occur and nerve damage may progress

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