Neuropathy Neuropathy Complications and Prevention 2 — Questions and Answers
Question 1: Which psychological comorbidity is most prevalent in patients with chronic neuropathic pain?
- Schizophrenia
- Depression and anxiety (Correct answer)
- Bipolar disorder
- Obsessive-compulsive disorder
Correct answer: Depression and anxiety
Depression and anxiety occur in up to 60% of patients with chronic neuropathic pain, significantly worsening pain perception and quality of life.
Question 2: Which structured educational program is most effective in preventing diabetic foot complications in neuropathy patients?
- Carbohydrate counting courses only
- Therapeutic patient education on foot care (Correct answer)
- Exercise rehabilitation programs
- Dietary counseling for weight loss
Correct answer: Therapeutic patient education on foot care
Structured therapeutic patient education on foot inspection, proper footwear, and early wound recognition significantly reduces foot complications.
Question 3: Corneal confocal microscopy is increasingly used to monitor neuropathy progression because it non-invasively assesses which structure?
- Epidermal nerve fiber density
- Corneal sub-basal nerve plexus density (Correct answer)
- Myelinated motor fiber diameter
- Dorsal column integrity
Correct answer: Corneal sub-basal nerve plexus density
Corneal confocal microscopy visualizes the sub-basal nerve plexus of the cornea, which reflects small fiber neuropathy status throughout the body.
Question 4: In patients with hereditary neuropathies like CMT disease, which intervention preserves function by preventing contractures?
- High-dose corticosteroids
- Physical therapy, orthotics, and AFO bracing (Correct answer)
- Plasma exchange monthly
- Intravenous immunoglobulin
Correct answer: Physical therapy, orthotics, and AFO bracing
Physical therapy, custom orthoses, and ankle-foot orthoses (AFOs) maintain mobility and prevent contractures in hereditary motor neuropathies.
Question 5: Which infection complication must be urgently treated to prevent osteomyelitis in a neuropathic foot ulcer?
- Tinea pedis (athlete's foot)
- Deep soft tissue or wound infection (Correct answer)
- Onychomycosis
- Viral plantar wart
Correct answer: Deep soft tissue or wound infection
Deep soft tissue infections in neuropathic foot ulcers can rapidly progress to osteomyelitis (bone infection), which often necessitates amputation.
Question 6: Which supplement has evidence for potentially slowing progression of diabetic neuropathy by reducing oxidative stress?
- Vitamin E
- Alpha-lipoic acid (Correct answer)
- Coenzyme Q10
- Fish oil
Correct answer: Alpha-lipoic acid
Alpha-lipoic acid is an antioxidant with clinical evidence for reducing neuropathic pain and potentially slowing progression in diabetic neuropathy.
Neuropathy Neuropathy Complications and Prevention 2
Which psychological comorbidity is most prevalent in patients with chronic neuropathic pain?