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Fitz 9th > 159 - Leprosy > Flashcards

159 - Leprosy Flashcards

1
Q

Besides humans, M. leprae is also found as a zoonotic infection in _____ in the Southern United States, and recently in _____ in the British Isles

A

Armadillos

Red squirrels

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2
Q

More than 805 of all new cases are detected in only 3 countries

A

India
Brazil
Indonesia

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3
Q

Has the highest number of leprosy cases

A

India

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4
Q

Has the highest new case detection rate

A

Brazil

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5
Q

Special self-healing type of tuberculoid leprosy

Can be found as a single nodular lesion, but also as papules or plaques, usually on the face of the child

A

Infantile nodular leprosy

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6
Q

Special type of lepromatous leprosy

Has an ever higher bacillary load than the usual lepromatous leprosy, presenting as diffuse shiny nodules and papules

A

Histoid leprosy

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7
Q

Species in Lucio leprosy

A

Mycobacterium lepromatosis

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8
Q

Mycobacterium lepromatosis is found mainly in

A

Mexico

Caribbean

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9
Q

Triple Lewis response in normal skin

A

Erythema 5 to 10 seconds after intradermal injection of 1:1000 histamine
Secondary erythema two minutes after caused by capillary dilation
Wheal formation caused by exudation of liquid to the dermis

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10
Q

Response of lesional skin tointradermal injection of 1:1000 histamine

A

Incomplete Lewis response, with the absence of secondary erythema

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11
Q

Thinnest monofilament

A

Green

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12
Q

Thickest monofilament

A

Red

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13
Q

Loss of sensation using blue monofilament

A

Diminished light touch

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14
Q

Loss of sensation using purple monofilament

A

Diminished protective touch

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15
Q

Loss of sensation using red monofilament

A

Profound loss of protective sensation

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16
Q

Doubling time of M. leprae

A

13 days

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17
Q

Incubation time between infection and development of clinical disease

A

Usually between 3 and 7 years, although in some cases up to 20 years

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18
Q

Tuberculoid end of the spectrum having a strong Th_____ cell-mediated response whereas those at the lepromatous end have a skewed Th_____ response

A

1

2

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19
Q

TLR-1 and TLR-2 have a higher expression in

A

Tuberculoid leprosy

20
Q

M. leprae can modulate NF-kappa beta activation in Schwann cells, a function that can be inhibited by

A

Thalidomide

21
Q

ENL is an immunologic type _____ hypersensitivity response

A

III

22
Q

Type 1 reaction or reversal reaction is a type _____ hypersensitivity immune response

A

IV

23
Q

Characterized by sheets of predominantly spindle-shaped cells with nuclear pyknosis and foamy cytoplasm, vacuolated, and arranged in a storiform pattern
Resembles a fibrohistiocytic tumor

A

Histoid leprosy

24
Q

The predominant lymphocyte present in ENL is the _____, whereas _____ predominate in the lepromatous leprosy

A

T-helper cell

T-suppressor cells

25
Q

Lucio phenomenon is also knows as

A

Erythema necrotisans

26
Q

One or a few hypochromic lesions
No autonomic alteration
No thickened nerves

A

Indeterminate leprosy

27
Q

One or a few tuberculoid lesions

No more than one thickened nerve

A

Tuberculoid leprosy

28
Q

One or a few infiltrated lesions

One or more thickened nerves

A

Borderline tuberculoid leprosy

29
Q

One or many infiltrated lesions, that may be foveolar

Usually, more than one thickened nerve

A

Borderline leprosy

30
Q

Many infiltrated lesions, associated or not to nodules

Many thickened nerves

A

Borderline lepromatous leprosy

31
Q

Diffuse infiltration, nodules and autonomic dysfunctions

Many thickened nerves

A

Lepromatous leprosy

32
Q

Y/N: Reactions never occur in indeterminate patients

A

Yes

33
Q

Sudden worsening of skin lesions and nerve function impairment, with no apparent systemic involvement

A

Reversal reaction

34
Q

Majority of the reactional episodes occur in

A

Borderline forms

35
Q

Aggressive vasculitis with immune complex deposition affecting different organs

A

ENL

36
Q

Predominant leprosy type in ENL

A

Lepromatous leprosy

37
Q

Treatment for reversal reaction

A

Prednisone (1-2 mg/kg/d with slow taper ~3 mo)

38
Q

Treatment for ENL

A 
Thalidomide 100-400 mg/d
AND
Prednisone 1-2 mg/kg/d
OR
Pentoxifylline 400 mg thrice a day
39
Q

The percentage of HIV and other viral infections in leprosy patients is high, indicating that all leprosy patients should be tested for

A

HIV
HBV
HCV
HTLV-1

40
Q

Reactions vs relapses:

Respond well to treatment with antiinflammatory drugs

A

Reactions

41
Q

Reactions vs relapses:

Slowly progressing, almost always with resurgence of primary lesions followed by the gradual appearance of new lesions

A

Relapses

42
Q

3 groups of medications used for treating leprosy

A

Antibiotics
Antiinflammatory or immunosuppressants
Analgesic drugs

43
Q

Clinically detected as a violet color on sclera, lips, and the extremities of fingers together with malaise, headache, and dyspnea

A

Methemoglobinemia

44
Q

Main objection as far as patients are concerned is its affinity to fat tissue and macrophage deposits leading to skin hyperpigmentation

A

Clofazimine

45
Q

Highly bactericidal
Adverse effects include face and neck redness, pruritus and cutaneous rash, loss of appetite, nausea, vomiting, and diarrhea, malaise, purpura, epistaxis

A

Rifampicin

46
Q

Y/N: Pregnancy and breastfeeding contraindicate the use of multidrug therapy

A

No - do not contraindicate

Fitz 9th (108 decks)

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