Chapter 159 - Leprosy

Question 1

Leprosy is a chronic granulomatous disease affecting mainly skin and nerves caused by ___ intracellular pathogen Mycobacterium leprae

Answer 1

Obligate

Question 2

Leprosy involves skin and nerves but causes sequelae to (6)

Answer 2

Eyes
URTI
Lymphoid tissue
Testicles
Muscles 
Bones

Question 3

Hallmarks of leprosy (3)

Answer 3

Loss of sensation within skin lesions
Nerve swelling or pain
Demonstration of AFB in skin smears or biopsies

Question 4

80% of all new cases are detected only in 3 countries

Answer 4

India
Brazil
Indonesia

Question 5

___% of all leprosy patients will experience some type of reactional episode that may result in permanent neurologic deficit or disability

Answer 5

30-50%

Question 6

With implementation of multidrug therapy in 1982, treatment was shortened to ___ years and leprosy prevalence was reduced by more than ___%

Answer 6

2 years; 85%

Question 7

Highest number of leprosy caes in the world is __ while ___ has the highest new case detection rate amongst all countries.

Answer 7

India; Brazil

Question 8

A very high percentage of these (2) parameters means late diagnosis

Answer 8

Children with leprosy

Cases with grade 2 disability

Question 9

There is an overall genetic resistance toward developing leprosy, with more than ___% of people having natural immunity, with ___ being most important in preventing disease progression.

Answer 9

90%, cell-mediated immunity

Question 10

Ridley and Jopling proposed a __ group classification based on clinical, histopathologic, and immunologic criteria.

Answer 10

5

Question 11

Self-healing type of TL found as a single nodular lesion but also as papules/plaques on the face of a child

Answer 11

Infantile nodular leprosy

Question 12

Type of LL with higher bacillary load than usual LL with rafts of bacilli called globi presenting as diffuse shiny nodules and papules

Answer 12

Histoid leprosy

Question 13

Special type of leprosy wherein main skin manifestation is infiltration, found mainly in Mexico and the Carribean

Answer 13

Lucio leprosy

Question 14

All borderline forms are immunologically unstable.

True or False

Answer 14

True

Question 15

Triple Lewis response is incomplete only on lesional skin with absence of ___

Answer 15

Secondary erythema due to capillary dilatation which is dependent on nerve integrity

Question 16

Loss of sensation using blue Semmes-Weinstein monofilaments indicate ___; purple, ___; and red ___

Answer 16

Blue, diminished sensation of light touch
Purple, diminished protective sensation
Red, loss of protective sensation

Question 17

Neuropathy or chronic neuritis occurs in all forms of leprosy except

Answer 17

Indeterminate leprosy, clinical form

Question 18

Positive AFB result on slit skin smear eliminates ___

Answer 18

Primary neural leprosy

Question 19

Levels of testosterone were ___ correlated with number of lesions and proinflammatory cytokines

Answer 19

Inversely

Question 20

Syndrome of destruction of anterior nasal spine, resorption of alveolar processes of maxilla, loss of teeth

Answer 20

Rhinomaxillary syndrome

Question 21

M. Leprae has a doubling time of __ and incubation period of ___

Answer 21

13 days; 3 and 7 years

Question 22

Leprosy bacillus can attach to Scheann cells by binding to laminin 2 molecule of these (2) cell wall components

Answer 22

Phenolic glycolipid 1 (PGL1)

Laminin binding protein

Question 23

Individuals who have a positive anti-PGL1 titer have up to__ fold risk of developing leprosy

Answer 23

8

Question 24

Pentoxifylline is Category ___ drug

Answer 24

C