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PSBIM 2023 - IDS > Leprosy > Flashcards

Leprosy Flashcards

1
Q

Reservoir of leprosy

A

Humans
Armadillo

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2
Q

Risk factors for leprosy

A

Low level of education
Poor hygiene
Food shortages

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3
Q

Most important risk factor

A

Intimacy and duration of contact with leprosy patients

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4
Q

Morphologic index

A

A measure of uniformly stained solid bacilli on slit-skin smear examination.

Calculated as percentage of viable bacilli among the total number of bacilli counted under oil-immersion microscopy

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5
Q

Bacteriologic Index

A

A logarithmic-scaled measure of the density of bacilli of all forms found in the dermis upon slit-skin smear examination

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6
Q

Approach to diagnosis of
leprosy

A

Clinical diagnosis - 2 out of 3:

  1. Hypopigmented or erythematous skin lesion/s with definite loss or impairment of sensation
  2. Involvement of peripheral nerves demonstrated by definite thickening with sensory impairment
  3. Positive AFB
    - positive AFB in slit-skin smears
    -presence of AFB in a skin smear or biopsy sample
    -Positive result in biopsy PCR
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7
Q

WHO Classification of leprosy

A
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8
Q

Modes of transmission

A
  • Shed in large members from the mouth and nose of patients with untreated multibacillary leprosy (droplet infection)
  • From damaged skin
  • Human-to-human transmission
  • Zoonotic transmission through wild armadillos
  • Enters the body through the respiratory tract or through skin (wounds or tattoos)
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9
Q

Various spectrum of leprosy based on clinical , bacteriologic, pathologic, and immunologic parameters

A
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10
Q
A

Tuberculoid leprosy

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11
Q
A

Lepromatous leprosy

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12
Q

Comprise several common immunologically mediated inflammatory states that cause considerable morbidity

A

Lepra reactions

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13
Q

occur in almost half of patients with borderline forms of leprosy but not in patients with pure lepromatous disease

A

Type 1 Lepra reactions

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14
Q

Classic signs of Type 1 Lepra Reactions

A

Inflammation within previously involved macules, papules and plaques, and on occasion, the appearance of new skin lesions, neuritis, and fever

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15
Q

Nerve trunk most frequently involved in Type 1 lepra reaction

A

ulnar nerve at the elbow

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16
Q

Most dramatic manifestation of type 1 lepra reaction

A

foot drop

17
Q

Type 1 lepra reaction preceding the initiation of appropriate antimicrobial therapy

A

Downgrading reactions

18
Q

Type 1 lepra reaction which occur after the initiation of therapy

A

Reversal reactions

19
Q

Most characteristic microscopic feature of type 1 lepra lesions

A

Edema

20
Q

Occurs exclusively in patients near the lepromatous end of the leprosy spectrum (BL/LL)

A

Type 2 Lepra Reaction: erythema nodosum leprosum

21
Q

Most common features of type 2 lepra reaction

A

crops of painful erythematous papules that resolve spontaneously in a few days to week but may recur; malise and fever

22
Q

play a central role in the pathobiology of type 2 lepra reaction

A

TNF

23
Q

An unusual reaction seen exclusively in patients from the Caribbean and Mexico who have the diffuse lepromatosis form of lepromatous leprosy, most often those who are untreated

A

Lucio’s phenomenon

24
Q

Lesions are characterized by ischemic necrosis of the epidermis and superficial dermis, heavy parasitism of endothelial cells with AFB, and endothelial proliferation and thrombus formation in the larger vessels of the deeper dermis

A

Lucio’s phenomenon

25
Q

Most common complication of leprous neuropathy

A

Plantar ulceration (metatarsal heads)

26
Q

Slit lamp evaluation of LL patients

A

“corneal bleeding”

27
Q

Only leprosy treatment that is bactericidal

A

Rifampin

28
Q

Causes red0black skin discoloration that accumulates, particularly in lesional areas

A

Clofazimine

29
Q

WHO classification for patients with few bacteria in the dermis (BI<2)

A

Paucibacillary

30
Q

WHO classification for patients with many bacteria in the dermis (BI >2)

A

Multibacillary

31
Q

WHO recommended treatment for paucibacillary leprosy

A

Dapsone 100 mg daily
Rifampin 600 mg monthly (supervised) for 6 months

32
Q

WHO recommended treatment for multibacillary leprosy

A

Dapsone 100 mg daily &
Clofazimine 50 mg daily (unsupervised),
Rifampin 600 mg plus Clofazimine 300 mg monthly (supervised)

  • treatment for 2 years or until smears become negative
33
Q

Antimicrobial regimens recommended for the treatment of leprosy in adults

A
34
Q

Mechanisms and adverse effects of various drugs used for leprosy

A

PSBIM 2023 - IDS (17 decks)

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