Leprosy

Question 1

Classification → Ridley Jopling

Answer 1

Sources :
Refer aims essence
Zvor class on un academy

Question 2

Inverted saucer app morphology in?

Answer 2

BB

Question 3

Well defined plaques with satellite lesions seen in?

Answer 3

BT

Question 4

Macules nodules & Ill defined plaques seen in?

Answer 4

BL , LL

Question 5

Glove & stocking anaesthesia seen in?

Answer 5

BL

Question 6

Type I Lepra reaction:
Seen in?
Define it?

Answer 6

BT BB

Question 7

Type II lepra reaction
Seen in?
Define?

Answer 7

BL LL

Question 8

Well defined epithelia cell granuloma seen in?

Answer 8

TT BT

Question 9

Ill defined foamy macrophage granulomas seen in?

Answer 9

LL BL

Question 10

What would a type 1 lepra reaction present & look like on presentation?
Best treatment?
In which types is type I Lepra reaction seen?
Nerve involved?

Answer 10

Inflammation & Edema over pre existing lesion
Nerve involvement : patient on MDT therapy
Sometimes may also have - new lesions, low grade fever, neuritis

Steroids- prednisone 40 - 60mg/day from atleast 3-6 months else → recurrence
Gradually tapered
Indicated only in severe ulcerative lesion else ask patient to tolerate coz steroid t/t fr long duration is also dangerous
Do not stop anti leprosy drugs
Thalidomide - ineffective in type 1 lepra reaction

50% patients of Borderline forms-BT BB BL

Ulnar nerve → painful, tender → if not treated in 24hrs with steroids → irreversible nerve damage occurs
If peroneal nv. Involved → foot drop occurs

Question 11

What are lepra reactions?
Its types?

Answer 11

These are acute episodes in chronic course of leprosy
Type I & II

Question 12

Pathogenesis?

Answer 12

Lepra I → alteration in host CMI
Lepra II → immune complex reaction → erythema nodosum leprosum

Question 13

Rx of type I?

Answer 13

Mild → NSAIDs
Moderate → oral steroids, NSAIDs
Severe → oral steroids

Question 14

RX of type II?

Answer 14

Mild → NSAIDs
Moderate → NSAIDs, thalidomide ,chloroquine, clofazimine
Severe → thalidomide, oral steroids, parenteral antimony

Question 15

Name the MDT drugs?

Answer 15

Rifampicin
Clofazimine
Dapsone

Question 16

Rifampicin

Answer 16

Once a month dosage
S/e → orange urine

Question 17

Clofazimine ?

Answer 17

Most active when taken daily
S/e → brownish black discoloration
dry skin → disappears on stopping t/t

Question 18

Dapsone?

Answer 18

Avoid in Sulfa allergy patients
S/e → allergic skin rashes
exfoliative dermatitis

Question 19

Define paucibacillary?

Answer 19

<5 lesions
6 months treatment

Question 20

Define multibacillary?

Answer 20

> 5 lesions
12 months treatment

Question 21

Nerves with predilection for thickening in leprosy?

Answer 21

Mc - ulnar nv.at elbow
Median nv., superficial radial nv
Posterior auricular NV.
Greater auricular NV.
Posterior tibial nv.
Peroneal NV. (Common & superficial)
Supraorbital
Supratrochlear
Supraclavicular
Sural nerve

Question 22

4 type of peripheral nerve changes seen in leprosy?

Answer 22

1. Enlargement
2. Sensory loss
3. Nerve trunk palsies
4. Acral distal symmetric anaesthesia