Leprosy- Diagnosis

Leprosy- Diagnosis

Q. 1

The following test is not used for diagnosis of leprosy –

 A

Lepromin test

 B

Slit skin smear

 C

Fine needle aspiration cytology

 D

Skin biopsy

Q. 1

The following test is not used for diagnosis of leprosy –

 A

Lepromin test

 B

Slit skin smear

 C

Fine needle aspiration cytology

 D

Skin biopsy

Ans. A

Explanation:

Ans. is ‘a’ i.e., Lepromin test 

-The clinical diagnosis is confirmed by histological examination of skin biopsies and by the detection of acid fast bacilli in nasal discharges, scrapings from the nasal mucosa and slit-skin smears.

– A minimum of seven sites should be examined

1)  Smears from 4 skin lesions

2)  Smears from both ear lobes

3)  One nasal swab

Sample from the skin should be obtained from the edges of the lesion rather than from the centre.

  • Lepromin Test is not used to diagnose leprosy, nor does it indicate prior contact with lepra bacilli. I-1( althy persons in nonendemic areas with no chance of contact with the bacillus may give a positive lepromin test.

Q. 2

The following test is not used for diagnosis of leprosy :

 A

Lepromin test

 B

Slit skin smear

 C

Fine needle aspiration cytology

 D

Skin biopsy

Q. 2

The following test is not used for diagnosis of leprosy :

 A

Lepromin test

 B

Slit skin smear

 C

Fine needle aspiration cytology

 D

Skin biopsy

Ans. A

Explanation:

A i.e. Lepromin test


Q. 3

Lepromin test is positive in which leprosy

 A

Lepromatous

 B

Indeterminate

 C

Histoid

 D

Tuberculoid

Q. 3

Lepromin test is positive in which leprosy

 A

Lepromatous

 B

Indeterminate

 C

Histoid

 D

Tuberculoid

Ans. D

Explanation:

D i.e. Tuberculoid


Q. 4

A 16 year old student reported for the evaluation of multiple hypopigmented macules on the trunk and limbs. All of the following tests are useful in making a diagnosis of leprosy, except:

 A

Sensation testing

 B

Lepromin test

 C

Slit smears

 D

Skin biopsy

Q. 4

A 16 year old student reported for the evaluation of multiple hypopigmented macules on the trunk and limbs. All of the following tests are useful in making a diagnosis of leprosy, except:

 A

Sensation testing

 B

Lepromin test

 C

Slit smears

 D

Skin biopsy

Ans. B

Explanation:

B i.e. Lepromin test

Lepromin test has no diagnostic value; it has only prognostic significanceQ as it tells about cell mediated immunity & classify the type of disease. Lepromin test is most positive in TT because cell mediated immunity is least suppressedQ


Q. 5

Slit smear negative leprosy is-

 A

Neuritic type

 B

Tuberculoid type

 C

Indeterminate type

 D

All

Q. 5

Slit smear negative leprosy is-

 A

Neuritic type

 B

Tuberculoid type

 C

Indeterminate type

 D

All

Ans. D

Explanation:

Ans. is ‘a’ i.e., Neuritic type; ‘b’ i.e., Tuberculoid type & ‘c’ i.e., Indeterminate type

o Indeterminate type, tuberculoid type, Pure neuritic type Bacteriologically negative.

o Borderline Bacteriologically variable

o Lepromatous type —> Bacteriologically positive.


Q. 6

In the management of leprosy, Lepromin test is most useful for –

 A

Herd immunity

 B

Prognosis

 C

Treatment

 D

Epidemiological investigations

Q. 6

In the management of leprosy, Lepromin test is most useful for –

 A

Herd immunity

 B

Prognosis

 C

Treatment

 D

Epidemiological investigations

Ans. B

Explanation:

Ans. is ‘b’ i.e., Prognosis 


Q. 7

Most important in establishing diagnosis of leprosy is:    

March 2010

 A

Evidence of neural involvement

 B

Hypopigmented patches

 C

Slit smear for AFB

 D

Positive lepromin test

Q. 7

Most important in establishing diagnosis of leprosy is:    

March 2010

 A

Evidence of neural involvement

 B

Hypopigmented patches

 C

Slit smear for AFB

 D

Positive lepromin test

Ans. C

Explanation:

Ans. C: Slit smear for AFB

Tissue smear testing/slit-skin smears.

An incision is made in the skin, and the scalpel blade is used to obtain fluid from a lesion.

The fluid is placed on a glass slide and stained by using the Ziehl-Neelsen acid-fast method or the Fite method to look for organisms.

The bacterial index (BI) is then determined as the number of organisms at 100X with oil immersion.

Skin smears have high specificity but low sensitivity because 70% of all patients with leprosy have negative smear results. However, this test is useful because it detects the most infectious patients.

Presence of AFB in suggestive skin lesions, even in the absence of sensory deficit, confirms the diagnosis of leprosy. Lepromin test is not of diagnostic importance but is of prognostic importance.


Q. 8

Patient with leprosy, smear sample taken show 10 – 100 bacilli in one field. Bacterial index is ‑

 A

1+

 B

2+

 C

3+

 D

4+

Q. 8

Patient with leprosy, smear sample taken show 10 – 100 bacilli in one field. Bacterial index is ‑

 A

1+

 B

2+

 C

3+

 D

4+

Ans. D

Explanation:

Ans. is ‘d’ i.e., 4+

Bacteriological Index For Leprosy

  • It is a rough index expressing probable number of acid fast bacilli for standardized microscopic field in skin smear.
  • It is indicative of the load of bacteria at the site from which smear is taken.
  • It does not differentiate between live and dead bacilli.
  • It is not an indication of total bacillary load in the body.
  • Ridleys scale is followed to calculate the bacterial index.
  • = no bacilli in 100 fields

1+ = 1 – 10 bacilli in 100 fields 2+ = 1 – 10 bacilli in 10 fields 3+ = 1 – 10 bacilli in 1 fields 4+ = 10 – 100 bacilli in 1 field 5+ = 100 – 1000 bacilli in 1 field 6+ = >1000 bacilli in 1 field.

  • Our patient has 10 – 100 bacilli in 1 field thus the bacteriological index is – 4+

Q. 9

A type of Leprosy is shown in the image.All of the following are its features except:

 A

Lepromin test is positive

 B

Sensory disturbance is less severe.

 C

Cigarretes in pack appearance is seen.

 D

Less immunity

Q. 9

A type of Leprosy is shown in the image.All of the following are its features except:

 A

Lepromin test is positive

 B

Sensory disturbance is less severe.

 C

Cigarretes in pack appearance is seen.

 D

Less immunity

Ans. A

Explanation:

Ans:A.)Lepromin test is positive

Image shows:Lepromatous leprosy (LL). There is collection of proliferating foam macrophages (lepra cells) in the dermis with a clear subepidermal zone.



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