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MEDSURG -FINALS (SIR ERICH > Hansen’s Disease (Leprosy) > Flashcards

Hansen’s Disease (Leprosy) Flashcards

1
Q

is an infectious disease caused by Mycobacterium leprae which involves the skin and peripheral nerves.

A

leprosy

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2
Q

Causative agent

A

Mycobacterium leprae

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3
Q

Leprosy was recognized in the ancient civilizations of

A

China, Egypt, and India

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4
Q

The earliest documented account of leprosy is around

A

1550 B.C on Egyptian papyrus.

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5
Q

Through out history, the badly affected have often been hated by their communities and families.

A

History of Leprosy

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6
Q

Discovered by

A

Gerhard Armauer Hansen in 1873

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7
Q

is a chronic infectious disease caused by an acid-fast, rod-shaped bacillus, Mycobacterium leprae.

A

Leprosy

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8
Q

T/ F

Unlike other mycobacteria, it does not grow in artificial media or even in tissue culture.

A

TRUE

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9
Q

INCUBATION TIME

A

multiplies very slowly ( 5 YEARS) average of 3 years

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10
Q

MOT of leprosy

A

DROPLETS!!

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11
Q

T/F
Leprosy is NOT highly infectious

A

True beh anuna?

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12
Q

Untreated, leprosy can cause progressive and permanent damage

A

skin, nerves, limbs and eyes.

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13
Q

MOT

A
  • most widely held belief is that the disease is transmitted by contact between cases of leprosy and
    healthy persons.
  • Transmission nasal discharges (droplets).
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14
Q

Leprosy is known to occur at all ages ranging from early infancy to very old age.

A

ALL ages mare, ingat you!

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15
Q

Risk factors for leprosy

A
  • Close contact
  • People living in Endemic Area
  • Immunity
  • Genetic influences
  • Armadillo Exposure
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16
Q

Contacts of patients with leprosy have a higher risk of developing leprosy than the general population

A

Close contact

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17
Q

People who live in the areas where leprosy is endemic. (Endemic areas are: )

A

parts of India, China, Japan, Nepal, Egypt, and other areas) and especially those people in constant physical contact with infected people.

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18
Q

immunocompromised individuals are more susceptible to infection.

A

Immunity

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19
Q

There is some evidence that genetic defects in the immune system may cause certain people to be more likely to become infected (region q25 on chromosome 6)

A

Genetic influences

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20
Q

Genetic influences region and chromosome?

A

(region q25 on chromosome 6)

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21
Q

Leprosy is enzootic in the nine-banded armadillo

A

Armadillo exposure

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22
Q

Classification of Leprosy

A
  • Skin smear result classification. ( WHO )
  • Clinical classification. (Ridley Jopling)
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23
Q

Skin smear result (WHO) classification :

A
  1. Paucibacillary leprosy (PB) – few Bacilli;
  2. Multibacillary leprosy (MB);
24
Q

Multibacillary leprosy (MB);

A

Any form of leprosy in which the patient shows positive smears at any site

25
Q

Two to five skin lesions with negative skin smear results at all sites.

A

Paucibacillary leprosy (PB) – few Bacilli;

26
Q

Clinical (Ridley Jopling) classification

A
  1. Indeterminate leprosy (IL)
  2. Tuberculoid leprosy (TT)
  3. Lepromatous leprosy (LL)
  4. Borderline leprosy (BL)
    • Borderline tuberculoid leprosy (BT)
    • Borderline borderline leprosy (BB)
    • Borderline lepromatous leprosy (BL)
27
Q

(Skin lesions)
One or a few sharply
defined annular asymmetric
macules or plaques with a
tendency toward central
clearing, elevated borders

A

Tuberculoid, (TT,BT) Leprosy

28
Q

(Nerve Lesions)
Skin lesions anesthetic
early; nerve near lesions
sometimes enlarged; nerve
abscesses most common in BT

A

Tuberculoid, (TT,BT) Leprosy

29
Q

AFB (0-1+)

A

Tuberculoid, (TT,BT) Leprosy

30
Q

Intermediate between BT.
and LL-type lesions; ill.
defined plaques with an
occasional sharp margin;
few or many in number

A

Borderline (BB, BL). Leprosy

31
Q

Hypesthetic or anesthetic
skin lesions; nerve trunk
palsies, at times symmetric

A

Borderline (BB, BL). Leprosy

32
Q

AFB 3-5+

A

Borderline (BB, BL). Leprosy

33
Q

Symmetric, poorly marginated, multiple infitrated nodules and plaques or diffuse infiltration: xanthoma-like or
(dermatofibroma papules; leonine
faces and eyebrow alopecia

A

Lepromatous (LL) Leprosy

34
Q

‘Hypesthesia a late sign; nerve palsies
/variable; acral, distal, symmetric
anesthesia common

A

Lepromatous (LL) leprosy

35
Q

AFB 4-6+

A

Lepromatous (LL) leprosy

36
Q

CLINICAL FEATURES

A

1.Skin lesions, usually anaesthetic
- Hypopigmented or erythematus patch / plaque .

2.Complete / partial loss of sensation.
- Painless wounds or burns on the hands or feet - - - -Paresthesias: tingling or numbness in the hands or feet Diminished sensation or loss of sensation within skin patch(es)

3.Thickening of peripheral nerves.

4.Lumps or swelling on the earlobes or face.

5.Tender, enlarged peripheral nerves

37
Q

Hypo pigmented patch, sensation normal, no palpable peripheral nerve and slit skin smear negative

A

Indeterminate Leprosy

38
Q

Annular, erythematous, anasthetic patch with well
defined and raised borders and SSS Negative.

A

Tuberculoid Leprosy

39
Q

Two hypopigmented patches, hypoasthetic well
defined borders, palpable peripheral nerve and SSS negative.

A

Tuberculoid leprosy

40
Q

a well-defined, hypopigmented, anesthetic macule with anhidrosis and a raised granular margin (arrowhead)

A

Tuberculoid (TT) leprosy

41
Q

Borderline lepromatous case showing borderline tuberculoid and
‘punched- out” mid borderline lesions together with papular and
nodular lesions more typical of lepromatous disease.

A

Borderline lepromatous leprosy
(BL/MB)

42
Q

Hands: signs and symptoms of leprosy

A

Claw hand due to median andulnar nerve damage

43
Q

Hands: signs and symptoms of leprosy

A

hands showing neurotrophic atrophy.

44
Q

The areas most commonly affected by leprosy are

A

superficial peripheral nerves , skin, ,mucous membranes of the upper respiratory tract, eyes , and tests

45
Q

is caused by the degree to which cell-mediated immunity is expressed , the extent of bacillary spread and multiplication , immunologic complication and nerve damage

A

Tissue damage

46
Q

an obligate intracellular acid-fast bacillus with unique ability to enter nerves

A

M. Leprae

47
Q

Diagnosis of leprosy is most commonly based on the

A

clinical sign and symptoms

48
Q

In an endemic country or area, an individual should be regarded as having leprosy if he or she shows ONE of the following cardinal signs : ( 4 signs)

A
  • skin lesion consistent with leprosy
  • with definite sensory loss
  • with or without thickened nerves
  • positive skin smears
49
Q

If you have a suspicious skin sore, your doctor will remove a small sample of the abnormal skin and send it to a laboratory to be examined

A

Skin biopsy

50
Q

If you have a suspicious skin sore, your doctor will remove a small sample of the abnormal skin and send it to a laboratory to be examined

A

Smear test

51
Q

Treatment: Common Drugs (CDR)

A

Dapson
Refampicine
Clofazimine

52
Q

The combination of these three drugs Is known as

A

multi drug therapy (MDT)

53
Q

6 month regimen for Paucibacillary (PB) Leprosy

A

Dapson 100 mg (daily)

Refampicin 600 mg (monthly)

54
Q

12 month regimen for Multibacillary (MB) Leprosy

A

Dapsone 100 mg (daily)

Refampicin 600 mg (monthly)

Clofazimine 300 mg (monthly) or 50 mg (daily)

55
Q

Complications include:

A

disfigurement
• hair loss, particularly on the eyebrows and eyelashes
• muscle weakness
• permanent nerve damage in the arms and legs
• inability to use the hands and feet
• Nosebleeds
• iritis (inflammation of the iris of the eye), glaucoma
(an eye disease that causes damage to the optic
nerve), and blindness
• Infertility
• kidney failure

MEDSURG -FINALS (SIR ERICH (13 decks)

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