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Pinta (skin disease) is caused by Treponema carateum 2. Symmetrical normoaesthetic macules are seen in- 1.
Lepromatous leprosy-------------------ans
Discussion- Leprosy- (P-264 Park) Cardinal signs- •
Anesthetic--> first goes temperature (cold first)
Enlargement of nerve--> ulnar nerve--> claw hand
BI*- Bacteriological Index (Used for classification)
MI- Morphological Index (Live bacilli--> therapeutic response)
Paucibacillary: 1-5 skin lesion : BI < 2 : TT, BT
Multibacillary: >5 skin lesion: BI > 2 : BB, BL, LL
Ridley Jopling classification- Depending on CMI-
TT--> Anesthetic + anhidrosis + complete loss of hair, saucer right way up lesions
BT--> Satellite lesions BB--> Inverted saucer, Punched out, Swiss cheese, Lepromin test -ve
BL--> Onion peel/cut onion--> Nerve
LL--> Leonine fascies, Glove+Stocking, BI 6+, globi, Genz zone (cell free zone below
Indian classification- Madr id classification + Pure neuritic form
High immunity (TT,BT) Low immunity (LL,BL)
immunity--> higher loss), AFB -/less, Plaques
Prevalence of leprosy--> 0.6 (1.34 per 10,000 › Ck PARK P-265)
Generation time › 12-14 days (longest)
Nerves involved in 100% cases--> Ulnar, Radial, Facial(in that order)
Leprosy affects everything except--> CVS, CNS, Ovary (affects uterus)--> ck
C/F--> Intermediate Leprosy (M/C INDIA)--> Facial les ions, no nerve thickening, smear negative
Histoid leprosy- Seen in INDIA--> Cause--> dapsone monotherapy resistence. Dome shaped nodes on normal skin, linear elongated bacilli. Lazar ine leprosy--> Synonym for Lucio's leprosy › Malnutrition, HIV--> Severe skin destruction
Leprosy treatment- •
MB- R/D/C 1 Yr
(FDT- Fixed duration therapy--> earlier MDT) Leprosy is only disease where I+D not done--> nerve damage will occur
Harr ison is good for all except leprosy.
Lepra reaction- 1.
Type I(Reversal reaction)- BT/BB, Type IV HS, IL-1,2; IFN-gamma, Neuritis› Steroid
Type II(ENL)- BL/LL—> TNF-alpha --> Thalidomide(inhibits TNF-alpha so DOC)-->other
9. A young man aged 19 years developed a painless penile ulcer 9 days after sexual intercourse with a professional sex worker; likely diagnosis is: 1.
Discussion- if in place of sex worker there is normal married male with painful ulcer then-->4 25. A case with bilateral inguinal swelling comes to the STD clinic what organism will you provisionally treat- 1.
LGV-------------------ans (Inguinal bubo- LGV and chancroid)
45. DOC for tertiary syphilis- 1.
Discussion: Congenital/Neuro Syphilis--> Crystalline pennicillin 49. All are seen in Lepromatous Leprosy except- 1.
Inflammatory reaction is sparse---------------------ans
Surface of the skin lesions is smooth and shiny
58. What is the time period required for the MI of a patient on treatment to become 0 on MDT- 1. 67. A case of Urethral discharge comes and the smear shows Intracellular Diplococci with PMN. How will you treat this case- 1.
Doxycycline 100 mg orally twice a day for 7 days
NGU- Scanty, Mucoid, Odourless, >5 PMN, M/C Chlamydia (McCoy cell line) Rx:
GU- Profuse, yellow, foul smelling, >5 PMN + Intracellular diplococci, Culture-BA; Rx:
Gonorrhoea- Cefixime 400mg, Ceftriaxone 250 mg stat
68. Persistent painless bleeding ulcer that spreads by inoculation is seen in- 1. 69. In HIV positive patient of syphilis what treatment will you give in early syphilis- 1.
Benzathine penicillin G, 2.4 million units IM--------------ans
Benzathine penicillin G, 2.4 million units IM one dose weekly for 3 weeks
Doxycycline, 100 mg PO, twice daily for 15 days
Doxycycline, 100 mg PO, twice daily for 30 days
Discussion- H/17 P-1044; Option 2--> late 71. How will you treat a case of chancroid with HIV- 1.
Doxycycline 100 mg orally twice a day for 7 days
Erythromycin 500 mg QID for 7 days-------------------ans
Discussion- 1 gm Azithromycin or 250 mg i. m. Ceftriaxone. In HIV 500 mg oral erythromycin 4 times per day for seven days
Eyre, Alexie premieres fill silver screen at Taos film festival by: Tania Casselle / Indian Country Today TAOS, N.M. – "Those teepees need Viagra," said comedian Drew Lacapa. He was watching an old black and white movie where a circle of whooping Indians hopped around Buster Keaton, tied to a stake in the center of a fire. "Do you know that dance?" The live Talking Couch
CV(Curriculum Vitae) Azar shokri Department of laboratory science,Faculty of Paramedical sciences. Hormozgan University of Medical Science,Bandar Abbas, IRAN A. Personal Information: Name: Azar Family: Shokri Sex: Female Date of Birth: 1969 Marital Status: Single Tel(office): (+98 761)6666367-8 Fax: (+98 761)6670724 E-mail: aramesh8632@yahoo.com Home: No80Forth floo