DTM&H - Leprosy & Buruli Ulcer
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Brazil
India
Indonesia
Belt across central and eastern Africa - CORRECT ANSWER - Where are the majority of
leprosy cases world wide?
That there is a delay in recognising the disease, diagnosing or awareness in the community -
CORRECT ANSWER - What does grade 2 disability at time of diagnosis likely mean
regarding management of leprosy?
Nerves and skin
(macrophages and schwann cells) - CORRECT ANSWER - What two sites in the body
does Leprosy affect? Which cells does it infect?
Gram positive Rod which is acid fast - CORRECT ANSWER - What does Leprosy look
like under gram stain?
Impossible to grow in vitro - CORRECT ANSWER - Is leprosy easy to grow in vitro?
At 30-33 degrees and therefore favours the peripheral sites where it is cooler - CORRECT
ANSWER - At what temperature does leprosy replicate?
10 days - CORRECT ANSWER - How long can M leprae survive in the environment?
Armadillo - CORRECT ANSWER - What is the natural reservoir for M leprae?
, - Thought to be transmitted via infected respiratory droplets - gets into URT but only after
prolonged contact
- Moves to cooler sites of the body e.g. skin, peripheral nerves, eyebrows - CORRECT
ANSWER - Explain how M leprae is transmitted?
3-5 years on average
(But really anything from 6 months to 20 years!) - CORRECT ANSWER - What is the
incubation period for leprosy?
5% - CORRECT ANSWER - What % of exposed persons have clinical signs or symptoms
of leprosy?
Disease symptoms depend on your immunological reaction to the bacteria
- At one end of spectrum you have true tuberculoid leprosy (mild disease with scanty skin
patches and few nerve invovlement). This is considered stable disease with a low bacterial load
and high immune response = PAUCIbacilliary
- At other end of spectrum you have true lepromatous leprosy (severe disease with symmetrical
skin and nerve involvement). This is considered stable with a HIGH bacterial load and LOW cell
mediated immunity = MULTIbacilliary
In between you have borderline versions of each - these are considered unstable and can change
into either of the other forms - CORRECT ANSWER - Explain the different spectrum of
disease presentations in leprosy?
- Definite loss of sensation in a skin lesion CONSISTENT with leprosy
- Thickening or ONE or MORE peripheral nerves
- Skin slit smear or biopsy positive for mycobacteria - CORRECT ANSWER - What are
the 3 clinical cardinal signs for leprosy?
- Skin lesions which can be variable in size and location but have reduced sensation
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Brazil
India
Indonesia
Belt across central and eastern Africa - CORRECT ANSWER - Where are the majority of
leprosy cases world wide?
That there is a delay in recognising the disease, diagnosing or awareness in the community -
CORRECT ANSWER - What does grade 2 disability at time of diagnosis likely mean
regarding management of leprosy?
Nerves and skin
(macrophages and schwann cells) - CORRECT ANSWER - What two sites in the body
does Leprosy affect? Which cells does it infect?
Gram positive Rod which is acid fast - CORRECT ANSWER - What does Leprosy look
like under gram stain?
Impossible to grow in vitro - CORRECT ANSWER - Is leprosy easy to grow in vitro?
At 30-33 degrees and therefore favours the peripheral sites where it is cooler - CORRECT
ANSWER - At what temperature does leprosy replicate?
10 days - CORRECT ANSWER - How long can M leprae survive in the environment?
Armadillo - CORRECT ANSWER - What is the natural reservoir for M leprae?
, - Thought to be transmitted via infected respiratory droplets - gets into URT but only after
prolonged contact
- Moves to cooler sites of the body e.g. skin, peripheral nerves, eyebrows - CORRECT
ANSWER - Explain how M leprae is transmitted?
3-5 years on average
(But really anything from 6 months to 20 years!) - CORRECT ANSWER - What is the
incubation period for leprosy?
5% - CORRECT ANSWER - What % of exposed persons have clinical signs or symptoms
of leprosy?
Disease symptoms depend on your immunological reaction to the bacteria
- At one end of spectrum you have true tuberculoid leprosy (mild disease with scanty skin
patches and few nerve invovlement). This is considered stable disease with a low bacterial load
and high immune response = PAUCIbacilliary
- At other end of spectrum you have true lepromatous leprosy (severe disease with symmetrical
skin and nerve involvement). This is considered stable with a HIGH bacterial load and LOW cell
mediated immunity = MULTIbacilliary
In between you have borderline versions of each - these are considered unstable and can change
into either of the other forms - CORRECT ANSWER - Explain the different spectrum of
disease presentations in leprosy?
- Definite loss of sensation in a skin lesion CONSISTENT with leprosy
- Thickening or ONE or MORE peripheral nerves
- Skin slit smear or biopsy positive for mycobacteria - CORRECT ANSWER - What are
the 3 clinical cardinal signs for leprosy?
- Skin lesions which can be variable in size and location but have reduced sensation
