MCQs - Leptospirosis
Leptospirosis - How is it spread?
Water bodies contaminated with rodent urine
Leptospirosis - Introduction
Leptospirosis is an infectious disease. It is caused by spirochaetes. Farmers who do not use foot wear and who are exposed to contaminated water with rodent urine were the most common patients getting admitted with leptospirosis. Now the trend is changing. Anyone who is exposed to contaminated water and with break in their skin integrity is at risk. This includes people who explore forests and marshy lands and also city dwellers that live in cities with improper drainage system. In Indian cities like Kolkata one small scale rain is enough for water logging. These cities are also not free from rats and rodents. There lies the risk of getting the disease
Which are the two types of leptospirosis?
Icteric and Anicteric
Edematous and Non edematous
Haemorrhagic and non-haemorhagic
None of the above
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Answer: Icteric and Anicteric
Which are the signs and symptoms of anicteric leptospirosis?
Flu like symptoms
Nausea and Vomiting
Conjunctivitis
Pharyngitis
All of the above
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Answer: All of the above
Leptospirosis
Which are the signs and symptoms of icteric leptospirosis?
Fever
Jaundice
Renal failure
Hemorrhage
Involvement of other organ system
All of the above
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Answer: All of the above
Which form of leptospirosis is known as Weil’s disease?
Icteric
Anicteric
Both
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Answer: Icteric
Which are the tests done to diagnose leptospirosis?
Culture of leptospires
Microscopic agglutination testing
CBC
Renal function studies
Coagulation studies
Liver function studies
CSF analysis
Chest radiography
Biliary tract ultrasonography
ECG
All of the above
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Answer: All the above
Diagnostic Tests for Leptospirosis
- Culture of leptospires and Microscopic agglutination testing are the definitive diagnostic tests.
- Microscopic agglutination testing can be done only in reference laboratories.
- Other tests are done to check the involvement of other organs.
- For example, if the liver is involved, the liver function tests may show abnormalities and patient may have jaundice, nausea, vomiting or abdominal discomfort.
Leptospirosis
How is leptospirosis transmitted?
Exposure of mucous membranes or abraded skin to the contaminated water
By mosquito bites
By contact with the infected person
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Answer: Exposure of mucous membranes or abraded skin to the contaminated water
Which groups of people are at risk of developing leptospirosis?
Farmers
Veterinarians
Pet shop owners
Field agricultural workers
Plumbers
Meat handlers
Slaughterhouse workers
Coal miners
Workers in the fishing industry
Military troops
Milkers
Sewer workers
All the above
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Answer: All the above
Which are portals of entry for the organism in leptospirosis?
Skin
Mucous membranes
Conjunctiva
Lungs
The placenta during pregnancy
All of the above
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Answer: All of the above
Endothelial Injury in Leptospirosis
- The organism enters through the lymphatics into the blood stream and it causes endothelial injury to the blood vessel wall.
- The endothelium is usually only permeable to water and electrolytes. When the integrity is lost and the gap junctions widen, the plasma and cells come out though the blood vessel wall causing edema and inflammation to the surrounding tissues.
- The signs and symptoms will depend on which organ is involved as leptospira can easily enter organs like liver and kidney easily.
The reason/s for renal failure in leptospirosis is/are:
Interstitial nephritis
Tubular necrosis
Hypovolemia
All of the above
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Answer: All of the above
The most consistent pathologic finding in leptospirosis is:
Vasculitis of capillaries
Endothelial edema
Necrosis
Lymphocytic infiltration
All of the above
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Answer: vasculitis of capillaries
Which are organs which can be damaged by leptospirosis?
Adrenals
Liver
Lung
Skin
Blood vessels
Kidneys
All the above
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Answer: All the above
Lung involvement in Leptospirosis
- If there is vasculitis and endothelial dysfunction of the capillaries in the lungs, it can lead to life threatening complications as it leads to pulmonary congestion and edema or acute respiratory distress syndrome.
- Most of the leptospirosis are mild cases and are not fatal whereas if there is involvement of the lungs, the prognosis becomes bad as there is high mortality among these patients.
- Generally, if one survives the disease, though they experience long term illness and morbidity, most of them return to normal.
Leptospirosis - Summary
Leptospirosis may not be disease of the developed countries, but in India, we still get a lot of patients. Some of them develop serious complications and will be hospitalized for days together. They may need mechanical ventilation and dialysis during their hospital stay. Everyone who get exposed to the risk factors (especially the farmers) should be educated about leptospirosis and its complications
If you have any suggestions on this article or clarifications, please feel free to leave a comment.
Comments
Dianna Mendez on September 12, 2015:
I didn't even know this disease existed. I hope this helps someone avoid getting this awful condition.
Deb Hirt from Stillwater, OK on September 12, 2015:
This definitely is not something to fool with. We all need to take the time to take proper precautions from disease.
JR Krishna (author) from India on September 05, 2015:
Hi Dr Pran Rangan
Thanks for the visit
Dr Pran Rangan from Kanpur (UP), India on September 04, 2015:
A well written hub in MCQ format. Thanks and well shared.
