Updated date:

Sep 15, 2015

MCQs - Leptospirosis

Author:: JR Krishna

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.