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SPMP on Weil’s Disease Dr. S. Aswini Kumar. MD, A 25 year-old man is brought to the OP department with history of fever of two days duration XXII. 01. Diagnosis of Weil’s can be arrived at from the following history EXCEPT: High grade fever of continuous nature Running nose and throat pain Yellowish discoloration of eyes and urine Generalized aches and pains Non-specific headaches XXII. 02. Weil’s disease is most likely to occur in the following circumstances EXCEPT: Contamination of food and drinks by leptospira Exposure to rat’s urine in stagnant water Swimming or rafting in contaminated water Indoor bite by infected mosquito Occupationally in sewer workers XXII. 03. You will proceed with the physical examination to demonstrate the following: Temperature assessment by palpation Inspection of the conjunctiva for Icterus Palpation of the abdomen for hepatosplenomegaly Auscultation of the chest for adventitious sounds all of the above XXII. 04. The diagnosis of Weil’s disease can be suspected clinically, if the following clinical features are present EXCEPT: Deep icterus Sub-conjunctival hemorrhage Muscle tenderness Increased urine output History of possible exposure to rat’s urine XXII. 05. The diagnosis of infective hepatitis can be considered clinically by the following: Gradual progression of jaundice Loss of appetite and taste Aversion to cigarettes in smokers Family history of infective hepatitis All of the above XXII. 06. Chikungunya fever can be considered, from the presence of the following: Epidemic outbreak Pain and swelling of medium sized joints Severe functional disability Leucopenia All of the above XXII. 07. Investigations that may be done routinely to confirmthe diagnosis of Weil’s are the following EXCEPT: Presence of protinuria, RBC and cell casts Polymorphonuclear leucocytosis and high ESR Increase in absolute thrombocyte count Abnormal renal function tests Positive Weil’s antibody test XXII. 08. The following general measures are to be taken in the case of uncomplicated or anicteric Weil’s Disese, EXCEPT: All patients should be admitted Complete bed rest Plenty of oral fluids Light easily digestible diet Antipyretic medications SOS XXII. 09. Injection Crystalline penicillin is the drug of choice in treating Weil’s disease because: It is a leptospiral disease Organism is uniformly sensitive No resistance reported so far Without any undesirable side effects All of the above XXII. 10. The important parameters to be checked clinically on a daily basis, includes all of the following: Accurate measurement of intake and output Pulse rate and rhythm to exclude myocarditis Blood pressure monitoring to exclude internal bleeding Looking for features meinigeal irritation All of the above XXII. 11. Medications that may be routinely prescribed are the following EXCEPT: Acetaminophen 650mg orally SOS Doxycyline 100mg twice daily orally for seven days Frusemide 40mg IV q12hrly Polybion syrup 2tsp twice daily Saline nasal drops XXII. 12. Daily monitoring of the following laboratory parameters is essential, EXCEPT: Serum electrolytes Widal test Platelet counts Electrocardiogram Blood urea and serum creatinine XXII. 13. Weil’s syndrome is said to be present when the following are present, EXCEPT:
XXII. 14. Life threatening complications of Weil’s disease are the following EXCEPT:
Hemorrhagic pneumonia Bilateral Iridocyclitis Aseptic meningitis Acute renal failure Leptospiral myocarditis XXII. 15. The above complications can be suspected from the following EXCEPT: Hemoptysis and pulmonary rales Unilateral red congested eyes Alteration in sensorium and seizures Progressive azotemia Arrhythmias and heart failure XXII. 16. The following statements regarding Acute Renal failure in Weil’s disase are TRUE EXCEPT: Usually occurs during the second week of the illness Acute tubular necrosis is the pathology Hypovolemia and reduced renal perfusion contribute Hematuria is common but anuria is uncommon Renal function will recover completely with dialysis XXII. 17. The following statements regarding prognosis of Weil’s disease are true, EXCEPT: Temperature falls by lysis in 3-4 days Temperature may rise again in the anicteric form Untreated mortality in Weil’s syndrome is 15-20% Those who recover do so with residual complications Admission to MICU and close observation are mandatory