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22 Spmp On Weils Disease

22 Spmp On Weils Disease






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    22 Spmp On Weils Disease 22 Spmp On Weils Disease Document Transcript

    • 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
      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
      Blood urea and serum creatinine
      XXII. 13. Weil’s syndrome is said to be present when the following are present, EXCEPT:
      • Anicteric leptospirosis
      • Impaired renal function
      • Impaired hepatic function
      • Abnormal mental status
      • Hypotension and pulmonary hemorrhage
      • 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