22 Spmp On Weils Disease

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  • 1. 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:
    • Anicteric leptospirosis
    • 2. Impaired renal function
    • 3. Impaired hepatic function
    • 4. Abnormal mental status
    • 5. Hypotension and pulmonary hemorrhage
    • 6. 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