Infectious Diseases Long Essays

Infectious Diseases Long Essays

Question 1. What is the differential diagnosis of ulcers over the penis? How do you treat syphilis?

Answer:

Differential Diagnosis of Ulcers Over Penis:

• Chancre
• Chancroid
• lymphogranuloma venereum
• Genital herpes
• Neoplasm

Syphilis:

• It is a sexually transmitted disease

Syphilis Clinical Features:

1. Primary syphilis
   • Incubation period- about 21 days
   • Chancre develops
   • It is a solitary, painless, indurated, non-tendered, ulcerated, or eroded lesion
   • Initial,ly it was a dull red macule
   • Later it becomes ulcerated
   • Regional lymphadenopathy
2. Secondary syphilis
   • Appears about 6-8 weeks
   • Skin lesions appear as macules, papules, fol-locules, or, papulosquamous patches
   • Circinate lesions develop on the face
   • Headache
   • Fever, anorexia
   • Joint and muscle pain
   • Laryngitis, pharyngitis
   • Generalised lymphadenopathy
   • Lesions develop over the mucocutaneous junction
3. Tertiary syphilis
   • Develops about 5-10 years after primary infection
   • Affects the skin, central nervous system, CVS, mucous membrane
   • Lesions are called gumma
   • It is localized, chronic granulomatous lesion with a nodular or ulcerated surface
   • Causes generalized paresis, dementia, and strokes
   • Bone lesions cause osteomyelitis and destruction of joints

Syphilis Treatment:

Question 2. Describe clinical features, diagnosis, complications, and management of typhoid fever.
(or)
Discuss the etiology, clinical features, complications, and management of enteric fever.

Answer:

Typhoid Or Enteric Fever:

• It is an acute systemic illness

Etiology:

• Salmonella typhi
• Salmonella paratyphi

Enteric Fever Clinical Features:

• Incubation period- 10-14 days

1. First 5-7 days
   • High-grade, remittent fever with chills
   • Headache
   • Aches
   • Malaise
   • Constipation
   • Leucopenia
   • Dry cough
   • Epistaxis
   • Relative bradycardia
2. Between 1st and 2nd week
   • Rose spots develop over the trunk as small macules, red in color, and blanch on pressure
   • Splenomegaly
   • Bronchitis
   • Abdominal pain
   • Abdominal distension
   • Diarrhea
3. After 2nd week
   • Confusion
   • Delirium
   • Toxaemia
   • Coma

Read And Learn More: General Medicine Question and Answers

Enteric Fever Diagnosis:

Enteric Fever Complications:

1. Intestinal complications
   • Hemorrhage
   • Paralytic ileus
   • Perforation
   • Peritonitis
2. Extraintestinal complication
   • Meningitis
   • Cholecystitis
   • Pneumonia
   • Myocarditis
   • Bone and joint infection
   • Encephalopathy
   • Granulomatous hepatitis
   • Nephritis

Enteric Fever Management

Question 3. Describe the etiology, pathology, clinical features, and management of cervical TB lymphadenitis.

Answer:

Tuberculous Lymphadenitis:

• It is defined as achronic specific granulomatous inflammation with caseation necrosis of the lymph node

Etiology:

• Mycobacterium tuberculosis complex which includes M. tuberculosis, M. bovis, M. africanum, M. canetti, and M.caprae

Pathology:

• Pathological stages of the disease are:

1. Stage 1- lymphoid hyperplasia
   • Formation of tubercles and granulomas occurs without cassation necrosis
2. Stages 2 and 3
   • Caseation necrosis in the affected lymph nodes occurs
   • It is followed by the destruction of capsules of lymph nodes
   • Periadenitis
3. Stage 4
   • There is a rupture of caseous material into the surrounding soft tissue
   • Formation of abscess cavity

Tuberculous Lymphadenitis Clinical Features:

• Persistent, painless swelling of the lymph nodes
• Release of discharge of fluid
• Fever
• Weight loss
• Fatigue
• Night sweats

tuberculous LymphadenitisManagement:

1. Anti-tubercular therapy
   • Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol are given for 2 months
   • Followed by Isoniazid and Rifampicin for the next 4 months
2. DOTS therapy
3. Surgery- indicated in
   • Persistent fluctuant lesions
   • Failure with chemotherapy
   • Symptomatic relief

Question 4. Describe the etiology, clinical features, and management of intestinal amoebiasis.

Answer:

Intestinal amoebiasis

Caused by entamoeba histolytic

• E. histolytica can cause two types of pathological lesions as follows

1. Primary (or) Intestinal Amoebiasis:

• This condition is called amoebic dysentery.
• These ulcers may be generalized (or) may be localized to the ileocaecal (or) sigmoidorectal region.
• Occasionally ulcers may involve deeper tissues and cause perforation (or) peritonitis.
• Erosion of blood vessels may lead to bleeding.
• The superficial lesions generally heal without scarring.
• Deep ulcers form scars leading to strictures, partial obstruction, and thickening of the gut wall.

2. Extra-intestinal amoebiasis (or) secondary (or) metastatic lesions.

• Amoebic liver abscess:

Question 5. Diphtheria-etiology, Clinical FeatuManagementtntA

Answer:

Etiology:

• It is caused by Corynebacterium diphtheria

Diphtheria-etiology Clinical Features:

• It is insidious at the onset
• Moderate grade fever
• Tachycardia
• Sore throat
• Formation of greyish-greenish pseudomembrane on the tonsils
• Swollen neck- Bull neck
• Tender lymphadenopathy
• Nasal infection
• Hoarseness of voice
• Cough
• Respiratory obstruction
• Acute circulatory failure
• Myocarditis
• Nerve palsies
• Dysphagia
• Dysphonia
• Paraesthesia in the limbs

Diphtheria-Etiology Management:

1. Antitoxin diphtheric serum (ADS)
   • The dose varies from 20,000 to 1,00,000 units depending on the duration and severity of the disease
   • In mild cases, a lesser dose may be used
2. Antibiotics
   • Penicillin G-6,00,000 units every 12 hourly intravenously or
   • Amoxycillin 500 mg 8 hourly for 7-10 days
   • Patient allergic to penicillin
     • Erythromycin- 500 mg 6 hoourly or
     • Azithromycin 500 mg daily or
     • Rifampicin 600 mg daily
3. Tracheostomy