Bacterial Skin Infections Practice Questions

Q: The hard chancre is seen in:

Syphilis. ***Syphilis*** - The **hard chancre** is the characteristic lesion of **primary syphilis**, appearing at the site of infection. - It is typically a **painless, indurated ulcer with raised borders and a clean base**, which often heals spontaneously even without treatment. - Associated with **non-tender regional lymphadenopathy**, distinguishing it from the painful ulcers of chancroid. *Chancroid* - Chancroid is caused by *Haemophilus ducreyi* and presents with **soft, painful ulcers** (soft chancre) that bleed easily. - Unlike the hard chancre of syphilis, these lesions are multiple and often associated with **tender, suppurative lymphadenopathy**. *Granuloma inguinale* - This condition, caused by *Klebsiella granulomatis*, is characterized by **beefy-red, granulomatous lesions** that are typically painless and highly vascular. - It does not present with a chancre, but rather with progressive ulcerative lesions that can be destructive if untreated. *LGV* - **Lymphogranuloma venereum** (LGV) is caused by specific serovars of *Chlamydia trachomatis* and initially presents as a **transient, small, often unnoticed papule or ulcer**. - The most prominent feature of LGV is later development of significant **inguinal lymphadenopathy** (buboes) rather than a firm chancre.

Q: Hutchinson's syphilitic triad includes all except

Cardiovascular anomalies . ***Cardiovascular anomalies*** - **Hutchinson's syphilitic triad** specifically includes **interstitial keratitis**, **nerve deafness**, and **Hutchinson's teeth (notched incisors)** [1]. - **Cardiovascular anomalies** like **aortic regurgitation** or **aneurysm** are manifestations of **tertiary syphilis** and not part of the distinct triad affecting congenital syphilis. *Interstitial keratitis* - This is a key component of **Hutchinson's triad**, representing inflammation of the cornea without primary involvement of the epithelium or endothelium. - It is a common ocular manifestation of **congenital syphilis**, often leading to significant vision impairment if untreated [1]. *Nerve deafness* - This refers to **sensorineural hearing loss** and is another characteristic feature of **Hutchinson's triad**. - It results from damage to the **vestibulocochlear nerve** or inner ear structures due to syphilitic infection. *Notched incisor teeth* - Also known as **Hutchinson's teeth**, these are specifically malformed upper central incisors with characteristic notches [1]. - This dental anomaly is a classic sign of **congenital syphilis** and part of the triad.

Q: Treatment of lepra reaction includes:

Corticosteroids. ***Corticosteroids*** - **Corticosteroids** are the cornerstone of treatment for both Type 1 (reversal reactions) and Type 2 (erythema nodosum leprosum) lepra reactions due to their potent **anti-inflammatory** and **immunosuppressive** effects [1]. - They effectively reduce the severe inflammation, pain, and nerve damage that characterize these immune-mediated reactions, with **prednisolone** being a commonly used agent [1]. *Stoppage of drug* - Stopping anti-leprosy drugs is generally **not recommended** during a lepra reaction, as the reaction is an immune response to the presence of Mycobacterium leprae [1]. - Continuing **multi-drug therapy (MDT)** is crucial to eliminate the bacteria and prevent relapse, while corticosteroids manage the inflammatory reaction [1]. *Chloroquine* - **Chloroquine** is an antimalarial drug with some anti-inflammatory properties, but it is **not a primary treatment** for lepra reactions. - Its efficacy in managing the specific immune mechanisms involved in lepra reactions is limited compared to corticosteroids. *All of the options* - This option is incorrect because stopping anti-leprosy drugs is generally avoided, and chloroquine is not a primary therapeutic agent for lepra reactions. - The main treatment involves **corticosteroids** to control the immune-mediated inflammation.

Q: Which of the following is true regarding leprosy?

MBL recommended treatment for 12 months duration. ***MBL recommended treatment for 12 months duration*** - **Multibacillary leprosy (MBL)** requires a longer treatment regimen to effectively eradicate the higher bacterial load and prevent relapse. - The standard **WHO multidrug therapy (MDT)** for MBL involves **Rifampicin, Dapsone**, and **Clofazimine** for **12 months**. *All deformity cases are MBL* - Deformities can occur in both **Paucibacillary (PB)** and **Multibacillary (MBL)** leprosy, particularly due to **nerve damage** from inflammation or reactions. - The presence of deformity alone does not automatically classify a case as MBL; the **bacteriological index (BI)** and clinical presentation are crucial for classification. *Grenz zone is absent in Lepromatous leprosy* - The **Grenz zone** is a clear, uninvolved band of dermis separating the epidermis from the granulomatous infiltrates, and it is a characteristic histological feature often seen in **lepromatous leprosy**. - Its presence helps distinguish lepromatous leprosy from other dermal inflammatory conditions, as it indicates the spared superficial dermis. *Any positive smear 1+ is MBL* - While a positive smear indicates the presence of *Mycobacterium leprae*, the classification as **MBL** or **PB** depends on the **Bacteriological Index (BI)**. - A **BI of 2+ or more** at any site is typically used to classify a case as MBL, along with the number of skin lesions.

Q: Loss of lateral 1/3rd of eyebrow is seen in -

Lepromatous leprosy. ***Lepromatous leprosy*** - **Loss of the lateral one-third of the eyebrow** (also known as **madarosis**) is a characteristic feature of **lepromatous leprosy** due to chronic inflammation and nerve damage affecting hair follicles. - This, along with diffuse skin infiltration and nodule formation, is part of the typical presentation of the **multibacillary form** of the disease. *Tetanus* - Tetanus is characterized by **muscle spasms** and **lockjaw** due to the action of tetanus toxin on inhibitory neurotransmitters. - It does not cause hair loss or specific dermatological lesions like eyebrow loss. *Tinea capitis* - Tinea capitis is a **fungal infection of the scalp** that causes scaling, itching, and patchy hair loss on the head. - It does not typically affect the eyebrows or cause isolated loss of the lateral one-third part. *Tuberculosis* - Tuberculosis primarily affects the **lungs** but can manifest in various extrapulmonary sites. - While systemic symptoms and skin lesions (e.g., **lupus vulgaris**) can occur, **eyebrow loss** is not a characteristic feature of tuberculosis.

Q: In secondary syphilis all are seen except -

Interstitial keratitis. ***Interstitial keratitis*** - **Interstitial keratitis** is a hallmark manifestation of **congenital syphilis**, not secondary syphilis. - It involves non-ulcerative inflammation of the cornea, leading to scarring and vision loss. *Arthritis* - **Arthritis** can occur in secondary syphilis, typically presenting as a **non-inflammatory polyarthritis** affecting large joints. - This is due to the systemic effects of widespread spirochete dissemination. *Proteinuria* - **Proteinuria** can be a feature of **syphilitic glomerulonephritis**, which can occur during the secondary stage. - This renal involvement is a less common but recognized complication. *Condyloma lata* - **Condyloma lata** are highly infectious, raised, grayish-white lesions found in moist areas, such as the anogenital region and oral mucosa [1]. - They are a classic and highly characteristic skin manifestation of **secondary syphilis** [1].

Q: Ridley's scale is used in classification of which disease?

Leprosy. ***Leprosy*** - The **Ridley-Jopling classification** system is a historical and widely used method to classify leprosy based on clinical, histological, and immunological features [1]. - This scale categorizes leprosy into five forms: **tuberculoid (TT), borderline tuberculoid (BT), mid-borderline (BB), borderline lepromatous (BL), and lepromatous leprosy (LL)**, reflecting the patient's immune response to *Mycobacterium leprae* [1]. *Malaria* - Malaria is classified by **parasite species** (*Plasmodium falciparum, vivax, ovale, malariae, knowlesi*) and disease severity (uncomplicated vs. severe malaria). - There is no "Ridley's scale" involved in the classification of malaria. *Measles* - Measles, a viral disease, is typically diagnosed clinically based on its characteristic **rash, fever, cough, coryza, and conjunctivitis**. - Classification primarily involves whether it's uncomplicated or complicated (e.g., with pneumonia or encephalitis), not a specific Ridley's scale. *Tuberculosis* - Tuberculosis (TB) is classified by its **site of infection (pulmonary vs. extrapulmonary)**, bacteriological status (culture-positive or negative), and drug resistance profile. - The disease state is also described as latent TB infection (LTBI) or active TB disease; Ridley's scale is not used for TB.

Q: Genital ulcer followed by painful lymphadenopathy is seen in -

LGV. ***LGV*** - Lymphogranuloma venereum (LGV) is caused by specific serovars of *Chlamydia trachomatis* and classically presents with a **small, often transient and painless genital ulcer**, followed by **tender, suppurative inguinal lymphadenopathy** (buboes) [1]. - The inguinal lymph nodes can become greatly enlarged and may rupture, leading to **fistula formation**. *Granuloma inguinale* - This condition, also known as donovanosis, is characterized by **painless, progressive ulcerative lesions** without regional lymphadenopathy [1]. - The ulcers have a **beefy red, velvety appearance** due to abundant granulation tissue, distinguishing them from LGV. *Chancroid* - Chancroid is characterized by **painful genital ulcers with ragged borders** and an erythematous base, caused by *Haemophilus ducreyi* [1]. - While it can cause **painful inguinal lymphadenopathy**, the primary ulcer is typically much more prominent and painful than the transient lesion of LGV [1]. *Syphilis* - Primary syphilis presents as a **painless chancre** (genital ulcer) with **painless, firm regional lymphadenopathy**. - The classic firm, clean-based chancre and non-tender lymph nodes are key differentiating features from the painful buboes of LGV.

Q: Punched out lesion or inverted saucer appearance are characteristic of which type of leprosy?

Lepromatous. ***Lepromatous*** - **Punched-out lesions**, also known as "inverted saucer appearance," are characteristic of **lepromatous leprosy** due to extensive dermal infiltration and destruction by *Mycobacterium leprae*. - This form of leprosy involves a **weak cellular immune response** allowing widespread bacterial dissemination and visible skin lesions. *Tuberculoid* - Tuberculoid leprosy is characterized by a **strong cell-mediated immune response**, resulting in few, well-demarcated skin lesions with sensory loss. - It is typically **paucibacillary**, meaning few bacteria are present in the lesions, and does not cause punched-out or inverted saucer appearances. *Borderline tuberculoid* - Borderline tuberculoid leprosy presents with **moderate cell-mediated immunity** and a few skin lesions that are more numerous and less well-defined than in tuberculoid leprosy. - While it can be more extensive than tuberculoid, it typically does not exhibit the extensive tissue destruction leading to "punched-out" lesions characteristic of the lepromatous pole. *Borderline lepromatous* - Borderline lepromatous leprosy shows a **weak cellular immune response** and numerous, ill-defined lesions, often with varying sizes and shapes. - While it shares some features of lepromatous leprosy, the classic "punched-out" or "inverted saucer" appearance is more specifically associated with the widespread and uniform dermal infiltration of **full-blown lepromatous leprosy**.

Question 1

The hard chancre is seen in:

Accepted Answer

Syphilis

Answer

Chancroid

Answer

Granuloma inguinale

Answer

LGV

Question 2

Hutchinson's syphilitic triad includes all except

Accepted Answer

Cardiovascular anomalies

Answer

Interstitial keratitis

Answer

Nerve deafness

Answer

Notched incisor teeth

Question 3

Treatment of lepra reaction includes:

Accepted Answer

Corticosteroids

Answer

Stoppage of drug

Answer

Chloroquine

Answer

All of the options

Question 4

Which of the following is true regarding leprosy?

Accepted Answer

MBL recommended treatment for 12 months duration

Answer

All deformity cases are MBL

Answer

Grenz zone is absent in Lepromatous leprosy

Answer

Any positive smear 1+ is MBL

Question 5

Loss of lateral 1/3rd of eyebrow is seen in -

Accepted Answer

Lepromatous leprosy

Answer

Tetanus

Answer

Tinea capitis

Answer

Tuberculosis

Question 6

Which of the following regimens is recommended for multibacillary leprosy in children of 10 to 14 years of age?

Accepted Answer

Rifampicin 450 mg once a month (under supervision)+ Dapsone 50 mg daily (self-administered)+ Clofazimine 150 mg once a month (under supervision) and 50 mg every alternate day

Answer

Rifampicin 600 mg once a month (under supervision) + Dapsone 50 mg daily (self-administered)

Answer

Rifampicin 600 mg once a month (under supervision)+ Dapsone 100 mg daily (self-administered)+ Clofazimine 50 mg once a month (under supervision) and 25 mg every alternate day

Answer

Rifampicin 450 mg once a month (under supervision) + Dapsone 50 mg daily (self-administered)

Question 7

In secondary syphilis all are seen except -

Accepted Answer

Interstitial keratitis

Answer

Arthritis

Answer

Proteinuria

Answer

Condyloma lata

Question 8

Ridley's scale is used in classification of which disease?

Accepted Answer

Leprosy

Answer

Malaria

Answer

Measles

Answer

Tuberculosis

Question 9

Genital ulcer followed by painful lymphadenopathy is seen in -

Accepted Answer

LGV

Answer

Granuloma inguinale

Answer

Chancroid

Answer

Syphilis

Question 10

Punched out lesion or inverted saucer appearance are characteristic of which type of leprosy?

Accepted Answer

Lepromatous

Answer

Tuberculoid

Answer

Borderline tuberculoid

Answer

Borderline lepromatous

Bacterial Skin Infections — MCQs

Bacterial Skin Infections — MCQs

On this page

Practice by Chapter

Want unlimited practice?