Answer: MediQuiz #1

in Uncategorized by

If you want another go at the MediQuiz question, then click on this LINK! Answer and explanations after the jump!

So I did not think that so many people will get it correct, and by correct, I mean absolutely bang on the target! While this is indeed a heartening thing to see that our medical school education has not yet eroded our ability to use both the hemispheres, this is almost like a challenge to ask more difficult questions! The next one, Mediquiz #2 seems to have been a tad bit tougher, but as usual Kaustav Bera not only answered it, but gloated over it publicly too!

Anyways, as most of you said, it is indeed Leprosy. The reasons:

Image 1: Mahatma Gandhi was assassinated on January 31 and that day or the Sunday nearest to it is celebrated as World Leprosy Day in honor of his memory. In this particular picture, he is looking at some Mycobacterium leprae in Sevagram in 1940.

 

Image 2: Dharmendra antigen is used for the purpose of doing the Lepromin Test. The test is now being increasingly used especially for epidemiological studies with the ultimate object of controlling the spread of leprosy. Dharmendra antigen is a suspension of de­fatted leprosy bacilli first reported by Dharmendra in 1941-1942. But it was fur­ther standardised by bacterial count by Sengupta et al 1979. This antigen evokes an early as well as late reaction with an intrad­ermal dose of 0.1ml. (1)

Image 3: For the unfortunate mortals who do not know the lady, she is Jacqueline Fernandez and she has been hotting up the headlines consistently in the Indian news media… but I digress. She represents the Fernandez Reaction (2) in the Lepromin test. Within 48-72 hours of administration of the Lepromin test, an early positive reaction indicated by an erythematous induration maybe formed. This is a delayed hypersensitivity response to the bacillary antigen in the injected product and does not represent the true lepromin positivity or Mitsuda reaction, which is assessed at the end of 4 weeks. So it is just a false alarm, of sorts…

Image 4: Gerhard Henrik Armauer Hansen. Gerhard Henrik Armauer Hansen (29 July 1841 – 12 February 1912) was a Norwegian physician, remembered for his identification of the bacterium Mycobacterium leprae in 1873 as the causative agent of leprosy. [3]

 

Image 5 A & B: The West Indian wicket keeper/batsman Ridley Jacobs, who was also the image 5Windies skipper for a short time period after Carl Hooper retired and before Brian Lara took up the reins. The next one is an Olive Ridley Turtle. This is, of course, in allusion to the imageRidley Jopling Classification of Leprosy.

The axis of classification is the degree of Lepromin reaction. Kensuke Mitsuda first reported the lepromin reaction in 1919, which is usually called the Mitsuda reaction. This reaction was completed by Fumio Hayashi. [4]

 

REFERENCES:

1. Mohanty J, Mohanty HC. Lepromin response with dharmendra antigen in patients with leprosy. Indian J Dermatol Venereol Leprol [serial online] 1997 [cited 2011 Aug 11];63:385-7. Available from: http://www.ijdvl.com/text.asp?1997/63/6/385/4627

2. Histology of the Fernandez reaction. An appraisal. Thomas J, Joseph M, Ramanujam K, Chacko CJ, Job CK. Int J Lepr Other Mycobact Dis. 1981 Mar;49(1):1-8. PMID: 7195878

3. Hansen GHA (1874). “Undersøgelser Angående Spedalskhedens Årsager (Investigations concerning the etiology of leprosy)” (in Norwegian). Norsk Mag. Laegervidenskaben 4: pp. 1–88.

4. Hayashi F. Mitsuda’s skin reaction in leprosy. Intern J Lepr. 1:31-38,1933.

Skeptic Oslerphile, Scientist at the Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases. Interests include: Emerging Infections, Public Health, Antimicrobial Resistance, One Health and Zoonoses, Diarrheal Diseases, Medical Education, Medical History, Open Access, Healthcare Social Media and Health2.0. Opinions are my own!

Leave a Reply

Latest from Uncategorized

Weekend Research Reads #2

This weekend’s research reads is really heavy on the antibiotic/antimicrobial resistance head
Go to Top