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MCQs in Tropical Medicine

Rob Skelly DTM+H FRCP

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Answer 19

Characteristic findings in visceral leishmaniasis (kala azar) include:

False a. eosinophilia
True b. pancytopaenia
True c. polyclonal hypergammaglobulinaemia

False d. positive leishmanin test
True e. lymphadenopathy

a. A low or normal eosinophil count would be more usual

b. Pancytopaenia is common and is due to both marrow suppression and hypersplenism

c. Hypergammaglobulinaemia: this antibody response is ineffective in clearing Leishmania and diverts immune resources from concomitant infections. Indeed most deaths are due to intercurrent infection.

d. A positive Leishmanin test indicates good cell-mediated immunity. The test is usually negative in kala azar (like the tuberculin test in miliary tuberculosis) but becomes positive after treatment.

e. Hepatosplenomegaly generally occurs before lymph node enlargement

Copyright: Rob Skelly 2006