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IV.Make the sentences complete:

1.Diagnosis is suggested by …

2.Diagnosis is confirmed by …

3.The organism does not grow on ...

4.Biopsy specimens should be

taken from …

5.In lepromatous patients, specimens should be taken from …

6. Pathologic changes may be visible even in …

7. Lepromatous patients almost always have …

8. Antibody levels fall …

9. Antibody levels rise …

10. Antibodies may be useful in …

a) the advancing edge of tuberculoid lesions.

b) microscopic examination of biopsy specimens.

c) normal – appearing skin.

d) with effective chemotherapy.

e) monitoring disease activity.

f) nodules or plaques.

g) the clinical picture and peripheral neuropathy.

h) serum IgM antibodies to M. leprae.

i) artificial culture media.

j) with relapse.

V.Read the text «Symptoms». Speak about the symptoms according to the plan:

        1. The progression of symptoms

        2. The symptoms resulting from infection of the skin

        3. The symptoms resulting from infection of the peripheral nerves

        4. The symptoms that the patient with tuberculoid leprosy may have

        5. The symptoms of lepromatous leprosy

        6. The symptoms of borderline leprosy

        7. symptoms due to damage to other organs

Symptoms

Because the bacteria that cause leprosy mul­tiply very slowly, symptoms usually do not begin until at least 1 year after a person has been infected; on average, symptoms develop 5 to 7 years after infection. Once symptoms do appear, they progress slowly.

Leprosy mainly affects the skin and periph­eral nerves. The skin develops characteristic rashes and bumps. Infection of the nerves makes the skin numb or the muscles weak in areas controlled by those nerves.

Leprosy is categorized as tuberculoid, lepro­matous, or borderline according to the type and number of skin spots. The type of leprosy dictates the long-term prognosis, likely com­plications, and how long antibiotic treatment is needed.

In tuberculoid leprosy, a rash appears, con­sisting of one or a few flat, whitish areas. Ar­eas affected by this rash are numb because the bacteria damage the underlying nerves.

In lepromatous leprosy, many small bumps or large raised spots of variable size and shape appear on the skin. There are more areas of numbness than in tuberculoid leprosy, and certain muscle groups may be weak.

Borderline leprosy shares features of both tuberculoid and lepromatous leprosy. If not treated, borderline leprosy may improve re­sembling the tuberculoid form or worsen to be­come more like the lepromatous form.

The most severe symptoms of leprosy result from infection of the peripheral nerves, which causes a deterioration of person’s sense of touch and a corresponding inability to feel pain and temperature. People with peripheral nerve damage may unknowingly burn, cut, or otherwise harm themselves. Repeated damage may eventually lead to loss of fingers and toes. Also, damage to peripheral nerves may cause muscle weakness, at times resulting in clawing of the fingers and a «drop foot» deformity. Skin infection can lead to areas of swelling, and lumps, which, can be particularly disfigur­ing on the face.

People with leprosy also may develop sores on the soles of the feet. Damage to the nasal passages can result in a chronically stuffy nose and, if untreated, complete erosion of the nose. Eye damage may lead to blindness.

During the course of untreated or even treated leprosy, the body's immune response may produce inflammatory reactions. These reactions can produce fever and inflammation of the skin, peripheral nerves, and less com­monly the lymph nodes, joints, testes, kid­neys, liver, and eyes.

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