Question 7 from the second paper of 2014 asks for a substantial amount of detail regarding leptospirosis, including clinical features, diagnostic criteria, natural course of the disease, and specific treatment.
It is one of the tropical diseases listed in Sivakumar and Pelly's chapter of Oh's Manual (Ch. 73, p.743). Literally two paragraphs are spent on it; but the detailed model answer gives one the impression that the college expects a much more indepth knowledge of these tropical pathogens than a mere familiarity with the limited content of the Manual.
As such, the question favours infectious diseases specialists and people working in Queensland. For the rest of us, indepth knowledge must come from journal articles and textbook chapters.
Of specific interest:
The clinical features of leptospirosis are also presented in a good 2011 article, which asserts a certain order of importance over the protean manifestations of this disease. For the time-poor exam candidate, one can condense this wisdom in the following manner:
Leptospirosis in general:
Weil's disease in particular:
People describe a "biphasic" course.
Once the spirochetes generate a vigorous antibody response, their numbers in the bloodstream dwindle (that usually takes about a week). Thereafter, they remain adherent to the renal tubular epithelium, and are shed into the urine.
The Sanford Guide recommends benzylpenicillin.
Alternatives include ceftriaxone or doxycycline.
The course is for 7 days, is not without risk, and may be without benefit. A 2012 Cochrane review could not demonstrate any difference between antibiotic regimens, nor indeed any benefit from antibiotics in general. On the other hand, it is known that the sudden wholesale death of millions of spirochetes in one's bloodstream may give rise to the Jarisch-Herxheimer reaction, which is horrible inflammatory state featuring rigors, shock, a temperature up to 42°C, and possibly DIC.