B&l: Test 2: 10. Dugan : Borrelia And Rickettsial Infections

Front 1

Borrelia is similar to normal G- organisms but lack something on their cell wall that is found in normal G-'s....

Back 1

Lack endotoxin (lipopolysaccharide)

Front 2

Borrelia burgdorferi causes what disease?

Back 2

Lyme disease

Front 3

what transmits Borrelia burgdorferi?

Back 3

a tick that has fed on an infected deer or mouse (birds may serve as reservoir)

Front 4

most important reservoir for Borrelia burgdorferi?

**

Back 4

white footed mouse

Front 5

3 stages of lyme disease?

**

Back 5

Stage I: localized skin infection (Erythema Migrans, early flu symtoms)

Stage II: Disseminated infection (feel like total shit, bad headaches, neurodisorders, cardiac disorders [AV block])

Stage III: Persistant infection (Encephalopathy, arthritis, acrodermatitis)

Front 6

what is the vector of Borrelia burgdorferi?

*

Back 6

Ixodes scapularis - deer tick

note: in the nymph stage

Front 7

Pts can have Secondary erythema migrans
Neurologic disorders (lymphocytic meningitis, cranial neuropathy)
Cardiac disorders (atrioventricular block)
Arthritis

in what stage of Lyme Disease?

Back 7

II

Front 8

Pts can have

Encephalopathy
Arthritis (polyarthritis of the large joints)
Acrodermatitis chronica atrophicans (Borrelia afzelii)


in what stage of Lyme Disease?

Back 8

III

Front 9

Pts can have

Erythema migrans
Early flu-like symptoms: malaise, fever, chills, stiff neck and various pains

in what stage of Lyme Disease

Back 9

I

Front 10

this is a bullseye like lesion that can be seen in stage I of Lyme disease

Back 10

Erythema migrans

Front 11

what are the only known virulence factors for for B. burgdorferi? what do they do?

Back 11

Outer Surface Proteins (A and C)

allow attachment to mammalian cell and extracellular matrix (thru proteoglycans, fibronectin and integrin receptors); no endotoxin

note: OspA will decrease and OspC will increase after feeding is initiated..this is required

Front 12

if you remove the tick within 24 hours..what will happen? Why?

**

Back 12

if tick removed within 24 hours → no infection!

After tick initiates feeding on an infected host OspA ↓ and OspC ↑

you stop this switch

Front 13

what surface protein can undergo variation and lead to resistance for b. burgdorferi?

Back 13

VIsE

Front 14

standard diagnosis for Lyme Disease? 2

Back 14

Demonstrate rising antibody titer or single high titer by ELISA

Confirmation by Western blot

Front 15

DOC for Lyme Disease?

Back 15

Doxycyclin

Front 16

What causes relapsing fever? What is the vector that transmits it? where is it found?

*

Back 16

Borrelia species

lice or ticks

commonly in West Africa (you could see in west US, Middle East, Southeast Asia)

Front 17

pt travels to Africa, gets a high fever that goes away, then comes back...what do they have? cause?

*

Back 17

Relapsing fever

Borrelia

Front 18

This bug is the smalles spirochete and is curved at both ends

Back 18

Leptospira

Front 19

most often causes kidney disease (leading to failure), and is found in the tropics... can start as fever, chills, and headache.

Back 19

Leptospira

Front 20

where does Leptospira come from?

Back 20

animal urine

Front 21

For Rickettsia rickettsii please give the following:

Disease Caused
Vector
Reservoir
US region

Back 21

Disease Caused: Rocky Mountain Spotted Fever
Vector: Tick (dermacentor:dog tick)
Reservoir: Rodent
US region: Appalachians

Front 22

For Rickettsia typhi please give the following:

Disease Caused
Vector
Reservoir
US region

Back 22

Disease Caused: Endemic Typhus
Vector:Flea
Reservoir: Rat
US region: Southeast

Front 23

For Anaplasma phagocytophilia please give the following:

Disease Caused
Vector
Reservoir
US region

Back 23

Disease Caused: Human Granulocytic Anaplasmosis
Vector: Tick (Ixodes)
Reservoir: Deer
US region: Nationwide

Front 24

For Ehrlichia chafeensis please give the following:

Disease Caused
Vector
Reservoir
US region

Back 24

Disease Caused: Human Monocytic Ehrlichiosis
Vector: Tick (Amblyomma)
Reservoir: Deer
US region: South and Midwest

Front 25

For Coxiella burnettii please give the following:

Disease Caused
Vector
Reservoir
US region

Back 25

Disease Caused: Q Fever
Vector: None
Reservoir: Mammals
US region: Nationwide

Front 26

emphasis on rickettsii, anaplasma, and ehrilichia

Back 26

those would be the 3 to know!!

Front 27

this is a systemic disease, where the local symptoms are due to the damage of small blood vessels. This entry and damage to the endothelium causes leakage and rash. What is this and what was the cause?
*

Back 27

Rocky Mountain Spotted Fever

Rickettsii

Front 28

pt presents after camping and has an abrupt onset of fever, chills, headache and a hemorrhagic rash (which is spreading from extremities to trunk). What do they have? cause?
*

Back 28

Rocky Mountain Spotted Fever

Rickettsii

Front 29

how does the rash spread in rocky mt spotted fever?

*

Back 29

from extremities to trunk

Front 30

Thrombocytopenia
Elevated aminotransferase levels
Hyponatremia
Anemia
Increased bilirubin
Increased creatinine kinase level

are lab findings for what?

Back 30

Rocky Mountain Spotted Fever

Rickettsii

Front 31

What test would you order if you suspected rocky mountain spider fever?

Back 31

Microimmunoflourescent antibodies (Complement fixing antibodies): four-fold rise in titer

Front 32

tx for rocky mountain spider fever? what was the major vector for this?

Back 32

doxycycline

Dermacentor variabilis (American dog tick)

Front 33

Ehrlichia chafeensis – what neutrophil is infected?

*

Back 33

Monocytes

Front 34

Anaplasma phagocytophilum -- what neutrophil is infefected?

*

Back 34

Granulocytes

Front 35

Lyme vs Rickettsii

Vertical transmission

Back 35

ticks can lay eggs that have the disease in Rickettsii

Front 36

intracytoplasmic vacuoles (morulae) can be found in neutrophils with what disease?.

Back 36

Ehrlichia chafeensis – human monocytic ehrlichiosis

Front 37

what is the vector for Ehrlichia chafeensis – human monocytic ehrlichiosis ?

Back 37

Lone star tick (ambyloma)

Front 38

DOC for ehrlichia or anaplasma?

Back 38

Doxycycline