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19 Cards in this Set

  • Front
  • Back
How is Lyme Disease transmitted?
Tick bite. Specifically Ixodes Scapularis (East Coast), and I. Pacificus (West Coast).
Where is Lyme Endemic?
North Atlantic, Wisconsin, California
How much time do you have to find and remove the tick before infection is transmitted?
24-48 hours. That's how long the tick has to feed before B. Burgdorferi is transmitted.
How is Lyme diagnosed in the lab?
Tests prior to 2 weeks post infection are likely to be negative. Lyme IgM antibody titers (2 wks post infection, peaks 3-6 weeks), IgG after 30 days. Positive tests should be verified via Western Blot or ELISA due to the test's cross-reactivity with antigens in normal flora.
What are the stages of Lyme Disease?
Stage 1: Erythema Chronicum Migrans (target lesion)
Stage 2: Cardiac & Neuro Involvement
Stage 3: Large Joint Arthritis
What season does Lyme predominate and why?
Summer-- that's when the tick nymphs who spread the disease feed.
How do you treat Lyme?
Stage 1: Doxycycline 14-21 days. Kids & pregnant women: Amoxicillin.

Neurologic Symptoms: Ceftriaxone IV 21-30 days

Arthritis: Doxycycline PO (2 mos) or Ceftriaxone IV (1 mo)

Arrhythmias: IV abx, monitoring, pacer
What are cardiac manifestations of Lyme Disease?
myocarditis, pericarditis, various forms heart block
What are neurologic manifestations of Lyme Disease?
Aseptic meningitis, encephalopathy, cranial neuropathies (Bell's Palsy), peripheral neuropathies.
When do the different stages of Lyme Disease occur after tick bite?
Tick Bite
Infection: 24-48 hrs
Stage 1: Soon after
Stage 2: weeks-months
Latent phase: weeks to months
Stage 3: weeks-months
Can you cure Lyme disease?
Yes. Remove the tick in under 24 hrs. Antibiotics also cure nearly all cases even in later stages. About 10% will have chronic disease.
How is Lyme Disease diagnosed?
1. Lives in endemic area
2. Has bull's eye rash
3. Other classic symptoms (cardiac, neurologic, arthritic/arthralgic)

1. Serum Ab Titers (after 2 weeks)
2. CSF Ab titers if neuro symptoms
4. western blot.

Blood cultures, head CT/MRI are useless.
What does an Ixodes tick look like?
As small as a poppy seed when unfed, as large as a raisin when fed.
How do you remove an Ixodes tick?
1. Grasp the tick's mouth area with clean tweezers as close to the skin as possible.
2. Pull upward with slow steady pressure
3. Do not twist, crush, use your own fingers, or try to burn or "suffocate" the thing with vaseline
4. Place the tick in a closed jar containing some rubbing alcohol.
What is the most common lethal infection in the world?
Where is malaria endemic?
tropical and subtropical areas of Asia, Africa, Central and South America
Under what circumstances does one encounter malaria in the United States?
patients who travelled to endemic areas with inadequate chemoprophylaxis, immigrants from endemic areas
Where is chloroquine-resistant malaria endemic?
Southeast Asia, South America, East Africa
What is the lifecycle of plasmodia protozoa?
Anopheles mosquito bite> sporozoites in saliva enter blood> hepatocytes

"Exo-Erythrocytic phase": cells multiply,differentiate into merozoites [Vivax and Ovale develop latent hypnozoites in liver that cause relapses]>

Erythrocytic Phase:
hepatocytes spit merozoites into blood. They differentiate into ring-shaped trophozoites. This grows into an ameoboid form, then schizont filled with merozoites.