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9th > Chapter 179- Lyme borreliosis > Flashcards

Chapter 179- Lyme borreliosis Flashcards

1
Q

Lyme disease is caused by

A

Borrelia burgdorfer

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2
Q

The most common cutaneous finding is Lyme Borreliosis

A

Erythema migrans

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3
Q

Matching type

  1. Borrelia burgdorferi
  2. Borrelia garinii
  3. Borrelia afzelii
A. Europe
B. Asia
C. North America
D. A and B
E. A and C
A

E
D
D

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4
Q

Transmission vectors of Lyme Borreliosis in US; in Europe; in Asia

A

Ixodes scapularis ticks
Ixodes ricinus ticks
Ixodes persulcatus

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5
Q

In the US, primary amplifying host of Borrelia burgdorferi; in Europe

A

White-footed mouse;

Birds, shrews, voles

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6
Q

There is transovarial passage of Borrelia burgdorferi.

True or False

A

False

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7
Q

Passage from one stage in the tick life cycle to the next

A

Transstadial transmission

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8
Q

Majority of human transmission is from adult ticks.

True or False

A

False, nyphal ticks

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9
Q

Primary drivers in dispersal of infected ticks

A

Deers

Birds

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10
Q

Lyme disease has a bimodal age distribution with prevalence in ___, onset in ____

A

5 to 9 years; 55 to 59 years
Males
June, July, August

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11
Q

1st symptom to develop with infection of Lyme Disease

A

Erythema migrans

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12
Q

Immunohistochemcial studies indicate the infiltrate to be composed of

A

CD4 T lymphocytes

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13
Q

Minimum of ___ hours is required for transmission of spirochete

A

36

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14
Q

Large, x > 5cm, expanding, erythematous rash along the lines of least skin tension (Langer lines) with central clearing and draker punctate center

A

Bull’s eye rash

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15
Q

Central clearing may be more common in ___

A

Borrelia garinii

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16
Q

Most common manifestation of hematogenous dissemination

A

Multiple EM rashes

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17
Q

Late cutaneous finding of Lyme disease have 2 phases

A

Inflammatory phase

Cutaneous atrophy phase

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18
Q

Bluish red discoloration on extensors with infiltrated purple bands adjacent to joints

A

Inflammatory phase

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19
Q

Particularly indicative of Lyme disease

A

Swelling of posterior aspect of lower extremities

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20
Q

‘Cigarette paper-like’ appearance and prominence of superficial veins

A

Cutaneous atrophy

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21
Q

Least common of cutaneous hallmarks of Lyme disease

A

Lymphocytic infiltrates

22
Q

Common denominator in patients with Borrelia-associated lymphoma

A

High titers of antibodies

23
Q

Highest frequency of infection eith Borrelia has been found in

A

Marginal zone lymphoma

24
Q

Cd5 and Cd10 are often found in Borrelia-associated B cell lymphoma.
True or False

A

False, centrocytic lymphoma

25
Q

Common areas for dissemination (4)

A

CNS
PNS
Heart
Joints

26
Q

Most common neurologic manifestations (3)

A

Meningitis
Cranial neuropathy
Radiculopathy

27
Q

Most characteristic neuropathy of early Lyme disease

A

Facial palsy

28
Q

Bannwarth syndrome is a triad characterized by (3)

A

Lymphocytic meningitis
Cranial palsy
Radiculoneuritis

29
Q

B. Burgdorferi has predilection for

A

AV node

30
Q

Most frequent clinical sign of late disseminated Lyme disease

A

Inflammatory arthritis

31
Q

Antibitic theray can hasten resolution of facial palsy and radiculitis.
True or False

A

False, EM, arthritis

32
Q

Profound depression, myalgia, polyarthralgia, and paresthesia, as well as neurocognitive abnormalities after infection with Borrelia burgdorferi

A

Posttreatment Lyme disease syndrome

33
Q

Ixodes ticks have ___ year ___ stage life cycle (___)

A

2
3
Larval —> Nymphal —> Adult

34
Q

Tick salivary protein which helps organism to evade immune response

A

Salp 15

35
Q

2 of the major regulators of Borrelial gene expression

A

Histidine kinase 1/ response regulator 1

Response regulator 2/RNA polymerase sigma S/RNA polymerase sigma N pathway

36
Q

Responsible for hematogenous spread of organism

A

OspC type A (RST1)

37
Q

Critical element of B. Burgdorferi survival

A

Motility

38
Q

Gold standard for diagnosis of Borrelia burgdorferi

A

Culture

39
Q

Main use in detecting B. Burgdorferi in synovial fluid of Lyme arthritis

A

PCR

40
Q

Increased risk for false positive IgM serologic testing (3)

A

Autoimmune diseases
Epstein Barr virus
Bacterial endocarditis

41
Q

Increased risk for false positive IgG serologic testing (5)

A 
Syphilis
Helicobacter pylori
SLE
Ehrlichiosis
Babesiosis
42
Q

Measures only IgG antibody early in course of disease by using constant region of B. Burgdorferi VIsE protein

A

C6 peptide test

43
Q

1st line treatment due to its excellent penetration to CNS and effectivity against A. Phagocytophilum

A

Doxycycline

44
Q

Used to treat children or pregnant women with Lyme disease

A

Cefuroxime

45
Q

Treatment regimen for Lyme disease

A

Doxycycline 100mg BID x 10 days
Amoxicillin 500mg TID x 14 days
Cefuroxime 500mg BID x 14 days

46
Q

Prophylaxis for Lyme disease

A

Doxycycline 200mg 1 dose

47
Q

With neurologic manifestations, treatment regimen is extended to

A

14 days

48
Q

With cardiac manifestations, treatment regimen is extended to

A

14-21 days

49
Q

With musculoskeletal manifestations, treatment regimen is extended to

A

28 days

50
Q

Prophylaxis should be started within

A

72 hours

9th (7 decks)

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