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M3 > IDS Lepto > Flashcards

IDS Lepto Flashcards

1
Q

3 nonspecific symptoms of mild form of Leptospirosis

A

FHM

fever
headache
myalgia

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2
Q

3 symptoms of Severe Leptospirosis

A

JRH

Jaundice
Renal dysfunction
Hemorrhagic diathesis

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3
Q

Severe lepto is a.k.a

A

Weil’s syndrome

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4
Q

pathologic species of Leptospirosis

a. L. interrogans
b. L. biflexia
c. both
d. neither

A

A, L. biflexia is free living

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5
Q

How many pathogenic species are there?

A

10

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6
Q

T/F vast majority of infections with leptospira cause no or only mild disease in humans

A

T

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7
Q

Severe potentially fatal complications is in what percentage of the patients?

A

1%

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8
Q

2 phases of leptospirosis

A

leptospiremic phase

immune phase

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9
Q

organisms proliferate, cross tissue barriers and disseminate hematogenously to all organs, leptospires can be isolated from the bloodstream. Which phase?

A

leptospiremic phase

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10
Q

binding to this allows Leptosires to evade complement mediated killing

A

Factor H

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11
Q

T/F blood cultures taken during immune phase will yield positive results,

A

F. appearance of antibodies coincides with disappearance of leptospires from the blood

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12
Q

Renal pathology in immune phase

a. acute tubular damage
b. interstitial nephritis
c. both
d. neither

A

C

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13
Q

Histopathology of the liver in leptospirosis

A

NIB

necrosis, focal
inflammation, foci of
Bile cannaliculi, plugging of

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14
Q

T/F platelet consumption plays an important role in the pathogenesis of leptospirosis

A

T

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15
Q

endothelial cell activation is reflected by

A

elevated plasma levels of soluble E-selectin and vWF

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16
Q

T/F there is swelling of activated endothelial cells, vasculitis, necrosis

A

F; no evident vasculitis, necrosis

17
Q

The only leptospiral virulence factor shown to satisfy Koch’s postulate. This encodes a surface-exposed protein with an unkown function

A

loa22

18
Q

TLRs involved in innate immunity in leptospirosis

A

TLR2

TLR4

19
Q

Incubation period of leptospirosis

A

1-2 weeks (1-30 days)

20
Q

How long is the leptospiremic phase

A

3-10 days

21
Q

during the immune phase, culture sample should be taken from ______ to demonstrate leptospires

A

urine

22
Q

All cases of leptospirosis always include a second phase

A

F

23
Q

natural course of mild leptospirosis usually involves spontaneous resolution within

A

7-10 days

24
Q

Characteristics of leptospirosis patients with higher mortality rates

A

My HAAIR

mental status, altered
Hypotension
Arryhtmias
Age >40
Insufficiency, respiratory
Renal failure, acute
25
Q

Electrolyte abnormality due to acute kidney injury in leptospirosis

A

Hypokalemia
Hyponatremia
Loss of magnesium in urine

26
Q

ECG changes in leptospirosis

A

nonspecific ST-T wave changes

27
Q

CSF shows pleocytosis that can range from a few cells to

A

> 1000 cells/uL

28
Q

CSF glucose levels in leptospirosis

A

normal

29
Q

pulmonary radiographic abnormalities in severe leptospirosis

A

patch bilateral alveolar pattern

30
Q

Definitive diagnosis of leptospirosis is made by

A

isolation of the organism form the patient
positive result in PCR
seroconversionor a rise in antibody titer

31
Q

standar serologic procedures for leptospirosis

A

MAT and 1145 ELISA

32
Q

real-time PCR is most effective when?

A

first 5 days of illness

33
Q

Treatment for severe leptospirosis

A

IV penicillin

34
Q

Treatment for mild cases

A

doxycycline

35
Q

reaction to endotoxin-like products released by death of harmful microorganisms that resembles sepsis, fever, chills, rigor, hypotension, headache, tachycardia, hyperventilation, vasocilation. This develops within hours after initiation of antimicrobial tx

A

Jarisch-Herxheimer reaction

36
Q

Treatment for patients with oliguri renal failure

A

peritoneal dialysis or hemodialysis

37
Q

T/F most patients with leptospirosis recover

A

T

38
Q

Mortality rates are highest among patients

A

PEP
Pulmonary hemorrhage, Weil’s
Elderly
pregnancy - fetal mortality

M3 (66 decks)

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