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Internal Medicine > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Bivalent leptospirosis vaccine

Tetravalent contains

A

Canicola and icterohaemorrhagiae

Grippotyphosa and Bratislava

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2
Q

Best way to diagnose leptospirosis

A

Rising MAT >1:1600 (likely to be positive at this level if not vaccinated)

Positive PCR urine or blood (can get false negatives)

ELISA positive - needs confirmed with rising MAT

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3
Q

Best test for FeLV infection

A

IFA for p27 antigen

ELISA good screening test but can be negative in early infection and needs to be confirmed with IFA

If both negative and highly suspicious can do PCR

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4
Q

Toxoplasma serology

A

IgG positive titre indicates exposure

IgM indicates active infection and reduces when the IgG rises

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5
Q

Toxoplasmosis treatment

A

Clindamycin 12.5-25mg/kg PO BID 4 weeks

TMS 15mg/kg PO BID

Azithromycin 5mg/kg PO BID

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6
Q

Best test for crenosoma vulpis

A

Zinc flotation

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7
Q

DDx skin fragility syndrome

A 
Diabetes mellitus
HAC
Progesterone
FIP
Cholangiocarcinoma
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8
Q

Definitive diagnosis of FIP

A

Immunohistochemistry for coronavirus antigen in tissue samples (good if there are skin lesions)

Effusion analysis has good predictive value (immunoflourescence of coronavirus antigen within macrophages in effusion is diagnostic of FIP)

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9
Q

Ddx for hypergammaglobulinaemia

In a cat

A 
Lymphoma
Multiple myeloma/plasma cell neoplasm
Chronic infection
FIV
FIP
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10
Q

Indicators of FIP on haem/biochem

A

A:g ratio <0.4
Glob > 35 g/l
Alpha1-acid-glycoprotein >1500
(Especially in effusions)

Anaemia non-regen
Lymphopaenia
Left shift neutrophilia

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11
Q

How to perform rivaltas test

A

One drop of fluid to 98% acetic acid solution - positive if a precipitate is formed

PPV 86%
NPV 96%

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12
Q

False positive rivalta test can occur with what diseases

A

Lymphoma

Bacterial peritonitis

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13
Q

Best test on CSF in cats for FIP

A

RT-PCR if having neurological signs (100% specificity and PPV for FIP)

Ab titre useless and CSF immunocytochemistry is sensitive/specific but too low to confirm FIP

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14
Q

Two main causes of tuberculosis in cats and dogs

A

M. Microti

M. Bovis

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15
Q

Is FeLV or fiv infection a consistent feature in cats with leprosy

A

No

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16
Q

Treatment of ehrlichia Canis

A

Doxycycline for at least 21 days for acute disease or 6-8weeks for chronic/subclinical disease

Imidocarb diproprionate if resistant to tetracyclines

Supportive: blood transfusions, glucocorticoids for immune-mediated disease

Human granulocyte colony stimulating factor, vincristine?

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17
Q

What is considered gold standard test for e.canis

A

Indirect immunoflourescent antibody titre (IFA)

Use PCR for monitoring response to tx

Should do serology and PCR to confirm

PCR is actually the most sensitive and specific test for ehrlichia

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18
Q

Cause of canine granulocytic ehrlichiosis

A

Anaplasma phagocytophilum

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19
Q

Transmission of anaplasma

A

Ixodes ricinus

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20
Q

Clinical signs of anaplasma phagocytophilum (canine granulocytic ehrlichiosis)

A 
Lethargy
Anorexia
Seizures
Reluctance to move
Weakness 
Fever
Lymphadenopathy
Diarrhoea
Neck pain
Splenomegaly
Lymphadenopathy
Lameness
Subcutaneous oedema
Multiorgan failure / shock
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21
Q

Diagnosis of anaplasma

A

Intracytoplasmic inclusions in neutrophils

Fourfold increase in IFA titre over 2-4 weeks

Positive PCR

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22
Q

Cause of canine cyclic thrombocytopaenia

A

Anaplasma platys

23
Q

Diagnosis of A.platys

A

PCR
Intra-platelet inclusions (morulae)

(Serology not possible)

24
Q

Feline ehrlichiosis clinical signs

A

Polyarthropathy
Fever
Uveitis

25
Q

Best way to diagnosis feline ehrlichiosis

A

PCR

And intracytoplasmic monocytic inclusions

26
Q

Acute manifestations of canine monocytic ehrlichiosis

A 
Fever
Anorexia
Weight loss
Haemorrhages
Purulent Ocular/nasal discharges 
Dyspnoea/cough
Lymphadenopathy
CNS signs
27
Q

Chronic manifestations of monocytic ehrlichiosis

A 
Lymphadenopathy
Weight loss
Anaemia
Bleeding
Glomerulonephritis and renal failure 
Depression
Weight loss
28
Q

Clinicopathologic abnormalities with canine ehrlichiosis

A 
Thrombocytopaenia
Non regen anaemia
Leucopaenia
Pancytopaenia
Monocytosis
Lymphocytosis
Hypoalbuminaemia
Hypergammaglobulinaemia
Low albumin:globulin ratio
Abnormal electrophoretic pattern
29
Q

Prognosis of acute ehrlichiosis

And chronic

A

Acute - Good

Chronic - guarded

30
Q

Infectious causes of glomerulonephritis

A 
Lymes 
Leishmania
Ehrlichia
Leptospirosis
Babesia 
Hepatozoon canis
31
Q

Diagnosis of babesiosis

A

Examination of a blood smear (inclusions)

Elisa
IFA
PCR - most sensitive

Dogs from endemic areas may be seropositive so should do PCR (if always been in the UK a positive antibody titre would likely be diagnostic)

32
Q

Treatment of babesiosis

A

Imidocarb diproprionate once then repeated in 14days

Dimenazene
Once

Phenamidine
Once and repeat in 24hrs

Trypan blue once

Steroids?? May reduce response of immune system if IMHA is involved but could worsen signs

33
Q

Prognosis of acute and chronic babesiosis

A

Acute - good

Chronic - guarded

34
Q

Acute manifestation of babesiosis

A 
Fever
Anorexia
Lymphadenopathy
Splenomegaly
Weakness
Pallor
Haemolytic anaemia (may be immune mediated)
Splenomegaly
Thrombocytopaenia 
Disproportionately high urea 
Mixed acid base disorders
35
Q

Chronic manifestations of babesia

A

Intermittent fever
Variable appetite
Marked loss of weight
Regenerative anaemia

Can process to multi organ failure :
Acute renal failure, hepatopathy and icterus, cerebral pathology, acute respiratory distress syndrome

36
Q

Clinical signs of acute lymes disease

A 
Fever
Inappetance
Lethargy
Lymphadenomegaly
Polyarthropathy (lanes, stiffness)
37
Q

Clinical signs of chronic lymes

A 
Recurrent intermittent non erosive arthritis
2 or more joints involved
Erythema
Glomerulonephritis
Myocarditis
Neurological signs
38
Q

Treatment of lymes

A 
Doxycycline
Penicillin like antibiotics
Tetracycline
NSAID
Ceftriaxone IV if chronic
39
Q

Lymes prognosis

A

Acute - good usually improves in two weeks

Chronic - guarded

40
Q

Hepatozoon canis clinical signs

A 
Fever 
Lethargy
Pallor
Mucopurulent ocular discharge
Anorexia
Vomiting
Bloody diarrhoea
Myalgia (temporal muscle atrophy)
Myosotis
Myocarditis
Posterior paresis
Tetraparesis
SC oedema
Hind limb oedema
Lumbar pain
Pneumonia 
Hepatitis
Splenitis
Glomerulonephritis
41
Q

Clinicopathologic abnormalities with hepatozoon canis

A 
Neutrophilia
Increased ALP
Hypoalbuminaemia
Hypoproteinaemia
Hypoglycaemia
Mild non regen anaemia
42
Q

Diagnosis of h.canis

A

Inclusions within neutrophils on blood smear

Serology - Elisa (most sensitive method)

Muscle biopsy

43
Q

Treatment of hepatozoon canis

A

TMPS

+/-

Clindamycin
Pyrimethamine
Decoquinate (anti coccidial) use for years
Imidocarb (unsure about this one not enough studies)

44
Q

How long for bone marrow to react to haemolysis

A

3-5 days

45
Q

Vaccinations against infectious disease for dogs

A

Babesiosis vaccine
Lymes vaccine
Leishmania vaccine

46
Q

Prevention of leishmaniasis in endemic areas

A

Keep dogs in at dawn and dusk

Deltamethrin impregnated collars

47
Q

Treatment of leishmaniasis

A

Megline antiomoniate daily s/c for 3-6 weeks
Allopurinol twice weekly orally (can be continued)
Miltefosine

48
Q

Clinical signs of leishmaniasis

A 
Pyrexia
Lymphadenopathy
Cutaneous crusting/alopecia
Renal disease
Onychogryphosis
Conjunctivitis/uveitis secondary glaucoma
Vasculitis (poly arthritis)
Thrombocytopaenia and bleeding
Non-regen anaemia 
DIC

See hyperglogulinaemia and hyperalbuminaemia on bloods

49
Q

What is caval syndrome

A

The concomitant presence of right sided congestive heart failure and intravascular haemolysis

50
Q

Diagnosis of dirofilaria immitis

A

Visualisation of larvae in blood smear or using modified knots test

Antigen Elisa (may get false neg if low worn burdens)

Serology (only really useful for ruling out infection as may have been previously exposed and treated)

PCR - good but not widely available

May see worms in pulmonary artery/ r ventricle on echo

Eosinophilia +/- worms on BAL

51
Q

Treatment of dirofilaria immitis

A

Melarsomine dihydrochloride
Physical removal of worms via jugular
Eliminate microfilariae 4-6 weeks after adulticide therapy (using ivermectin or milbemycin oxime) can give prednisolone alongside this

In cats only supportive tx as usually clear infection themselves and high risk of thromboembolism with adulticide tx (steroids, oxygen etc)

52
Q

What test should be used to confirm a positive FIV in house Elisa

A

IFA

(PCR not great given low levels of circulating antigen)

Could do western blot but time consuming and expensive

Virus isolation is the gold standard but not commonly available

53
Q

Diagnosis of leishmania

A

Presence of amastigotes in tissue samples or LN aspirates

Serology May be negative early in course of disease when PCR is positive and then the titre will rise and PCR May be negative so best to use both tests together

Internal Medicine (11 decks)

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