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Pathology -- Infectious Disease > Infectious Disease -- Bacterial IV - Rickettsial and Zoonotic Diseases > Flashcards

Infectious Disease -- Bacterial IV - Rickettsial and Zoonotic Diseases Flashcards

1
Q

Three Intracellular Vector-Bourne Diseases (with vector)

A

Epidemic typhus (lice)
Rocky Mountain Spotted Fever (ticks)
Erlichiosis (ticks)

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2
Q

Three extracellular vector bourne diseases (with vector)

A 
Lyme Disease (ticks)
Relapsing Fever (lice or ticks)
Plague (fleas)
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3
Q

What are Rickettsia bacteria

A

Small, G- obligate intracellular bacteria

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4
Q

How are rickettsia transmitted

A

Arthropod (ticks, mites, fleas, or lice) bites or excreta

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5
Q

What do eschars typically look like?

A

Dark, Swollen, Crusted lesions that ma appear at inoculation site

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6
Q

How do you diagnose a rickettsial infection

A

Immunostaining of organisms
Antirickettsial serology (Convalesence)
Exposure to Vector

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7
Q

What cell type does rickettsia mainly multiply in?

A

Small vessel endothelia

There they cause vascular leakage issues in rickettsial diseases

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8
Q

Difference between mechanism of typhus and spotted fever group rickettsia

A

Typhus - Lyse endothelial cells

Spotted Fever – Spread Cell to Cell

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9
Q

Rickettsia exotoxins and endotoxins?

A

None

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10
Q

How does Rickettsia fuck up so many blood vessels

A
  1. Small vessel damage from thrombosis and hemorrhage
  2. NK cells make g-INF
  3. CD8 T Cells mediate immune responses responsible to most damage
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11
Q

Often seen pathological staining of Rickettsia

A
  • Perivascular cuffing (infection of endo cells with perivascular lymphocytic intermediate.)
  • Mostly lymphocytes, few neutrophils (approx 1 week)
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12
Q

Average Rickettsia clinical features

A

Fever, Rash, CNS symptoms, Gangrene

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13
Q

Severe Rickettsial clinical features

A

Hypovolemic Shock, DIC, Pulmonary Edema

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14
Q

Treatment for Rickettsia?

A

Doxycycline

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15
Q

What should be in the DDx of a Rickettsia patient

A 
Rickettsia
Meningococcemia
Rubeola
Rubella
Erlichiosis
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16
Q

Organism for Epidemic Typhus

A

R. prowazekii

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17
Q

Method of Epidemic Typhus Transmission

A

Head lice mediates human to human transmission

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18
Q

Manifestations of Epidemic Typhus

A

Centrifugal Rash –> CNS involvement
High Fever
Chills, Cough, Rash, Muscle Pain, Light Sensitivity

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19
Q

Untreated mortality Epidemic Typhus

A

10-60%

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20
Q

Clinical Findings in Severe cases of epidemic typhus

A

Gangrene – tis of fingers, nose, earlobes, scrotum, penis, and vulva

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21
Q

Morphology seen in Epidemic Typhus

A

Cuff of mononuclear inflammatory cells around vessels
Ecchymotic hemorrhages of organs
Microthrombi
No necrosis of vessels

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22
Q

Organism for Rocky Mountain Spotted Fever

A

R. rickettsi

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23
Q

Method of Rocky Mountain Spotted Fever transmission

A

American Dog Tick/Rocky Mountain Wood Tick

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24
Q

Incubation period for Rocky Mountain Spotted Fever?

A

7 days

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25
Symptoms of Rocky Mountain Spotted Fever
Fever, Nausea, Vomiting, Headache, Muscle Pain High Fever 2-3 weeks Rash appears by day 6 (Lymphocytes attack vessels)
26
Describe the rash in Rocky Mountain Spotted Fever
Hemorrhagic rash extends over entire body, including palms and soles. Typically spreads from periphery inward. Rarely, an eschar
27
Morphology seen in Rocky Mountain Spotted Fever
``` Perivascular Mononuclear Infiltrate Necrosis, Fibrin Extravasation Thrombosis of small blood vessels/arterioles Foci of necrotic skin Microinfarts in brain ```
28
Major Cause of Death in Rocky Mountain Spotted Fever
Noncardiogenic Pulmonary Edema
29
What kind of fluid is found in the pulmonary edema of Rocky Mountain Spotted Fever patients
Exudative | There are lymphocytes in the fluid
30
Where in the country does Rocky Mountain Spotted Fever tend to happen?
East Coast, South, Oklahoma/Arkansasish area
31
Potential Rocky Mountain Spotted Fever patient shows up in the cold of winter. They probably really have...
Meningitis
32
What is scrub typhus?
Caused by Orientia tsutsugamushi Endemic in Far East Like Typhus, but transmitted by mites Transitory Rash, Prominent Lymphadenopathy
33
Ehrlichiosis is caused by what organisms...
E. chaffeensis | Anaplasma phagocytophilum
34
Difference between clinical appearance of an Ehrlichiosis patient and a Rocky Mountain Spotted Fever
No Eschar | Rash Rare/Less Prominent
35
Ehrlichiosis is an infection of...
Neutrophils or Monocytes
36
Classic pathologic findings in Ehrlichiosis
Cytoplasmic Inclusions (Morulae) Shaped like mulberries These are masses of bacteria
37
Ehrlichiosis is transmitted by...
Ticks
38
Organism behind Lyme Disease...
Borrelia burgdorferi
39
Spirochetes in Lyme Disease are transmitted by...
Tick Bites Primarily -- White tail deer tick | Also Lice
40
How does Borrelia avoid host antibodies
Shifting antigenic markers
41
Where does Lyme Disease happen
Wisconsin and the NE US
42
So what is Lyme Disease anyway?
A multisystem chronic inflammatory disorder | Local lesion progresses to bacteremia and chronic lesions in distant organs.
43
Much of the pathology of Lyme Disease is caused by...
Immune response against the organism | - Triggered by LPS binding macrophage TLR2
44
How to prevent Lyme disease.
OspA vaccine commercially available for high risk groups | Vector Avoidance
45
How to treat Lyme Disease?
Doxycycline
46
What is specific to Lyme Disease -- Primary Disease?
Erythema chronicum migrans Skin, Rash shows vasodilation with dense perivascular inflammatory infiltrates of mononuclear leukocytes Fever
47
Things specific to secondary disease?
Dissemination of spirochetes | Joint Disease, Muscle Pain, Cardiac Arrhythmias, Meningitis, CN Involvement
48
Things specific to tertiary Lyme Disease?
CNA, Cardiac, and Skeletal involvement
49
Timeline for Secondary and Tertiary Lyme Disease
Secondary - Months | Tertiary - Years
50
Pathology of Lyme Disease
Focal Necrosis, Hemorrhages, and DIC | Skin rash -- vasodilation w/ dense perivascular inflam. infiltrates (lymphocytes)
51
Two diseases known for lymphoplasmacytic Cell infiltrate
Lyme Disease and Syphillis
52
Lyme Disease arthritis looks an awful lot like.... | Why
Rheumatoid Arthritis Synovial hyperplasia, lymphocytes+plasma cells Proliferative arteritis
53
Relapsing fever is caused by what organism
Borrelia recurrentis
54
Relapsing fever is transmitted by what organisms
Human Lice | Rodent Ticks
55
Symptoms of Relapsing fever?
1-2 week latent period Shaking chills, Fever, Headache, and Fatigue Successive Attacks
56
Successive attacks of Relapsing fever result from...
Ability of the organism to express new surface antigens | Forces the body to make new antibodies every time
57
What makes Relapsing fever fatal?
Hepatosplenomegaly
58
Generic shit about Yersnia pestis
G- Bacillus
59
Yersnia pestis method of transmission
Arthropod Bite (Flea bite from a rodent)
60
Pathology of Yersnia pestis
``` Rapid proliferation within lymphoid tissues Injection of YOPs Necrosis of Tissues and BVs Swelling of Lymphoid Tissue Leukocytosis/Septicemia/DIC ```
61
What are YOPs?
Yersnia Outer Proteins Inactivating molecules that regulate actin polymerization Inhibits secretion of inflammatory cytokines
62
What are the swollen lymphoid tissues of Yersnia pestis called?
Buboes
63
Cause of death in Yersnia pestis?
Septicemia/DIC
64
Four types of Yersnia pestis disease
Minor Plague Bubonic Plague Pneumonic Plague Septicemia
65
Symptoms of Minor Plague Yersnia pestis
Lymphadenopathy | Constitutional Symptoms
66
Symptom of Bubonic Plague Yersnia pestis
Prominent lymphadenopathy (buboes)
67
Symptoms of Pneumonic Plague Yersnia pestis
Hemorrhagic, Necrotizing Pneumonia | Primary or Secondary to bubonic infections
68
Most common form of Yersnia pestis
Bubonic Plague
69
Treatment for Yersnia pestis
Doxycycline
70
Mortality of Yersnia pestis untreated
50-90%
71
Two diseases especially associated with border waters
Lyme Disease | Giardia

Pathology -- Infectious Disease (23 decks)

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