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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
Q

Symptoms of Rocky Mountain Spotted Fever

A

Fever, Nausea, Vomiting, Headache, Muscle Pain
High Fever 2-3 weeks
Rash appears by day 6 (Lymphocytes attack vessels)

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26
Q

Describe the rash in Rocky Mountain Spotted Fever

A

Hemorrhagic rash extends over entire body, including palms and soles. Typically spreads from periphery inward.
Rarely, an eschar

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27
Q

Morphology seen in Rocky Mountain Spotted Fever

A 
Perivascular Mononuclear Infiltrate
Necrosis, Fibrin Extravasation
Thrombosis of small blood vessels/arterioles
Foci of necrotic skin
Microinfarts in brain
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28
Q

Major Cause of Death in Rocky Mountain Spotted Fever

A

Noncardiogenic Pulmonary Edema

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29
Q

What kind of fluid is found in the pulmonary edema of Rocky Mountain Spotted Fever patients

A

Exudative

There are lymphocytes in the fluid

30
Q

Where in the country does Rocky Mountain Spotted Fever tend to happen?

A

East Coast, South, Oklahoma/Arkansasish area

31
Q

Potential Rocky Mountain Spotted Fever patient shows up in the cold of winter. They probably really have…

A

Meningitis

32
Q

What is scrub typhus?

A

Caused by Orientia tsutsugamushi
Endemic in Far East
Like Typhus, but transmitted by mites
Transitory Rash, Prominent Lymphadenopathy

33
Q

Ehrlichiosis is caused by what organisms…

A

E. chaffeensis

Anaplasma phagocytophilum

34
Q

Difference between clinical appearance of an Ehrlichiosis patient and a Rocky Mountain Spotted Fever

A

No Eschar

Rash Rare/Less Prominent

35
Q

Ehrlichiosis is an infection of…

A

Neutrophils or Monocytes

36
Q

Classic pathologic findings in Ehrlichiosis

A

Cytoplasmic Inclusions (Morulae)
Shaped like mulberries
These are masses of bacteria

37
Q

Ehrlichiosis is transmitted by…

A

Ticks

38
Q

Organism behind Lyme Disease…

A

Borrelia burgdorferi

39
Q

Spirochetes in Lyme Disease are transmitted by…

A

Tick Bites Primarily – White tail deer tick

Also Lice

40
Q

How does Borrelia avoid host antibodies

A

Shifting antigenic markers

41
Q

Where does Lyme Disease happen

A

Wisconsin and the NE US

42
Q

So what is Lyme Disease anyway?

A

A multisystem chronic inflammatory disorder

Local lesion progresses to bacteremia and chronic lesions in distant organs.

43
Q

Much of the pathology of Lyme Disease is caused by…

A

Immune response against the organism

- Triggered by LPS binding macrophage TLR2

44
Q

How to prevent Lyme disease.

A

OspA vaccine commercially available for high risk groups

Vector Avoidance

45
Q

How to treat Lyme Disease?

A

Doxycycline

46
Q

What is specific to Lyme Disease – Primary Disease?

A

Erythema chronicum migrans
Skin, Rash shows vasodilation with dense perivascular inflammatory infiltrates of mononuclear leukocytes
Fever

47
Q

Things specific to secondary disease?

A

Dissemination of spirochetes

Joint Disease, Muscle Pain, Cardiac Arrhythmias, Meningitis, CN Involvement

48
Q

Things specific to tertiary Lyme Disease?

A

CNA, Cardiac, and Skeletal involvement

49
Q

Timeline for Secondary and Tertiary Lyme Disease

A

Secondary - Months

Tertiary - Years

50
Q

Pathology of Lyme Disease

A

Focal Necrosis, Hemorrhages, and DIC

Skin rash – vasodilation w/ dense perivascular inflam. infiltrates (lymphocytes)

51
Q

Two diseases known for lymphoplasmacytic Cell infiltrate

A

Lyme Disease and Syphillis

52
Q

Lyme Disease arthritis looks an awful lot like….

Why

A

Rheumatoid Arthritis
Synovial hyperplasia, lymphocytes+plasma cells
Proliferative arteritis

53
Q

Relapsing fever is caused by what organism

A

Borrelia recurrentis

54
Q

Relapsing fever is transmitted by what organisms

A

Human Lice

Rodent Ticks

55
Q

Symptoms of Relapsing fever?

A

1-2 week latent period
Shaking chills, Fever, Headache, and Fatigue
Successive Attacks

56
Q

Successive attacks of Relapsing fever result from…

A

Ability of the organism to express new surface antigens

Forces the body to make new antibodies every time

57
Q

What makes Relapsing fever fatal?

A

Hepatosplenomegaly

58
Q

Generic shit about Yersnia pestis

A

G- Bacillus

59
Q

Yersnia pestis method of transmission

A

Arthropod Bite (Flea bite from a rodent)

60
Q

Pathology of Yersnia pestis

A 
Rapid proliferation within lymphoid tissues
Injection of YOPs
Necrosis of Tissues and BVs
Swelling of Lymphoid Tissue
Leukocytosis/Septicemia/DIC
61
Q

What are YOPs?

A

Yersnia Outer Proteins
Inactivating molecules that regulate actin polymerization
Inhibits secretion of inflammatory cytokines

62
Q

What are the swollen lymphoid tissues of Yersnia pestis called?

A

Buboes

63
Q

Cause of death in Yersnia pestis?

A

Septicemia/DIC

64
Q

Four types of Yersnia pestis disease

A

Minor Plague
Bubonic Plague
Pneumonic Plague
Septicemia

65
Q

Symptoms of Minor Plague Yersnia pestis

A

Lymphadenopathy

Constitutional Symptoms

66
Q

Symptom of Bubonic Plague Yersnia pestis

A

Prominent lymphadenopathy (buboes)

67
Q

Symptoms of Pneumonic Plague Yersnia pestis

A

Hemorrhagic, Necrotizing Pneumonia

Primary or Secondary to bubonic infections

68
Q

Most common form of Yersnia pestis

A

Bubonic Plague

69
Q

Treatment for Yersnia pestis

A

Doxycycline

70
Q

Mortality of Yersnia pestis untreated

A

50-90%

71
Q

Two diseases especially associated with border waters

A

Lyme Disease

Giardia

Pathology -- Infectious Disease (23 decks)

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