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Small Animal Medicine > Infectious Dz - Blood Borne 3 > Flashcards

Infectious Dz - Blood Borne 3 Flashcards

1
Q

What causes Rocky Mountain Spotted Fever (RMSF)?

A

Rickettsia ricketsii, a gram negative, obligately intracellular bacteria

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2
Q

What type of illness is RMSF?

A

An acute, febrile illness

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3
Q

What is the vector (non-specific) for Rickettsia ricketsii?

A

Ticks

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4
Q

Where does RMSF commonly occur in US?

A

In southeastern and south central states - where the ticks are present

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5
Q

What cells does R. ricketsii infect?

A

endothelial cells by inducing phagocytosis by these cells

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6
Q

Once R. rickettsii infects endothelial cells, what does it do?

A

It causes damage to the endothelial cells leading to vasculitis and increased microvascular permeability. This permeability leads to tissue edema

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7
Q

Is RMSF an acute or chronic disease?

A

acute

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8
Q

What will you find on PE in patients with RMSF?

A

Fever (80% of naturally infected dogs), ocular signs, splenomegaly, lymphadenomegaly, nasal discharge, tachypnea, epistaxis, petechia, ecchymoses, peripheral edema, gangrenous necrosis, orchitis and scrotal edema, CNS signs, and generalized pain This is a lot of signs, but she specifically highlighted fever

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9
Q

What will you find on CBC in patients with RMSF?

A

Thrombocytopenia, leukocytosis, and mild non-regenerative anemia

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10
Q

What will you find on chemistry in patients with RMSF? UA?

A

Chemistry - Hypoalbuminemia (from vasculitis) UA - variable (proteinuria, hematuria, and bilirubinuria)

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11
Q

True or False: RMSF suspected patients should be treated before diagnostic test results are returned.

A

True - the tests take too long

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12
Q

How is RMSF diagnosed?

A

Serology (IFA) and PCR

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13
Q

How is RMSF treated?

A

Doxycycline and supportive care

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14
Q

What is the prognosis for RMSF?

A

Good to excellent if diagnosed and treated early

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15
Q

How is RMSF prevented?

A

with tick prevention

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16
Q

Can humans get RMSF from their dogs?

A

Not exactly, they can be sentinels of tick exposure. They personally cannot give it to humans, but the ticks on the dogs can.

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17
Q

Pete is a 7 YO MC Golden that has presented for a 3 day history of lethargy, inappetence, and vomiting. This is the first time in his life that he has not eaten. You practice in NC. He is on flea and HW prevention, not tick prevention. On his PE you note he has a 103.7 F fever, he is 5-7% dehydrated, there is ocular mucoid discharge in both eyes, and the fundic exam is WNL. There are prominent submandibular and prescapular LNs and a slightly stiff gait. His CBC reveals thrombocytopenia, and slight neutrophilia. The chemistry panel reveals albumin and the UA reveals a USG of 1.026 and 1+ protein.

What do you want to do next for pete?

a. He must have Babesia because he lives in the South. Start imidocarb right away.
b. Systemic workup including abdominal x-rays and ultrasound. Just because this is an infectious disease lecture doesn’t mean he has an infectious disease.
c. Culture his urine because he has a fever and proteinuria.
d. Perform a 4Dx SNAP test.

A

B, C, and D

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18
Q

Which of the following doxycycline responsive infections is associated with a vasculitis that can lead to peripheral edema because the causative organism infects endothelial cells?

a. Mycoplasma haemofelis
b. Rickettsia rickettsii
c. Ehrlichia canis
d. Anaplasma phagocytophilum
e. Babesia canis vogeli

A

b. Rickettsia rickettsii

19
Q

What causes Lyme Borreliosis?

A

Borrelia burgdorferi a motile corkscrew-shaped (spirochete) bacteria

20
Q

What clinical signs are associated with lyme disease?

A

Most dogs have no signs of illness but they can have fever, arthritis, and renal disease

21
Q

In endemic areas, what percentage of dogs have been exposed to Lyme?

A

up to 80%

22
Q

What tick genus is responsible for transmitting Borellia burgdorferi?

A

Ixodes (specifically the ricinus-persulcatus complex) - this also transmits A. phagocytophilum

23
Q

What animals are reservoirs for Borellia burgdorferi?

A

Peromyscus leucopus (white-footed mouse) in the NE and upper Midwest

24
Q

How does B. burgdorferi adhere to the tick midgut?

A

Lipoprotein OspA expression

25
Q

How does B. burgdorferi bind disseminate in the mammalian host?

A

Lipoprotein OspC expression which is upregulated when a tick ingests mammalian blood

26
Q

What percentage of dogs will show overt illness signs of Lyme disease?

A

Only <10%

27
Q

What are the clinical features of Lyme disease?

A

Fever, lameness (joint closest to tick bite is first affeced), mild to moderate thrombocytopenia, and Lyme associated nephritis

28
Q

What is Lyme-associated nephritis?

A

Membranoproliferative glomerulonephritis

29
Q

In patients that develop Lyme-associated nephritis, what is the prognosis?

A

poor

30
Q

What will the chemistry and UA show in patients with Lyme-associated nephritis?

A

Chemistry - Hypoalbuminemia +/- azotemia UA - isosthenuria and proteinuria

31
Q

Do cats get infected with B. burgdorferi?

A

They can be infected but it is unknown if there is clinical disease in cats

32
Q

How do you diagnose Lyme disease?

A

Diagnosis is difficult because 90-95% of dogs exposed to B. burgdorferi do not develop clinical disease, but serology is the best choice

33
Q

What is the best serologic test for Lyme disease and why?

A

C6 ELISA because it can differentiate between vaccination and actual exposure. If a patient has been vaccinated for Lyme disease and not actually exposed to B. burgdorferi the test will be negative. The Antech AccuPlex4 test cannot differentiate between infection and vaccination

34
Q

How is Lyme disease treated?

A

Antimicrobial treatment, but only in dogs that are seropositive will illness consistent with Lyme disease - Doxycycline

35
Q

How is Lyme nephritis treated in a stable dog (no azotemia)?

A

Doxy, ACE inhibitors, antithrombotics, reduced protein diet, Omega 3 fatty acids, and antihypertensives if needed

36
Q

How is Lyme nephritis treated in severe cases?

A

supportive care and CKD treatments

37
Q

Lyme nephritis has a better outcome with what?

A

Immunosuppression - Mycophenolate and a tapering dose of prednisolone

38
Q

What is the prognosis for Lyme disease?

A

In dogs that show no signs - great (they aren’t showing signs) Lyme arthritis - rapidly recover Lyme nephritis - guarded to poor prognosis

39
Q

What Bb testing is recommended for healthy dogs?

A

Screen healthy dogs in endemic areas annually for Bb antibodies If positive, test for proteinuria so you can intervene if there is PLN, and check CBC and chemistry for cytopenias

40
Q

How is Lyme disease prevented?

A

Tick control and vaccination (recombinant vaccine is preferred although the duration of immunity is questioned)

41
Q

Which of the following is true about Lyme disease?

a. It is caused by a protozoan parasite from the Apicomplexa phylum
b. PCR is the best test for Lyme as it has the highest sensitivity.
c. As long as you vaccinate for Lyme disease, tick control is not important
d. When dogs show clinical signs of Lyme disease, fever and arthritis are the most common signs.

A

d. When dogs show clinical signs of Lyme disease, fever and arthritis are the most common signs.

42
Q

Briggs is a 6YO MC Labrador that is presenting for vomiting, lethargy, and being stiff in all four legs for the past week. On physical examination you note that he has tacky mucus membranes. The CBC showed that he is anemic and had thrombocytopenia. Chemistry revealed that he is azotemic, has hyperphosphatemia, and low albumin. His USG is 1.015 and 4+ protein in the urine. His UPC is 7.1. What do you want to do next diagnostically for Briggs? a. Culture urine b. Leptospirosis test c. 4Dx SNAP test d. all of the above

A

d. all of the above

43
Q

Briggs is a 6YO MC Labrador that is presenting for vomiting, lethargy, and being stiff in all four legs for the past week. On physical examination you note that he has tacky mucus membranes. The CBC showed that he is anemic and had thrombocytopenia. Chemistry revealed that he is azotemic, has hyperphosphatemia, and low albumin. His USG is 1.015 and 4+ protein in the urine. His UPC is 7.1. You find out that Briggs is Lyme positive and that he has a nephropathy of some sort.

What do you want to treat Briggs with?

a. Doxycycline
b. Baytril, benazepril, clopidogrel, and Mycophenolate
c. Doxycycline, benazepril, clopridogrel, and mycophenolate
d. Doxycylcine, benazepril, clopidogrel, and cyclosportine e. Doxycycline, benazepril, and clopidogrel.

A

c. Doxycycline, benazepril, clopidogrel, and mycophenolate

The 2 main drugs that should’ve pointed you to this answer is the doxy and the mycophenolate

44
Q

What is Briggs prognosis?

A

Guarded - since he already has azotemia he will need aggressive intervention

Small Animal Medicine (100 decks)

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