Infectious Leptospira

Question 1

Coiled thin motile organisms with hooked ends and 2 periplastic flagella with polar extrusion

Answer 1

Leptospira

Question 2

Leptospira transmission

Answer 2

Direct contact with urine, blood and tissue fr infected animal
Exposure to environmental contaminant

Question 3

Leptospira rf:

Answer 3

Veterinarians, agricultural
Direct or indirect contact with animal
Recreational freshwater activity

Question 4

Fever of 3-10d
Proliferation of organism
Hematogenous dissemination
Leptospira isolated fr blood stram

Answer 4

Leotospiric phase

Question 5

Strong inhibitor of complement response

Answer 5

Factor 8

Question 6

Disappearance of leptospires
Appearance of antibody,
Leptospires

Answer 6

Leptospiruric

Immune phase

Question 7

Virulencr factor encoding surface exposed protein

Answer 7

loa22

Question 8

Gold standard for dx

Answer 8

Culture and isolation

Question 9

High accuracy in 1st 5 days of illness

Answer 9

PCR

Question 10

Used in PH
Seroconversion or a rise in antibody titer
1:1600 cut off for PH
Preferred 4 fold or greater RISE in titer bet acute and convalescent phase (2nd week)

Answer 10

MAT

Question 11

Tx for mild leptospirosis

Answer 11

Doxycycline 100mg PO BID

Amox
Ampi

Question 12

Moderate/Severe

Answer 12

Penicillin 1.5 m IM/IV
Ceftriaxone 2g IV
Cefotaxime

Question 13

Leptospirosis other tx

Answer 13

Aggressive fluid and electrolyte resuscitation
Peritoneal dialysis
Mech vent
Glucocorticoids

Question 14

Develops within hours after initiation of antimicrobial

Answer 14

Jarisch-Herxheimer rx

Common in syphilis and penicillin use

Question 15

During the immune phase culture is best obtained from

Answer 15

urine

Question 16

Hemorrhage
Severe calf pain
Wading in flood water

Answer 16

Leptospiremic blood

Question 17

Tx for mod to severe leptospirosis

Weil’s

Answer 17

Penicillin

Question 18

Doxycycline contraindicated in children bec

Answer 18

Affects bone and cartilage growth
Yellowing of teeth
Arrest of epiphyseal growth

Question 19

Doxycycline chemoprophylaxis

Answer 19

200 mg OD x 7 days

Question 20

Most common indication if penicillin in PH

Answer 20

Rheumatic fever 5-15 y/o

Question 21

Poor morbidity in malaria

Answer 21

Cytoadherence
Rosetting
Agglutination

Question 22

Why is there fever in malaria

Answer 22

lysis of rbc

Question 23

Fever cytokines

Answer 23

IL 1

IL 6

Question 24

Poor prognosis sx for malaria

Answer 24

Hypoglycemia <40

Question 25

For ovale, vivax, malariae and falciparum sensitive

Answer 25

Chloroquine

Amodiaquine

Question 26

Radical tx for ovale and vivax

Answer 26

Chloroquine or Amodiaquine
Primaquine (14d)
do not give in G6PD

Question 27

P falciparum tx

Answer 27

Artesunate + Sulfadoxine
A and amodiaquine
Artemeter lumefantrine
A and mefloquine
DHA piperaquine

Question 28

Severe falciparum tx

Answer 28

Artesunate IV
Artemeter IM
Quinidine IV
Quinine dihydrochloride

Question 29

Quinidine SE

Answer 29

ECG monitoring

Question 30

Sulfa se

Answer 30

SJS

Question 31

Test to confirm presence of leptospira during the acute phase

Answer 31

Isolation by culture