Infectious Leptospira Flashcards

1
Q

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

A

Leptospira

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2
Q

Leptospira transmission

A

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

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3
Q

Leptospira rf:

A

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

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4
Q

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

A

Leotospiric phase

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5
Q

Strong inhibitor of complement response

A

Factor 8

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6
Q

Disappearance of leptospires
Appearance of antibody,
Leptospires

A

Leptospiruric

Immune phase

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7
Q

Virulencr factor encoding surface exposed protein

A

loa22

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8
Q

Gold standard for dx

A

Culture and isolation

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9
Q

High accuracy in 1st 5 days of illness

A

PCR

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10
Q

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)

A

MAT

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11
Q

Tx for mild leptospirosis

A

Doxycycline 100mg PO BID

Amox
Ampi

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12
Q

Moderate/Severe

A

Penicillin 1.5 m IM/IV
Ceftriaxone 2g IV
Cefotaxime

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13
Q

Leptospirosis other tx

A

Aggressive fluid and electrolyte resuscitation
Peritoneal dialysis
Mech vent
Glucocorticoids

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14
Q

Develops within hours after initiation of antimicrobial

A

Jarisch-Herxheimer rx

Common in syphilis and penicillin use

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15
Q

During the immune phase culture is best obtained from

A

urine

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16
Q

Hemorrhage
Severe calf pain
Wading in flood water

A

Leptospiremic blood

17
Q

Tx for mod to severe leptospirosis

Weil’s

A

Penicillin

18
Q

Doxycycline contraindicated in children bec

A

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

19
Q

Doxycycline chemoprophylaxis

A

200 mg OD x 7 days

20
Q

Most common indication if penicillin in PH

A

Rheumatic fever 5-15 y/o

21
Q

Poor morbidity in malaria

A

Cytoadherence
Rosetting
Agglutination

22
Q

Why is there fever in malaria

A

lysis of rbc

23
Q

Fever cytokines

24
Q

Poor prognosis sx for malaria

A

Hypoglycemia <40

25
For ovale, vivax, malariae and falciparum sensitive
Chloroquine | Amodiaquine
26
Radical tx for ovale and vivax
Chloroquine or Amodiaquine Primaquine (14d) do not give in G6PD
27
P falciparum tx
``` Artesunate + Sulfadoxine A and amodiaquine Artemeter lumefantrine A and mefloquine DHA piperaquine ```
28
Severe falciparum tx
Artesunate IV Artemeter IM Quinidine IV Quinine dihydrochloride
29
Quinidine SE
ECG monitoring
30
Sulfa se
SJS
31
Test to confirm presence of leptospira during the acute phase
Isolation by culture