Lecture 11

Question 1

What organisms spread via vectors?

Answer 1

Borrelia
Rickettsia
Yersinia Pestis

Question 2

Borrelia shape and stain

Answer 2

Long spirochetes

GramNeg, NO LPS!

Question 3

What does borrelia have in place of LPS?

Answer 3

Inflammatory lipoproteins in OM

Question 4

B. recurrentis, B. hermsii, 20 others cause what?

Answer 4

Recurrent fever

Question 5

B. recurrentis, B. hermsii, 20 others (recurrent fever) symptoms?

Answer 5

Sudden onset fever
Intense headache
Muscle pain
SYMPTOMS RECUR EVERY 5-10 DAYS

Question 6

What causes recurrent fever via B. recurrentis, B. hermsii, 20 others?

Answer 6

Antigen keeps switching

New lymphocytes have to be made on a cyclic basis

Question 7

What can B. recurrentis, B. hermsii, 20 others lead to after recurrent fever?

Answer 7

Necrotic foci in parenchymatous organs

Question 8

B. burgdorferi + 9 others cause what?

Answer 8

Lyme disease

Question 9

Lyme disease initial symptoms

Answer 9

Flu-like symptoms

erythema chronicum migrans

Question 10

Lyme disease secondary symptoms

Answer 10

facial nerve palsy
meningitis
carditis

Question 11

B. recurrentis spreads how?

Answer 11

Lice

Question 12

B. hermii spreads how?

Answer 12

Soft-bodied ticks from rodent reservoir

many infected ticks out west, but outbreaks are rare

Question 13

B. burgdorferi spreads how?

Answer 13

Transmitted by deer ticks

Question 14

What protein on B. recurrentis, B. hermsii is the one with variation?

Answer 14

VMP protein antigen

Question 15

How do you treat recurrent fever?

Answer 15

Doxy or synthetic PCNs

Can use 3 gen ceph to treat recalcitrant infections

Question 16

Shape and stain of rickettsia

Answer 16

Small rods

Gram Neg

Question 17

Rickettsia metabolism

Answer 17

Obligate intracellular parasite

Question 18

What are the four types of rickettsia

Answer 18

Typhus
Spotted fever
Ehrlichia/anaplasma
Coxiella burnetti

Question 19

Where do typhus group rickettsias grow

Answer 19

Host cytoplasm

Question 20

Where do spotted fever group rickettsias grow

Answer 20

Host cytoplasm

Question 21

Organism has a common lifecycle to chlamydia

Answer 21

Ehrlichia and anaplasm group rickettsias

Question 22

What do ehrlichia and anaplasm group rickettsias lack?

Answer 22

No PG or LPS

Question 23

How does typhus group rickettsia cause illness?

Answer 23

Parasite of blood endothelium –> vasculitis
Begins on chest and moves to extremities
Severe prostration and high fever
R. akari causes smallpox-like rash

Question 24

What bug causes spotted fever type rickesttsia

Answer 24

R. rickettsii

Question 25

R. rickettsi (spotted fever type) causes illness how?

Answer 25

Endothelial pathogen | Rash on extremities that moves to trunk

Question 26

What special disease belongs to spotted fever type rickettsia

Answer 26

Rocky Mountain Spotted fever

Question 27

Rocky mountain spotted fever symptoms

Answer 27

``` Abrupt fever HA N/V Myalgias, arthralgias Abodominal pain due to vasculitis of organs (50% fatal without treatment) ```

Question 28

Ehrlichia chaffeensis (monocytic erlichiosis, HME) causes illness how?

Answer 28

Obligate parasite of monocytes and macrophages | Pathology from immune response

Question 29

``` Ehrlichia chaffeensis (monocytic erlichiosis, HME) symptoms? ```

Answer 29

``` HA Myalgias Thrombocytopenia Lymphopenia Bone marrow granulomas Like RMSF but without vasculitis ```

Question 30

Anaplasma phagocytophilum (anaplasmosis, HGA) sypmtoms?

Answer 30

Maybe rash | Symptoms like Ehrlichia

Question 31

How does Anaplasma phagocytophilum (anaplasmosis, HGA) cause illness?

Answer 31

Obligate parasite of neutrophils and granulocytes | Pathology from immune response

Question 32

Coxiella (Q-fever) resembles what?

Answer 32

resembles influenza or pneumonia rather than typhus

Question 33

Chronic coxiella can lead to what?

Answer 33

Endocarditis in PTs with defective heart valves

Question 34

Typical presentation of coxiella?

Answer 34

Fever with pneumonia/hepatitis 2-3 weeks after exposure

Question 35

What two bugs cause typhus group rickettsial infection and how do you get each?

Answer 35

R. prowazekii-human lice R. typhi-rat flea Prevalent where hygiene is low

Question 36

Where is spotted fever common and how do you get it in each place?

Answer 36

East US-dog tick | West US-wood-tick

Question 37

Ehrlichia and Anaplasma are spread how?

Answer 37

Ticks

Question 38

Coxiella burnetii (Q-fever) is spread to humans how?

Answer 38

Dust or aerosal from infected animals-goats, cattle, sheep, cats (even though it is spread to other animals via ticks)

Question 39

Coxiella burnetti attacks what part of the body?

Answer 39

Lung epithelium

Question 40

How do rickettsias attack blood vessels?

Answer 40

Phospholipase A targets cell membranes to lice blood vessels and other epithelium R. Rickettsii also attacks smooth muscle

Question 41

What is the treatment for rickettsial infections

Answer 41

Tetracycline/doxycycline