Leishmania/Mycobacteria

Question 1

Geographically, where will you find Lutzomyia

Answer 1

New World

Question 2

Geographically, where will you find Phlebotomus

Answer 2

Old World

Question 3

Vector for Leishmania

Answer 3

Sandflies

Question 4

Time of day that sandflies feed

Answer 4

Crepuscular, nocturnal

Question 5

Main reservoir of cutaneous and mucocutaneous Leishmania

Answer 5

Rodents, wild animals

Question 6

USA states with endemic Leishmania

Answer 6

-Texas (reportable)
-Oklahoma

-Alabama
-Michigan
-Ohio

Question 7

Species that get Leishmania infantum infections

Answer 7

Dogs
Cats
Humans (Braziliensis, donovani)

Question 8

In which cell does Leishmania live

Answer 8

Macrophages

Question 9

When Leishmania is in the host’s body, what form is it in

Answer 9

Amastigote, non-flagellate

Question 10

When Leishmania is in the foregut and mouthparts of Sandflies (infectious state), which form is it in

Answer 10

Promastigote (flagellated)

Question 11

Where in the dog’s body would you find Leishmania

Answer 11

Bone marrow, lymph nodes, skin, spleen, liver

Question 12

How can a host develop Leishmania WITHOUT a sandfly vector

Answer 12

*Vertical transmission
*Sexual transmission (epididymus, glans penis, testis, prepuce)
*Blood transfusions

Question 13

T or F: Most dogs that contract Leishmania are clinical

Answer 13

False. Many are subclinical

Question 14

Age of Leishmania infection

Answer 14

Bimodal

2-4 years old (younger)
7+ years old (older)

Question 15

Breeds predisposed to Leishmania

Answer 15

*Boxer
*GSD
*Rottweiler
*Cocker spaniel

Question 16

Immune response type that makes you RESISTANT to Leishmania infection

Answer 16

Th1

Question 17

Immune response type that makes you SUSCEPTIBLE to Leishmania infection

Answer 17

Th2

Question 18

Which cell is important for control of Leishmania infections

Answer 18

Macrophages

(which Leish likes to invade!)

Question 19

Which cytokines are crucial for inducing macrophage anti-leishmanial activity

Answer 19

IFN-g
IL-2
TNFa

(Th1)

Question 20

Which cells can lyse infected bacrophages

Answer 20

Cytotoxic T cells

Question 21

If dogs have cutaneous lesions, they probably also have ________

Answer 21

Visceral lesions

Question 22

Ocular lesions of Leishmania

Answer 22

Conjunctivitis
Anterior uveitis
Blepharitis
KCS

Question 23

Most common cutaneous lesion of Leishmania

Answer 23

*Exfoliative dermatitis

Prominent on pinnae, head, extremities, pressure points

Nasodigital hyperkeratosis, periocular alopecia (lunettes)

-Can also have ulcerative dermatitis on paws, pinnae, MC junctions

Question 24

What organs can enlarge with Leishmania

Answer 24

Lymph nodes
Spleen

+weight loss, muscle atrophy despite strong appetite

Question 25

Which disease 2' to Leishmania is the typical cause of death

Answer 25

CKD (PUPD) Occurs 2' circulating immune complexes, vasculitis

Question 26

Clinical signs from circulating immune complexes 2' Leishmania

Answer 26

PUPD -> Renal failure Vasculitis Uveitis Polyarthritis

Question 27

Labwork findings with Leishmania

Answer 27

-Elevated liver enzymes -Renal values -Proteinuria

Question 28

T or F: PCR of peripheral blood is likely to diagnose Leishmania

Answer 28

FALSE. Rarely detected in peripheral blood. Antibody tests are better in peripheral blood. High antibody levels are associated with high tissue parasite loads

Question 29

What is the most sensitive test to diagnose Leishmania? Where should you collect your sample from

Answer 29

PCR for Leishmania DNA Bone Marrow/Lymph node >> Skin > Conjunctiva > Whole blood/buffy coat

Question 30

Histopath stain to find Leishmania amastigotes

Answer 30

Giemsa stain

Question 31

Which adnexa is often affected by Leishmania, which causes the exfoliative dermatitis

Answer 31

Sebaceous glands

Question 32

T or F: Leishmania is often curable with Meglumine antimoniate and allopurinol

Answer 32

False. Relapses are common

Question 33

Main drug to treat Leishmania? Side effects?

Answer 33

Meglumine antimoniate (SC) AEs: Nephrotoxic. Cellulitis at injection site

Question 34

MOA of allopurinol in Leishmania treatment

Answer 34

Hypothanine that is metabolized by Leishmania to produce an *inosine analogue* Inosine analog is incorporated into Leishmania RNA --> inhibits parasite multiplication

Question 35

Alternative treatment to meglumine antimoniate for Leishmania? MOA?

Answer 35

Miltefosine Directly toxic on Leishmania. Use WITH allopurinol

Question 36

Prevention of Leishmania

Answer 36

*Inside at dusk/dawn *Commercial vaccine (Brazil, Europe) *Permethrin, Imidacloprid, Deltamethrin topicals

Question 37

Most common species of CUTANEOUS Leishmania

Answer 37

*L braziliensis *L peruviana Can have coninfections with L infantum

Question 38

Breed with canine VISCERAL leishmaniosis in USA

Answer 38

Foxhounds! (Starting in NY, but found all over N America)

Question 39

Best stain for Actinomyces on histopath

Answer 39

Giemsa Gram Silver (NEGATIVE for acid fast/ Fite Faraco_

Question 40

T or F: FIV/FeLV is a predisposing factor for actinomyces

Answer 40

FALSE. Actinomyces are usually healthy individuals. Nocardia is immunosuppressed ones

Question 41

Predisposed signalment for Nocardia infection

Answer 41

Male, immunocompromised

Question 42

Where is Nocardia found? Where is actinomyces found?

Answer 42

Nocardia: soil Actinomyces: commensal

Question 43

Are atypical mycobacteria rapid or slow growing

Answer 43

Rapid

Question 44

Most common clinical lesion associated with atypical mycobacteria

Answer 44

Panniculitis (esp cats >> dogs)

Question 45

What medication is used to treat Nocardia? AE of long term use?

Answer 45

TMS Myelosuppression

Question 46

How would you identify mycobacteria on cytology

Answer 46

Negatively staining rods within macrophages (or free-floating)

Question 47

Will you see Mycobacteria on H&E histopath?

Answer 47

No. Not visible within macrophages on histo Need to use acid fast

Question 48

Which species causing feline leprosy causes periocular lesions only, with a good prognosis

Answer 48

Mycobacteria tarwinese

Question 49

Which species causing feline leprosy causes more generalized lesions that ulcerate in young animals, with a worse prognosis

Answer 49

Mycobacteria lepraiefelis

Question 50

Difference between feline leprosy and atypical mycobacteria

Answer 50

Feline leprosy: dermal nodules, slow growing Atypical: SC nodules, inguinal pad, fast growing

Question 51

Reservoir for Mycobacteria microti

Answer 51

Rodents

Question 52

Reservoir for Mycobacteria bovis

Answer 52

Cattle, badgers

Question 53

Route of transmission for slow growing Mycobacteria (microti, bovis)

Answer 53

Bites

Question 54

Signalment of cat with Mycobacterium avium complex (MAC)

Answer 54

Immunosuppressed Breeds: Siamese, Abyssinian

Question 55

Most common Leishmania species in dogs

Answer 55

Leishmania infantum