Lyme, Babesiosis, Ehrlichiosis and Anaplasmosis, RMSF

Question 1

Early lyme disease treatment

Answer 1

Doxy, Amoxicillin, Cefuroxime

Question 2

Late carditis or neurologic disease in lyme disease treatment

Answer 2

IV penicillin or IV ceftriaxone

Question 3

Arthritis and facial nerve palsy in lyme disease treatment

Answer 3

doxy

Question 4

Findings on blood smear for babesiosis

Answer 4

Intraerythrocytic parasites in ring or tetrad formation (maltese cross)

Question 5

In babesiosis cases of low parasitemia consider

Answer 5

PCR for Babesia DNA

Question 6

Treatment of Babesiosis

Answer 6

Monitor Asymptomatic patients for 3 months

Atovaquone plus azithromycin for symptomatic patients or persistent parasitemia after 3 months

Question 7

Treatment of severe Babesiosis

Answer 7

Clinda + quinine

Question 8

Anaplasma infect

Answer 8

leukocytes

Question 9

E. chaffeensis causes

Answer 9

human monocytic ehrlichiosis (HME)

Question 10

A. phagocytophilum causes

Answer 10

human granulocytic anaplasmosis (HGA)

Question 11

Notable findings for Ehrlichiosis and Anaplasmosis

Answer 11

Leukopenia, thrombocytopenia

Presence of morulae (clumps of organisms in the cytoplasm of leukocyte)

Question 12

Testing for Ehrlichiosis and Anaplasmosis

Answer 12

whole blood PCR

Question 13

Three organisms transmitted by black legged deer tick/Ixodes tick

Answer 13

HGA, Lyme disease, Babesiosis

Question 14

Treatment for HME and HGA

Answer 14

Doxycycline

Question 15

RMSF Diagnosis

Answer 15

Immunohostochemistry or PCR of skin biopsy

Question 16

Treatment of RMSF

Answer 16

Doxy;

Chloramphenicol in pregnant patients

Question 17

Treatment of UTI in pregnancy

Answer 17

7 days of Amox-clav, Nitrofurantoin, Cefpodoxime, cefixime. Urine culture after treatment

Question 18

Patients in long term care facility with pyelo should recieve empiric coverage for

Answer 18

Vanc resistant Enterococcus and Fluoroquinolone resistant Gram negative rods