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Emerging Pathogen > Lyme Disease > Flashcards

Lyme Disease Flashcards

1
Q

Name of the skin lesion that associated with tick’s bite

A

Erythema Migrans

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2
Q

What directly cause the Lyme disease?

A

The cause was found to be a spirochete, Borrelia burgdorferi.

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3
Q

T/F
Arthropod-transmitted viruses in the patients with “Lyme arthritis” associated with the same bacteria from the Lyme disease

A

False
Steere looked for antibodies against 38 known tick-transmitted infections and 178 other arthropod-transmitted viruses in the patients with “Lyme arthritis”, but no one was positive.

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4
Q

Name of the bacteria causes Lyme disease

A

Borrelia burgdorferi

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5
Q

Borrelia burgdorferi

A

Borrelia burgdorferi in the United States

Borrelia mayonii in the upper midwestern U.S.

Borrelia afzelii, B. burgdorferi, B. garinii in Europe and Asia

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6
Q

Borrelia mayonii

A

the upper midwestern U.S.

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7
Q

Borrelia afzelii, B. burgdorferi, B. garinii

A

in Europe and Asia

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8
Q

Ixodes ticks

A

hard ticks. Hard ticks have a plate called a scutum on the dorsum and mouth parts visible when viewed from above.

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9
Q

Ixodes scapularis

A

in the eastern and north central North America

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10
Q

Ixodes pacificus

A

in northern California and Oregon

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11
Q

Ixodes persulcatus

A

in Asia and Eastern Europe

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12
Q

Ixodes ricinus

A

in Europe and Western Asia

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13
Q

Reservoirs of Borrelia Spirochetes Causing Lyme Disease

A

In the northeastern U.S it is mainly the white-footed mouse, but chipmunks, voles, shrews, and birds can also serve as reservoirs.

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14
Q

T/F
The mouse maintains a spirochetemia with no symptoms.

A

True

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15
Q

T/F
In Europe songbirds are the reservoir of B. garinii, in Japan, rodents are the reservoir.

A

True

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16
Q

Deer and Lyme disease (Exam)

A

Deer are important for the tick survival (adults feed and winter over on deer), but the deer do not support the survival of the spirochete, as complement in the deer is lytic.

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17
Q

T/F
In the southern U.S., lizards can be hosts for ticks, but lizards are relatively refractory to Borrelia burgdorferi (zoo-prophylactic host)

A

True

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18
Q

Birds and Lyme disease

A

Birds are phoretic hosts, carrying the ticks and spirochetes to Canada where the spirochete enzootic cycle is not well established.

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19
Q

% of recall a tick bite in early lyme disease

A

Only 25% of patients recall a tick bite

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20
Q

T/F
Lyme disease -Erythema migrans progression less than 2 weeks

A

False
Over 2 weeks

21
Q

Early Disseminated Lyme Disease occurs within ( ) weeks of the illness

A

Occurs within 2-3 weeks of the illness

22
Q

Manifestations from Early Disseminated Lyme Disease
(Exam)

A

1) Multiple skin lesions of erythema migrans (bacteremic spread back to the skin)
2) Carditis manifested by heart block (first, second, and third degree), at times with myopericarditis
3) Lymphocytic meningitis, cranial nerve palsy(ies), cerebellar ataxia, encephalomyelitis
4) Ocular abnormalities-conjunctivitis (common) with keratitis, iridocyclitis, retinal vasculitis, choroiditis, and/or optic neuropathy possible but not common

23
Q

T/F Early Lyme disease can cause the 7th cranial nerve palsy

A

True

24
Q

T/F Early Lyme disease can cause the carditis

A

True

25
Q

Late Lyme Disease

A

Occurs months to even years after the onset of infection.

26
Q

Adult, Nymph ,and female only

A
27
Q

Late Lyme disease associated with (Exam)

A

1) Arthritis
2) Peripheral neuropathy, encephalopathy
3) Acrodermatitis chronica atrophicans

28
Q

Late lyme disease and arthritis

A

Arthritis
Intermittent swelling (effusion) of one or a few joints, often the knee
Without treatment can be relapsing and resolve over a long period or become chronic

29
Q

Late lyme disease and Acrodermatitis chronica atrophicans

A

Acrodermatitis chronica atrophicans
Occurs 6 months to 8 years after onset, in Europe, due to B. afzelii
Extensor surfaces of the hands and feet; bluish-red, edema, then atrophy

30
Q

T/F
Lyme disease during pregnancy can cause congenital issues

A

False
There is no definable congenital Lyme disease syndrome.
Pregnant women are treated as are other patients, but doxycycline or tetracycline are not used.

31
Q

Coinfections seen with Lyme Diseas

A

Babesia microti (the cause of babesiosis) and Anaplasma phagocytophilum (the cause of human granulocytic anaplasmosis) may each be seen in patients with Lyme disease, as the Ixodes ticks can transmit each of the three pathogens.

32
Q

Coinfections seen with Lyme disease

A

1) Babesia microti (the cause of babesiosis)
2) Anaplasma phagocytophilum (the cause of human granulocytic anaplasmosis)

33
Q

T/F
The diagnosis of lyme disease is based on serology, with antibody taking at least two weeks to develop.

A

True

34
Q

T/F
A positive ELISA screen must be confirmed with a Western blot
to diagnose the Lyme disease

A

True

35
Q

T/F There are many false positive IgG test results, making IgG of limited value

A

Flase
There are many false positive IgM test results, making IgM of limited value

36
Q

T/F Once a patient has Lyme, the IgM bands may persist for many years.

A

False Once a patient has Lyme, the IgG bands may persist for many years.

37
Q

T/F A positive IgG Western blot only indicates infection at some point in time, not necessarily active.

A

True

38
Q

Always rule out concomitant ( ) and () infections

A

Always rule out concomitant Anaplasma and Babesia infections

39
Q

T/F Culture of Borrelia burgdorferi culture is not available in most clinical labs.

A

True

40
Q

How do you isolate spirochete?

A

In research studies, the spirochete has been isolated from blood, CSF, and skin biopsies.

41
Q

How to treat early lyme disease?

A

Doxycycline, amoxicillin, or cefuroxime

42
Q

How to treat Carditis associated with early lyme disease?

A

Doxycycline or IV ceftriaxone or IV penicillin with an anti-inflammatory medication

43
Q

How to treat late lyme disease

A

Doxycycline, amoxicillin, IV ceftriaxone, or IV penicillin for arthritis
IV ceftriaxone or IV penicillin for peripheral neuropathy

44
Q

Erythema migrans develops ( ) days after the tick bite, usually within ( ) days; seen in ( ) of patients.

A

Erythema migrans develops 1-31 days after the tick bite, usually within 7-14 days; seen in 80% of patients.

45
Q

Locations of erythema migrans

A

Often near axilla, inguinal region, popliteal fossa, belt line

46
Q

Features of EM

A

Expands in size over days
Central clearing, targetoid appearance are common; central blistering can be seen
Border is clearly demarcated
Multiple lesions indicate early dissemination, not multiple bites

47
Q

Systemic symptoms associated with Early lyme disease

A

Fatigue, fever, chills, headache, stiff neck, myalgias, arthralgias are commonly seen.

48
Q

Coinfections seen with Lyme disease

A

1) Babesia microti (the cause of babesiosis)
2) Anaplasma phagocytophilum (the cause of human granulocytic anaplasmosis)
3)

Emerging Pathogen (6 decks)

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