Micro - Gram Negative Bacteria VIII

Question 1

gram negative corkscrew bacteria

Answer 1

spirochetes

periplasmic flagella

Question 2

Dx of spirochetes

Answer 2

darkfield microscopy

silver stains

Question 3

syphilis

Answer 3

treponema pallidum

-goes through 3 stages

Question 4

primary syphilis

Answer 4

painless chancre

erupts 3-6 weeks after infection

resolves without scar

Question 5

secondary syphilis

Answer 5

bacteremic stage
-6 weeks after chancre heals

widespread rash, lymphadenopathy, organ involvement

• rash palms, soles, mucous membranes, oral cavity
• condyloma latum

resolves over 6 weeks

Question 6

condyloma latum

Answer 6

painless wart-like lesion in warm moist areas

-seen in secondary syphilis

Question 7

latent syphilis

Answer 7

serologic tests positive

-patient asymptomatic

Question 8

tertiary syphilis

Answer 8

develop over 6-40 years

• gummatous - localized granuloma lesions in skin and bones - become fibrous
• cardiovascular - aneurysm forms in aorta
• neurosyphilis - asymptomatic, subacute meningitis, meningovascular syphilis, tabes dorsalis, general paresis (mental/psych symptoms)

Question 9

asymptomatic neurosyphilis

Answer 9

clinically normal

-CSF positive

Question 10

acute meningitis Dx

Answer 10

CSF with high neutro count, high protein, low blucose

-treponema pallidum and mycobacterium tuberculosis

Question 11

tabes dorsalis

Answer 11

in tertiary syphilis
-damage posterior columns and dorsal roots of spinal cord

• disrupted vibration and proprioception - ataxia
• loss of reflexes and loss of pain and temp

Question 12

argyll robertson pupil

Answer 12

constricts during accomodation but not to light

-with syphilis

aka prostitutes pupil

Question 13

congenital syphilis

Answer 13

fetus of infected pregnant woman
-high mortality rate

• early - within 2 years - widespread rash and condyloma latum
• late - similar to adult tertiary - no cardiovascular involvement

saddle nose, saber shins, hutchinsons teeth, mulberry molars

Question 14

saddle nose, saber shins, hutchinsons teeth, mulberry molars

Answer 14

with congenital syphilis

Question 15

how many latent syphilis resolve?

Answer 15

2/3 - 66%

Question 16

nonspecific treponemal tests

Answer 16

measure titers for Abs against lipids released with cellular damage

-common tests - VDRL and RPR tests

non-specific - 1% of adults without syphilis will have these Abs

Question 17

specific treponemal tests

Answer 17

look for Abs against the spirochete itself

-FTA-ABS test

Question 18

FTA-ABS test

Answer 18

specific treponemal test for syphilis

-treponema pallidus

Question 19

jarisch herxheimer phenomenon

Answer 19

patients with syphilis being treated have worsened symptoms

-fever, chills, malaise, headache, muscle aches

Question 20

endemic syphilis

Answer 20

treponema pallidum subspecies endemicum

• africa and middle east
• share by drinking and eating utensils

skin lesions in oral mucosa and gummas of skin

Question 21

yaws

Answer 21

treponema pallidum subspecies pertenue

• disease of moist tropics
• papule appears and grows
• secondary lesions form
• gummas on skin and long bones

-face disfigurement - gangosa

Question 22

pinta

Answer 22

treonema pallidum subspecies carateum

• latin america
• red and blue skin lesions
• then depigment - turn white

Question 23

gangosa of face

Answer 23

with yaws

-treponema pallidum subspecies pertenue

Question 24

borrelia

Answer 24

giemsa or wright stains

Question 25

lyme disease

Answer 25

borrelia borgdorferi
-ixodes tick

-3 stages

Question 26

most commonly reported tick-borne illness in US

Answer 26

lyme disease

-borrelia borgdorferi

Question 27

early localized stage of lyme disease

Answer 27

skin lesion at site of tick bite

-erythema chronicum migrans

Question 28

erythema chronicum migrans

Answer 28

lesion at site of tick bite in early localized stage of lyme disease

starts off as red flat rash

• spreads out over time
• outer border red - center turn blue

Question 29

early disseminated stage of lyme disease

Answer 29

to skin, nervous system, heart, and joints

• multiple ECM lesions on body
• meningitis, cranial nerve palsies (bells), peripheral neuropathies

Question 30

AB nodal block

Answer 30

most common cardiac abnormality in lyme disease

Question 31

late stage of lyme disease

Answer 31

chronic arhritis that lasts more than one year

also - encephalopathy

Question 32

relapsing fever

Answer 32

caused by borrelia recurrentis

• fever, chills, headaches, muscle aches
• rash and meningeal involvement
• drenching sweats
• resolves for 8 days - then relapses
• continues to relapse

Question 33

why relapse in relapsing fever?

Answer 33

borrelia recurrentis

• has ability to cause antigenic variation
• of surface antigens

Question 34

leptospira

Answer 34

aerobic spirochetes
-hook on each end

in urine of animals

Question 35

adventure racing

Answer 35

associated with leptospirosis

Question 36

two phases of leptospirosis

Answer 36

first - bacteria invade blood and CSF
-high fever, malaise, muscle aches

second - IgM antibodies form

• meingismus
• CSF - elevated white count

Question 37

weils disease

Answer 37

caused by leptospira interrogans

• infectious jaundice
• renal failure, hepatitis, mental status change, hemorrhage