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ABBEY MSII Unit 2 > Micro U2 L2. > Flashcards

Micro U2 L2. Flashcards

1
Q

Borrelia burgdorferi bacteriology

A

motile spirochete, flat wave shape, NOT spiral - larger (stain with silver, IF, standard microscopy), tick borne, mammal reservoirs, transmits in summer in 24-48 hrs

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2
Q

What is the pathogenesis of borrelia burgdorferi?

A

Lyme disease - 1. bite site to 2. blood to 3. heart, joints, CNS. NO toxins, primarily immune evasion

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3
Q

Signs/symptoms stage one of borrelia burgdorferi?

A

expanding macular rash (bullseye), some flu like symptoms (high fever if there is confection with erlichia or babesioa

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4
Q

Signs/symptoms stage two of borrelia burgdorferi?

A

months: cardiac and neurologic involvement: myocarditis, heart block, aseptic meningitis, bell’s palsy, bilateral facial nerve palsy

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5
Q

Signs/symptoms stage three of borrelia burgdorferi?

A

months: arthritis in large joints (knees) -> younger, chronic progressive CNS disease -> older

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6
Q

What are signs/symptoms of post treatment lyme?

A

lingering fatigue, joint pain, mental status changes

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7
Q

What labs can be done to confirm borrelia burgdorferi?

A

serology (ELISA) or IF (usually negative less than 2 weeks post infection) - will look the same if they’ve had lyme before. confirm with western blot or PCR

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8
Q

Treatment for stage 1 borrelia burgdorferi

A

doxycycline or amoxicillin

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9
Q

Treatment for late stage borrelia burgdorferi

A

ceftrixone

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10
Q

How do you know if treatment is working for borrelia burgdorferi/lyme?

A

jarisch herxheimer reaction

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11
Q

What is borrelia recurrentis and borrelia hermsii?

A

relapsing fever

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12
Q

Borrelia recurrentis and borrelia hermsii bacteriology

A

microscopically visible in blood smears, grow on special media

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13
Q

What is the vector/reservoir for b. recurrentis?

A

vector: body louse (from too much scratching) reservoir: humans

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14
Q

What is the vector/reservoir for b. hermsii?

A

vector: soft ticks; reservoir: small mammals, ticks

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15
Q

Which has a worse prognosis: b. recurrentis or b. hermsii?

A

b. recurrentis

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16
Q

What is a way to tell the difference between b. recurrentis and b. hermsii clincally?

A

b. hermsii has 3 relapses while b.recurrentis typically only has one

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17
Q

B. recurrentis and hermsii pathogenesis

A

spirochetes invade blood from bite site, multiply in many tissues -> general malaise and organ dysfunction -> neutralizing antibodies develop -> killing by immune system creates selective pressure for antigen variation -> disease resumes -> repeat

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18
Q

Diagnosis for B. recurrentis and hermsii

A

history of tick bite, fever (2+ episodes 3-5 days with well week inbetween), chills, headaches, organ dysfunction Labs: blood smear, culture optional

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19
Q

Treatment for B recurrentis and hermsii

A

tetracycline - Jarisch Herxheimer reaction

20
Q

Rickettsia bacteriology

A

very short rods, hard to gram stain, arthropod vectors, obligate intracellular parasites, human is dead end host (infected by accident)

21
Q

What are the similarities between Borrelia and Rickettsia?

A
  1. arthropod vectors 2. mammalian vectors 3. tetracycline sensitivity
22
Q

What are the differences between Borrelia and Rickettsia?

A
  1. very short rods, hard to gram stain (borrelia large) 2. obligate intracellular parasites (borrelia not)
23
Q

What are the three forms of Rickettsia?

A
  1. rocky mountain spotted fever 2. mediterranean spotted fever 3. typhus
24
Q

Rocky mountain spotted fever

A

vectored by ticks, bacteremia (easily enter blood stream), invade and multiply in vascular endothelium, blood vessels leak as infected cells die causing a rash

25
Q

What virulence factors do the spotted fevers have?

A
  1. omp A&B for adhesion 2. Type 4 secretion system for entry 3. phospholipase A2 to escape endosome 4. Act A - actin based cell-cell spread
26
Q

Mediterranean spotted fever

A

dog ticks - not common in US - cause eschar type thing on skin

27
Q

What is seen on exam of rocky mountain spotted fever?

A

headache, fever, myalgia, vasculitis rash (begins in extremities and then to trunk), history of tick, progresses to delirium, coma, DIC

28
Q

Treatment of the spotted fevers

A

doxycycline if not pregnant (even for children). alternate for pregnant: chloramphenicol

29
Q

Epidemic Typhus pathogenesis

A

bacteria multiply in vascular endothelium - untreated course ~2 weeks - mortality from vascular collapse or pneumonia

30
Q

What is different about typhus compared to other vectored bacterial infections?

A

humans are normal host and reservoir* - vectored by lice which die from the bacteria!!!!

31
Q

Brill-Zinsser Disease

A

recrudescent typhus - less severe than initial course, risk factors include malnutrition or inadequate antibiotics during first typhus

32
Q

Murine Typhus pathogenesis

A

accidental transmission to humans of cat/rat typhus - seen in S and SW US

33
Q

Scrub Typhus pathogensis

A

accidental transmission to humans of O. tsutsugamushi - vectored by chigger - milder than epidemic typhus

34
Q

Diagnosis of typhus

A

epidemic: abrupt onset fever, chills, unremitting headache, lymphadenopathy, rash (TRUNK TO PERIPHERY), CNS symptoms, cough, deafness, flea bite, natural disaster, war, medical ro military personnel - more common in cold weather

35
Q

How can you tell the difference between typhus and rocky mountain spotted fever by rash?

A

typhus: trunk to periphery while RMSF is peripher to trunk rash

36
Q

Murine and Scrub difference from Epidemic clinically

A

more common in warm weather - cough and lymph node involvement more common - milder

37
Q

Lab for ricketssia

A

IF assay, immunoassay, PCR

38
Q

Treatment for ricketssia

A

antibiotics before labs come back - doxycycline or chloramphenicol (preg)

39
Q

Ehrlichia bacteriology

A

tiny gram -; obligate intracellular; replicate in cytoplasm of WBC; form clusters called morulae(look like blackberries); accidental transmission to humans

40
Q

Ehrlichia pathogenesis

A

asymptomatic - can have flulike symptoms, GI symptoms, meningitis, and/or DIC

41
Q

Diagnosis for ehrlichia

A

severe headache, myalgias, fever, shaking chills, history of travel. LAB: CBC

42
Q

Treatment for ehrlichia

A

doxycycline, alternate fluoroquinolones

43
Q

Anaplasma bacteriology

A

small gram -; obligate intracellular; survive and multiply in early endosome of WBC (esp neutrophils); grow in morulae, vectored by ticks

44
Q

Difference between anaplasma and ehrlichia

A

anaplasma: endosome of WBC instead of cytoplasm - more serious - can put healthy people in intensive care

45
Q

Similarities of rickettsia, ehrlichia, anaplasma

A

small cocci-to-short rods transferred by arthropod vectors

ABBEY MSII Unit 2 (19 decks)

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