Outdoor Pets and Animals Flashcards
Lyme Disease Rocky Mountain Teatnus Toxo Rabies Malaria Histoplasmosis
Lyme Disease
One week
Rocky Mountain spotted fever
One week
Histoplasmosis
Nope
Tetanus
One week
Toxoplasmosis
Nope
Rabies
Yes (immediately) reportable
Malaria
One week
What causes Lyme Disease?
Borrelia burgdorferi
What is Lyme disease named after?
Old Lyme, Connecticut
What did the children in CT was thought to have?
Juvenile rheumatoid arthritis
What is the most common tick- borne disease in U.S. and Europe
Lyme disease
What is the name of the tick that transmits lyme disease?
Ixodes species ticks
Where do you encounter the tick that transmit Lyme disease?
Backyards and outdoor recreational areas
What is the most reportable disease in the U.S.?
Lyme Disease
Which tick is found in eastern and north central regions of North America?
I. scapularis
Which tick is found in western North America?
I. pacificus
How long does it take a tick to go through a cycle?
two years
What stage of lyme disease is the primary vector?
infected nymph
Why is the infected nymph the main stage?
bc its very small and stays attached for longer period
How long do ticks stay attached for transmission of lyme disease?
72 hrs
How many stages are in lyme disease?
3 stages
What symptoms are seen in Stage 1 of lyme?
- Flu like symptoms
- typical skin rash (erythema migrans)
What symptoms are seen in Stage 2 of lyme?
- facial (cranial nerve VII) palsy
- Meningitis
What symptoms are seen in Stage 3 of lyme?
arthritis
What is the problem with the stages of lyme disease?
there is a great deal of overlap
What is the more accurate classification of lyme disease?
- early and late manifestation
- Localized or disseminated
What stage is erythema migrans found in?
Stage 1
When can you begin empiric antibiotic treatment immediately?
the presence of erythema migrans rash
What stage is musculoskeletal symptoms seen in lyme disease?
Stage 3
What leads to sclerotic skin plaques and atrophy at a later stage w/ hair loss also occurring later in some patients?
Acrodermatitis chronica atrophican
How do you diagnose Lyme disease?
Serologic testing
How is lyme disease treated?
Doxycycline
How is lyme disease treated in pregnant women?
amoxicillin
How do you prevent avoidance of lyme disease.
wearing light colored long sleeve shirt, long pants, and pants tucked into socks and DEET repellant
T/F 90% of lyme disease episodes completely resolve with standard antibiotic therapy?
TRUE
Gram negative, obligate intracellular bacterium?
Rickettsia rickettisia
Where does most cases of Rocky mountain occur?
outside the Rocky Mountain area
What months do RMSF occur?
April to September
Which 5 states are RMSF found?
- North Carolina
- Tennessee
- Oklahoma
- Missouri
- Arkansas
Which tick causes RMSF?
Dermacentor variabilis (American dog tick)
What are the biggest signs and symptoms of RMSF?
- severe multiorgan dysfunction and fatality
- RASH!
What is the stage of the RMSF rash?
Faint macules >maculopapules >petechiae
What is the characteristic finding in the RMSF rash?
involvement of the palms and soles
Diagnosis is based on what in RMSF?
on Clinical Grounds early in the illness
What is the Triad for RMSF?
Fever
Rash
Tick bite
What diagnostic test is used for RMSF?
indirect immunofluorescent antibody (IFA) assay (retrospective)
The highest mortality rate of RMSF is seen in?
- very young children
- the elderly
- Native Americans
What causes the high mortality rate in RMSF?
- being diagnosed late and being undiagnosed
What is the treatment for RMSF?
Doxycycline
What causes Tetanus?
Clostridium tetani
What is the name of the neurotoxin produced by clostridium tetani?
tetanospasmin
Where is clostridium tetani found?
spores in soil
What is the MOA for tetanus?
neurotoxin interferes w/ neurotransmission, binding to the spinal synapses of inhibitory neurons
What is the most common and severe form of tetanus?
generalized
How many types of tetanus is there?
4
What is the presenting symptom of generalized tetanus?
trismus (lockjaw)
What are classic findings in generalized tetanus?
- Stiff neck
- Opisthotonus
- Risus sardonicus
Which type of tetanus often evolves in generalized tetanus?
local
Which type of tetanus affects only one extremity or body region?
local
Which type of tetanus involves cranial nerves?
cephalic
Which cranial nerve is most often effected in tetanus?
facial
What causes neonatal tetanus?
application of unconventional substances to the umbilical stump
What is the diagnostic test for tetanus?
NONE
What is a DDX for tetanus?
Strychnine poisoning (rate poison)
What is the treatment methods for tetanus?
- Halting toxin production
- Neutralization of unbound toxin
What antimicrobial therapy is used for tetanus?
Metronidazole IV
What is the treatment for passive immunization of tetanus?
Human tetanus immune globulin (HTIG)
What is used to treat hypertension and tachycardia in tetanus?
Labetalol
What is used to control muscle spasms in tetanus?
Diazepam
What is used treat autonomic instability in tetanus?
magnesium sulfate
What is the treatment of tetanus?
penicillin or metronidazole
and
human tetanus immunoglobulin (HTIG), equine antitoxin
What causes Toxoplasmosis?
Toxoplasma gondii
Ingestion of oocysts in food or water contaminated by cats?
Toxoplasmosis
Primary infection of toxoplasmosis occurs in which patient?
immunocompetent person
Congenital infection of toxoplasmosis occurs in which patient?
pregnant women and fetus
If the mother is exposed EARLY there is a low risk of transmission, but baby is at?
high risk of disease
If mother is exposed LATER there is a high risk of transmission, but baby is at?
low risk of disease
What syndrome causes retinochoroiditis?
congenital toxoplasmosis
What is the most common late presentation of congenital toxoplasmosis?
Toxoplasmosis Retinochoroditis
Tertiary infection of toxoplasmosis occurs in whom?
immunocompromised person
What diagnosis is used toxoplasmosis?
labs
PCR
What is the treatment for toxoplasmosis in primary infection?
NO TXT
Self limited
What is the txt for toxoplasmosis in secondary infection?
<18wks gestation: Spiramycin
>18wks gestation: Pyrimethamine and Sulfadiazine
When do you give pyrimethamine and sulfadiazine to treat >18 wks gestation?
fetal infection is documented by + amniotic fluid PCR
Which medicine is teratogenic in toxoplasmosis treatment?
Pyrimethamine
Immunocompromised host treatment for toxoplasmosis?
Pyrimethamine + sulfadiazine
Newborn txt for toxoplasmosis?
pyrimethamine + leucovorin
Severe or prolonged txt for toxoplasmosis?
pyrimethamine + sulfadiazine
pyrimethamine + clindamycin
What causes Rabies?
rhabdovirus
How do you diagnosis rabies?
direct fluorescent antibody testing
What is the most specificity diagnosis of rabies?
posterior neck at the hairline biopsy
What is the passive prophylaxis treatment for rabies?
human rabies immune globulin (HRIG)
What is the active prophylaxis txt for rabies?
human diploid cell vaccine or purified chick embryo cell vaccine
What is the baddest species of malaria?
P. Falciparum
Which two species causes liver phase malaria?
P. vivax and P.ovale
What is the diagnosis of Malaria?
Giemsa-stained blood smears
What is the medical treatment for malaria?
Chloroquine
What medicine treats hypnozote malaria?
Primaquine
Who is admitted for malaria?
pts w/ falciparum
What med is used to prevent malaria?
Atovaquone- proguanil and doxycycline
What is disease has a “bulls-eye” lesion?
Lyme disease