Pick Doxycycline (Tick Illnesses Lec 4) Flashcards
What is the vector for Lyme disease?
Ixodes tick (aka hard-bodied tick/deer tick/blacklegged tick)
2 general locations that Lyme disease is found in the US
Upper midwest and Northeast
Classic characteristic of disseminated lyme disease:
cranial neuritis (CN7 Palsy)
Joint problems associated with Lyme disease:
____ is seen in stage 2
_____ is seen in stage 3
Arthralgias
Arthritis, esp in knee
Cardiac problem associated with Lyme:
AV nodal block
DDx of CN7 palsy, besides Lyme:
Bell’s Palsy (most common; idiopathic)
HSV (no rash)
Herpes-Zoster (vesicles in audtiory canal)
Treatment of Lyme disease:
Doxycycline (sometimes ceftriaxone)
What bacteria causes Rocky Mountain Spotted Fever?
Rickettsia Rickettsii
R. Rickettsii has a trophism for ________
vascular endothelial cells
Vector for RMSF
american dog tick
Location RMSF is seen:
Upper SE US ie NC, TN
_______ and _______ are common pathophysiologic findings of RMSF. They are caused by an increased vascular permeability due to _____
hyponatremia, thrombocytopenia; vasculitis
Describe the rash of RMSF:
faint macules progressing to a vasculitic rash and petechiae;
may involve palms and soles!
Do the lesions in RMSF blanch?
no
Elevated ______ seen in RMSF may indicate liver failure
transaminases
2 main disease to think of in patient presenting w/ fever + petechial rash on palms and soles:
Thus, treatment should be ________
meningococcal disease and RMSF
Ceftriaxone and doxy
_____ may be given to pregnant patients with RMSF
Chloramphenicol
Bacterial organism causing Ehrlichiosis:
Ehrlichia chaffeensis
Vector for Ehrlichiosis:
Lone star tick
Symptoms of Ehrliciosis/Anaplasmosis: (3)
____ is rare
fever, headaches, myalgias;
rash
Treatment for ehrliciosis/anaplasmosis =
DOXY
Lab findings of Ehrliciosis/Anaplasmosis = (3)
Leukopenia, Thrombocytopenia, Elevated transaminase
Where is ehrliciosis common?
SE
Where is anaplasmosis common?
Upper MW and NE
What bacteria causes anaplasmosis?
Anaplasma phagocytophilum
Vector for anaplasmosis:
Co-infection with _____ is common
Ixodes tick
Lyme disease
Causative organism of Malaria:
Plasmodium species
Vector of malaria:
anopheles mosquito
_____ reproduction of plasmodium occurs in human hepatocytes
asexual
______ can produce dormant hypnozoites in hepatocytes, which can reactivate in 3-12 months
P vivax/P ovale
The most severe of the plasmodium species is ______
Plasmodium falciparum
P. malarie has a ______ cycle; ie fevers are _____ hrs apart
quartan; 72
P vivax and P ovale have a _____ cycle; ie fevers are ___ hrs apart
tertian; 48
plasmodium _____ have a trophism for hepatocytes
sporozoites
Seizures suggest infection caused by plasmodium _____
falciparum
Paroxysmal chills, fever, and rigors suggest infection caused by plasmodium _____ or _____
vivax/ovale typically; also malariae
Cardinal symptom in malarial infections
fever
____ is very unusual in malaria
rash
P falciparum can cause _____ and _____ in vasculature, including the CNS
sequestration, agglutination
_____ is a poor prognostic sign in P falciparum. It is due to decreased _____ gluconeogenesis
hyopglycemia
hepatic
Metabolic ______ can occur in P falciparum
acidosis
Blood vessel occlusion can classically affect these 2 organs:
kidneys, lungs
What kind of blood smears are used to diagnose Malaria? Evaluating for?
thick and thin;
ring forms
For non Falciparum malaria, ___ is the treatment of choice in sensitive patients
chloroquine
For falciprum, _____-based combos are preferred
arteminsin
_____ has the shortest lead up and follow up of anti-malarial drugs used in travelers and is preferred
Malarone
Malarone consists of ______
Atovaquine + Proguanil
_____ is typically avoided in malarial prophylaxis due to CNS side effects
mefloquine
