Pick Doxycycline (Tick Illnesses Lec 4)

Question 1

What is the vector for Lyme disease?

Answer 1

Ixodes tick (aka hard-bodied tick/deer tick/blacklegged tick)

Question 2

2 general locations that Lyme disease is found in the US

Answer 2

Upper midwest and Northeast

Question 3

Classic characteristic of disseminated lyme disease:

Answer 3

cranial neuritis (CN7 Palsy)

Question 4

Joint problems associated with Lyme disease:
____ is seen in stage 2
_____ is seen in stage 3

Answer 4

Arthralgias

Arthritis, esp in knee

Question 5

Cardiac problem associated with Lyme:

Answer 5

AV nodal block

Question 6

DDx of CN7 palsy, besides Lyme:

Answer 6

Bell’s Palsy (most common; idiopathic)
HSV (no rash)
Herpes-Zoster (vesicles in audtiory canal)

Question 7

Treatment of Lyme disease:

Answer 7

Doxycycline (sometimes ceftriaxone)

Question 8

What bacteria causes Rocky Mountain Spotted Fever?

Answer 8

Rickettsia Rickettsii

Question 9

R. Rickettsii has a trophism for ________

Answer 9

vascular endothelial cells

Question 10

Vector for RMSF

Answer 10

american dog tick

Question 11

Location RMSF is seen:

Answer 11

Upper SE US ie NC, TN

Question 12

_______ and _______ are common pathophysiologic findings of RMSF. They are caused by an increased vascular permeability due to _____

Answer 12

hyponatremia, thrombocytopenia; vasculitis

Question 13

Describe the rash of RMSF:

Answer 13

faint macules progressing to a vasculitic rash and petechiae;
may involve palms and soles!

Question 14

Do the lesions in RMSF blanch?

Answer 14

no

Question 15

Elevated ______ seen in RMSF may indicate liver failure

Answer 15

transaminases

Question 16

2 main disease to think of in patient presenting w/ fever + petechial rash on palms and soles:
Thus, treatment should be ________

Answer 16

meningococcal disease and RMSF

Ceftriaxone and doxy

Question 17

_____ may be given to pregnant patients with RMSF

Answer 17

Chloramphenicol

Question 18

Bacterial organism causing Ehrlichiosis:

Answer 18

Ehrlichia chaffeensis

Question 19

Vector for Ehrlichiosis:

Answer 19

Lone star tick

Question 20

Symptoms of Ehrliciosis/Anaplasmosis: (3)

____ is rare

Answer 20

fever, headaches, myalgias;

rash

Question 21

Treatment for ehrliciosis/anaplasmosis =

Answer 21

DOXY

Question 22

Lab findings of Ehrliciosis/Anaplasmosis = (3)

Answer 22

Leukopenia, Thrombocytopenia, Elevated transaminase

Question 23

Where is ehrliciosis common?

Answer 23

SE

Question 24

Where is anaplasmosis common?

Answer 24

Upper MW and NE

Question 25

What bacteria causes anaplasmosis?

Answer 25

Anaplasma phagocytophilum

Question 26

Vector for anaplasmosis:

Co-infection with _____ is common

Answer 26

Ixodes tick

Lyme disease

Question 27

Causative organism of Malaria:

Answer 27

Plasmodium species

Question 28

Vector of malaria:

Answer 28

anopheles mosquito

Question 29

_____ reproduction of plasmodium occurs in human hepatocytes

Answer 29

asexual

Question 30

______ can produce dormant hypnozoites in hepatocytes, which can reactivate in 3-12 months

Answer 30

P vivax/P ovale

Question 31

The most severe of the plasmodium species is ______

Answer 31

Plasmodium falciparum

Question 32

P. malarie has a ______ cycle; ie fevers are _____ hrs apart

Answer 32

quartan; 72

Question 33

P vivax and P ovale have a _____ cycle; ie fevers are ___ hrs apart

Answer 33

tertian; 48

Question 34

plasmodium _____ have a trophism for hepatocytes

Answer 34

sporozoites

Question 35

Seizures suggest infection caused by plasmodium _____

Answer 35

falciparum

Question 36

Paroxysmal chills, fever, and rigors suggest infection caused by plasmodium _____ or _____

Answer 36

vivax/ovale typically; also malariae

Question 37

Cardinal symptom in malarial infections

Answer 37

fever

Question 38

____ is very unusual in malaria

Answer 38

rash

Question 39

P falciparum can cause _____ and _____ in vasculature, including the CNS

Answer 39

sequestration, agglutination

Question 40

_____ is a poor prognostic sign in P falciparum. It is due to decreased _____ gluconeogenesis

Answer 40

hyopglycemia

hepatic

Question 41

Metabolic ______ can occur in P falciparum

Answer 41

acidosis

Question 42

Blood vessel occlusion can classically affect these 2 organs:

Answer 42

kidneys, lungs

Question 43

What kind of blood smears are used to diagnose Malaria? Evaluating for?

Answer 43

thick and thin;

ring forms

Question 44

For non Falciparum malaria, ___ is the treatment of choice in sensitive patients

Answer 44

chloroquine

Question 45

For falciprum, _____-based combos are preferred

Answer 45

arteminsin

Question 46

_____ has the shortest lead up and follow up of anti-malarial drugs used in travelers and is preferred

Answer 46

Malarone

Question 47

Malarone consists of ______

Answer 47

Atovaquine + Proguanil

Question 48

_____ is typically avoided in malarial prophylaxis due to CNS side effects

Answer 48

mefloquine