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Path Infectious Diseases Test #1 > Rickettsia/Lyme Disease/Zoonotic Disease > Flashcards

Rickettsia/Lyme Disease/Zoonotic Disease Flashcards

1
Q

Describe Rickettsia

A

intracellular infection of endothelial cells with perivascular lymphocytic infiltrate (perivascular cuffing)

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2
Q

General characteristics of Rickettsia

A

small, gram-neg. obligate intracellular bacteria that inhabits ticks, mites, fleas or lice

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3
Q

What appears at the inoculation site of a rickettsia infection

A

dark, swollen, crusted lesion (eschar)

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4
Q

where do rickettsia multiply?

A

mainly in small vessel endothelia

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5
Q

severe manifestations of rickettsial infection are due to

A

vascular leakage secondary to endothelial cell damage

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6
Q

What do rickettsial infections not have

A

no exotoxins or endotoxins (LPS is nontoxic)

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7
Q

What immune response is responsible for rickettsial infections

A

cytotoxic T-cells

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8
Q

Epidemic typhus method of transmission

A

head lice

prisons, concentration camps, refugee camps

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9
Q

symptoms of epidemic typhus (R. prowazekii)

A

begins with centrifugal rash followed by CNS involvement in the form of apathy, dullness, stupor, and even coma
high fever, chills, cough, rash, severe muscle pain, sensitivity to light, delirium

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10
Q

severe epidemic typhus

A

gangrene of fingers, nose, earlobes

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11
Q

fatalities with epidemic typhus increased with

A

G6PD deficiency (african americans)

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12
Q

syndrome related to epidemic typhus transmitted by fleas on rodents

A

murine typhus

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13
Q

important pathological markers for epidemic typhus

A

mononuclear cuffing of vessels, ecchymotic hemorrhages of affected organs

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14
Q

Rocky mountain spotted fever

A

R. rickettsi; tick bite

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15
Q

What kind of tick carries R. rickettsi

A

ixotid or hard ticks - American Dog Tick, Rocky Mountain Wood Tick

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16
Q

Disease progression of rocky mountain spotted fever

A

incubation period 7 days

high fever for 2-3 weeks, nausea, vomiting, headache muscle pain restlessness, insomnia

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17
Q

describe rocky mountain spotted fever rash

A

extends over entire body, including palms and soles; rare eschar
begins on periphery (palms, wrists, soles) and spread to trunk, neck and face

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18
Q

major cause of death with rocky mountain spotted fever

A

noncardiogenic pulmonary edema

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19
Q

morphology of rmsf

A

perivascular mononuclear infiltrate
necrosis, fibrin extravasation, and thrombosis of small blood vessels and arterioles
foci of necrotic skin
microthrombi, microinfarcts in brain

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20
Q

Where is scrub typhus group endemic

A

Far east, china, india

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21
Q

scrub typhus group caused by

A

Orientia (formerly Rickettsia) tsutsugamushi

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22
Q

scrub typhus is transmitted by

A

lice

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23
Q

Ehrlichiosis (Erlichia chaffeensis or Anaplasma phagocytophilum)

A

no eschar, rare rash

infects neutrohpils or monocytes, not endothelial cells

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24
Q

characteristic histology or Ehrlichiosis infection

A

cytoplsmic inclusions (morulae) - shaped like mulberries, masses of bacteria

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25
Ehrlichiosis transmitted by
dog ticks, and deer ticks
26
Describe lyme disease (Borrelia burgdorferi)
spirochetes transmitted to man by tick bites from animals or lice (man to man)
27
type of tick that carries lyme disease?
tick of the white-tailed deer, which also infects dogs, horses and people
28
how does borrelia avoid host production of antibodies
shift antigenic markers
29
local lyme disease lesion progresses to
bacteremia and chronic inflammatory lesions in distant organs
30
lyme disease skin rash shows
vasodilation with dense perivascular inflammatory infiltrates of mononuclear leukocytes
31
prevention of lyme disease
OspA vaccine commercially available forhigh risk groups; vector avoidance; therapy: doxycycline
32
pathogenesis of lyme disease
bacteremia disseminates the spirochetes to many organs with focal necrosis, hemorrhages late manifestations include chronic arthritis, polyneuropathy, and encephalitis
33
primary disease of lyme disease
initial bulls-eye lesion appearance with spreading erythematous margins and a blanching center known as erythema chronicum migrans fever and constitutional symptoms
34
secondary lyme disease
bacteremic dissemination of spirochetes most victims complain of joint disease weeks to months after initial inoculation o the organisms also muscle, pain, cardiac arrhythmias, meningitis with CN involvement
35
tertiary lyme disease
CNS, cardiac, and skeletal involvement in later stages
36
morphology of lyme disease
lymphoplasmacytic infiltrates synovial hyperplasia with lymphocytes and plasma cells onion-skin arteritis
37
Describe Borrelia recurrentis (relapsing fever)
spirochete; transmitted by human lice (B.hermsii) or rodent ticks (B. recurrentis) to humans
38
Describe the disease characteristics of relapsing fever
1-2 week latent period; shaking chills, fever, headache and fatigue fatal disease is accompanied by massive enlargement of spleen and liver
39
successive attacks of borrelia recurrentis is from
results from the ability of the organism to express new surface antigens; with each wave of attack, the body must make new antibodies to clear the organism
40
Describe the plague organism
gram-negative bacillus
41
mode of transmission of the plague
arthropod bite; man's an accidental victum of cycle where organism spreads among wild animals; especially rodents "sylvatic cycle"
42
Forms of Disease from the Plague
1. minor plague - prominent lymphadenopathy and constitutional symptoms 2. bubonic plague - buboes (most common form) 3. pneumonic plague - hemorrhagic, necrotizing pneumonia primary or secondary to (2) 4. septicemia (rapidly fatal)
43
Pathologic mechanisms of the plague (Yersinia pestis)
rapid proliferation of organisms within lymphoid tisues injection of toxins (YOPs) that kill host cells - inhibits actin and cytokines necrosis of tissue and blood vessles; swelling of lymphoid tissue striking leukocytosis; septicemia/DIC
44
Tularemia (Francisella tularensis)
pleomorphic gram-neg coccobacillus; facultative, intracellular
45
How do you get tularemia
contact with rabbits or rabbit skins; direct contamination of skin or conjunctiva by organism
46
forms of disease from tularemia
1. ulceroglandular tularemia: local skin lesion ulcerated pustule enlargement of lymph nodes, bacteremic phase 2. primary or secondary pulmonary infection with ilar lymphadenopathy 3. oculoglandular form
47
Pathologic mechanisms of tularemia
purulent necrosis and granulomatous reactions, leukocytosis not striking fatalities associated with endotoxin-like reactions
48
Pet-related diseases
``` pasteurela multocida (cats) Bartonella henselae (cats) Toxoplasmosis (cats) Chlamydia psittaci (birds) Leptospirosis (dogs) rabies (wild dogs, raccoons, foxes, skunks, coyotes) ```
49
Live-stock related diseases
``` Bacillus anthracis (sheep and goats) Listeria moncytogenes Brucella (goats, cows, pigs, dogs) Q fever (ticks from sheep and cattle) Glanders (pseudomonas mallei)/Meliodosis (Pseudomonas pseudomallei) - horses, donkeys and mules ```
50
Pasteurella multocida
gram neg. coccobacillus present in the oral cavity of many species rapidly developing cellulitis, abscesses, sepsis systemic infections require IV Abx (augmentin)
51
Bartonella henselae (Cat-scratch disease)
self-limited bacterial infection giving rise to localized lymphadenopathy associated with kittens and fleas
52
Bartonella henselae in people with AIDS
bacillary angiomatosis | multiple skin nodules with vasular proliferation distinct from Kaposi's sarcoma
53
Ornithosis (Chlamydia psittaci)
inhalation of dust-borne contaminated excretia from birds pneumonia may involve severe dyspnea interstitial inflammation with edema, hyperemia, mononuclear infiltration
54
lethal generalized disease caused by Chlamydia psittaci
marked by focal necrosis in liver and spleen; diffuse mononuclear infiltrative changes in kidneys, heart and brain
55
Salmonellosis transmitted by
turtles, reptiles
56
Toxoplasmosis gondii is an
obligate intracellular protozoan
57
Clinical syndromes of toxo
1. infection of mother in 1st trimester leads to severe disseminated infection - transplacental transmission 2. congenital or 3rd trimester infection may lead to chorioretinitis and blindness 3. AIDS or immunosuppressed: encephalitis
58
pathogenesis/pathology of toxo
1. able to infect all types of cells; binds to laminin receptors on host cells 2. in normal person, infection is characterized by lymphoid hyperplasia 3. extensive destructive lesions of the CNS as well as liver, heart lungs and adrenals in immunosuppressed/neonates 4. reaction of latent infection in AIDS
59
Describe the disease caused by Leptospira interrogans
mild disease: acute, self-limited febrile illness with biphasic fever and meningeal irritation; conjunctival irritation and hyperemia
60
Leptospirosis is a common disease in
dogs organism excreted in urine; also transmitted by direct contact with water contaminated with animal products, urine; hazard to campers and swimmers
61
lymphocytic atypical meningitis
severe leptospirosis with jaundice, bleeding and renal failure Weil's disease
62
pathogenesis of Leptospira interrogans
leptospirae quickly disseminates through the liver, spleen kidneys CNS with little cellular reactions, resembles viral meningitis
63
Rabies caused by
rabies virus transmitted to humans by contamination of open wounsd or mucous membranes by saliva from infected animals
64
rabies lesions characterized by
presence of Negri bodies in nerve cells; can only be diagnosed by direct examination of brain tissue from infected animal
65
lymphocytic choriomengintis virus
hamsters and other pocket pets/immunosupressed
66
Anthrax organism
highly pathogenic, encapsulated, gram-positive, large spore producing rod
67
Anthrax mode of transmission
contact with animals, animal hides, or animal products, particularly sheep and goats
68
forms of disease from anthrax
1. cutaneous disease - small hemorrhagic pustule develops into black eschar with very painful lymphadenitis 2. pulmonary disease - woolsorter's disease; extensive pneumonia with serofibrinous exudation, development of septicemia
69
pathologic mechanims of anthrax
antiphagocytic activity, edema factor, cytotoxic factor
70
antrax infections associated with
leukopenia, bacteremia may give rise to meningitis, electrolyte imbalance, hemoconcentration and DIC leads to death
71
Main point of anthrax as a weapon of biological terror
potential weapon of biological terrorism due to stability in environment, high virulence and ease of respiratory transmission
72
Listeria monocytogenes
small gram positive rod, facultative psychrophile, microaerophilic motile rode
73
Forms of disease from listeriosis
1. abortion; maternal infection may be inapparent 2. neonatal sepsis with leptominingitis 3. meningitis in immunosuppressed adults
74
pathologic mechanisms of listeria
exudative meningitis with numerous gram positive rods in CSF
75
Brucellosis organism
gram neg aerobic coccobacilli
76
method of transmission of brucellosis
contact with infected tissues (esp aborted fetuses and placentas) unpasteurized milk and milk products occupational exposure for veterinarians, meat workers
77
Pathologic mechanism of brucellosis
intracellular habitat and macrophage activation is essential for halting their growth
78
Q Fever (Coxiella burnetti)
1. headahce, cough, myalgia, lymphadenopathy, hepatosplenomegaly 2. rare pneumonias

Path Infectious Diseases Test #1 (10 decks)

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