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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
Q

Ehrlichiosis transmitted by

A

dog ticks, and deer ticks

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26
Q

Describe lyme disease (Borrelia burgdorferi)

A

spirochetes transmitted to man by tick bites from animals or lice (man to man)

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27
Q

type of tick that carries lyme disease?

A

tick of the white-tailed deer, which also infects dogs, horses and people

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28
Q

how does borrelia avoid host production of antibodies

A

shift antigenic markers

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29
Q

local lyme disease lesion progresses to

A

bacteremia and chronic inflammatory lesions in distant organs

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30
Q

lyme disease skin rash shows

A

vasodilation with dense perivascular inflammatory infiltrates of mononuclear leukocytes

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31
Q

prevention of lyme disease

A

OspA vaccine commercially available forhigh risk groups; vector avoidance;
therapy: doxycycline

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32
Q

pathogenesis of lyme disease

A

bacteremia disseminates the spirochetes to many organs with focal necrosis, hemorrhages
late manifestations include chronic arthritis, polyneuropathy, and encephalitis

33
Q

primary disease of lyme disease

A

initial bulls-eye lesion appearance with spreading erythematous margins and a blanching center known as erythema chronicum migrans
fever and constitutional symptoms

34
Q

secondary lyme disease

A

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
Q

tertiary lyme disease

A

CNS, cardiac, and skeletal involvement in later stages

36
Q

morphology of lyme disease

A

lymphoplasmacytic infiltrates
synovial hyperplasia with lymphocytes and plasma cells
onion-skin arteritis

37
Q

Describe Borrelia recurrentis (relapsing fever)

A

spirochete; transmitted by human lice (B.hermsii) or rodent ticks (B. recurrentis) to humans

38
Q

Describe the disease characteristics of relapsing fever

A

1-2 week latent period; shaking chills, fever, headache and fatigue
fatal disease is accompanied by massive enlargement of spleen and liver

39
Q

successive attacks of borrelia recurrentis is from

A

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
Q

Describe the plague organism

A

gram-negative bacillus

41
Q

mode of transmission of the plague

A

arthropod bite; man’s an accidental victum of cycle where organism spreads among wild animals; especially rodents “sylvatic cycle”

42
Q

Forms of Disease from the Plague

A
  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
Q

Pathologic mechanisms of the plague (Yersinia pestis)

A

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
Q

Tularemia (Francisella tularensis)

A

pleomorphic gram-neg coccobacillus; facultative, intracellular

45
Q

How do you get tularemia

A

contact with rabbits or rabbit skins; direct contamination of skin or conjunctiva by organism

46
Q

forms of disease from tularemia

A
  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
Q

Pathologic mechanisms of tularemia

A

purulent necrosis and granulomatous reactions, leukocytosis not striking
fatalities associated with endotoxin-like reactions

48
Q

Pet-related diseases

A 
pasteurela multocida (cats)
Bartonella henselae (cats)
Toxoplasmosis (cats)
Chlamydia psittaci (birds)
Leptospirosis (dogs)
rabies (wild dogs, raccoons, foxes, skunks, coyotes)
49
Q

Live-stock related diseases

A 
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
Q

Pasteurella multocida

A

gram neg. coccobacillus present in the oral cavity of many species
rapidly developing cellulitis, abscesses, sepsis
systemic infections require IV Abx (augmentin)

51
Q

Bartonella henselae (Cat-scratch disease)

A

self-limited bacterial infection giving rise to localized lymphadenopathy
associated with kittens and fleas

52
Q

Bartonella henselae in people with AIDS

A

bacillary angiomatosis

multiple skin nodules with vasular proliferation distinct from Kaposi’s sarcoma

53
Q

Ornithosis (Chlamydia psittaci)

A

inhalation of dust-borne contaminated excretia from birds
pneumonia may involve severe dyspnea
interstitial inflammation with edema, hyperemia, mononuclear infiltration

54
Q

lethal generalized disease caused by Chlamydia psittaci

A

marked by focal necrosis in liver and spleen; diffuse mononuclear infiltrative changes in kidneys, heart and brain

55
Q

Salmonellosis transmitted by

A

turtles, reptiles

56
Q

Toxoplasmosis gondii is an

A

obligate intracellular protozoan

57
Q

Clinical syndromes of toxo

A
  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
Q

pathogenesis/pathology of toxo

A
  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
Q

Describe the disease caused by Leptospira interrogans

A

mild disease: acute, self-limited febrile illness with biphasic fever and meningeal irritation; conjunctival irritation and hyperemia

60
Q

Leptospirosis is a common disease in

A

dogs
organism excreted in urine; also transmitted by direct contact with water contaminated with animal products, urine; hazard to campers and swimmers

61
Q

lymphocytic atypical meningitis

A

severe leptospirosis with jaundice, bleeding and renal failure
Weil’s disease

62
Q

pathogenesis of Leptospira interrogans

A

leptospirae quickly disseminates through the liver, spleen kidneys CNS with little cellular reactions, resembles viral meningitis

63
Q

Rabies caused by

A

rabies virus transmitted to humans by contamination of open wounsd or mucous membranes by saliva from infected animals

64
Q

rabies lesions characterized by

A

presence of Negri bodies in nerve cells; can only be diagnosed by direct examination of brain tissue from infected animal

65
Q

lymphocytic choriomengintis virus

A

hamsters and other pocket pets/immunosupressed

66
Q

Anthrax organism

A

highly pathogenic, encapsulated, gram-positive, large spore producing rod

67
Q

Anthrax mode of transmission

A

contact with animals, animal hides, or animal products, particularly sheep and goats

68
Q

forms of disease from anthrax

A
  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
Q

pathologic mechanims of anthrax

A

antiphagocytic activity, edema factor, cytotoxic factor

70
Q

antrax infections associated with

A

leukopenia, bacteremia may give rise to meningitis, electrolyte imbalance, hemoconcentration and DIC leads to death

71
Q

Main point of anthrax as a weapon of biological terror

A

potential weapon of biological terrorism due to stability in environment, high virulence and ease of respiratory transmission

72
Q

Listeria monocytogenes

A

small gram positive rod, facultative psychrophile, microaerophilic motile rode

73
Q

Forms of disease from listeriosis

A
  1. abortion; maternal infection may be inapparent
  2. neonatal sepsis with leptominingitis
  3. meningitis in immunosuppressed adults
74
Q

pathologic mechanisms of listeria

A

exudative meningitis with numerous gram positive rods in CSF

75
Q

Brucellosis organism

A

gram neg aerobic coccobacilli

76
Q

method of transmission of brucellosis

A

contact with infected tissues (esp aborted fetuses and placentas)
unpasteurized milk and milk products
occupational exposure for veterinarians, meat workers

77
Q

Pathologic mechanism of brucellosis

A

intracellular habitat and macrophage activation is essential for halting their growth

78
Q

Q Fever (Coxiella burnetti)

A
  1. headahce, cough, myalgia, lymphadenopathy, hepatosplenomegaly
  2. rare pneumonias

Path Infectious Diseases Test #1 (10 decks)

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