SPIROCHETES Flashcards

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1
Q

coiled spirochete

CANNOT be cultured in vitro - lacks Krebs cycle

MICROAEROPHILIC

A

Treponema pallidum

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2
Q

PRIMARY SYPHILIS

A

PAINLESS chancre

highly INFECTIOUS, heals spontaneously in 3-6 wks

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3
Q

SECONDARY SYPHILIS

A

palmar rash
lymphadenopathy
CONDYLOMA LATA

occurs after 1-3 mos

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4
Q

TERTIARY SYPHILIS

A

occurs years after inoculation

NEUROSYPHILIS

  • asymptomatic
  • meningovascular
  • tabes dorsalis
  • general paresis
  • Argyll-Robertson pupil/Prostitute pupil
  • dementia paralytica

AORTITIS

  • aneurysms
  • aortic regurgitation

GUMMAS

  • hepar lobatum
  • skin, bone others
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5
Q

CONGENITAL SYPHILIS

A

snuffles/saddle nose
mulberry molars

HUTCHINSON TRIAD: Hutchinson teeth, deafness, keratitis

saber shins

rhagades (angle of mouth)

HIGOUMENAKIS SIGN (clavicle) - unilateral enlargement of the sternoclavicular portion of the clavicle

CLUTTON’S JOINTS (SYNOVITIS)

PULMONARY HEMORRHAGE

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6
Q

MOST SPECIFIC test. when an active chancre or condyloma latum is predent

A

DARK FIELD MICROSCOPY

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7
Q

Nontreponemal

used for SCREENING

cardiolipin, cholesterol and purified lecithin

A

VDRL
RPR

decreased sensitivity in EARLY PRIMARY SYPHILIS and LATE SYPHILIS

for MONITORING TREATMENT

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8
Q

Treponemal Specific

A

EIA
TPHA
FTA-ABS

used to confirm the diagnosis in px w/ positive VDRL/RPR

higher sensitivity/specificity

FOREVER POSITIVE

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9
Q

FALSE POSITIVE VDRL RESULTS

A

Virus
Drugs (marijuana)
Rheumatic fever, RA
Lupus, Leprosy

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10
Q

Influenza like symptoms few hours after receiving penicillin d.t. lysis of treponemes

A

Jarisch-Herxheimer reaction

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11
Q

FALSE POSITIVE (FTA-ABS)

A

Lupus

Lyme Disease

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12
Q

MOST SPECIFIC, EARLIEST POSITIVE, REMAINS POSITIVE LONGEST

A

FTA-ABS

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13
Q

31/M, treated w/ Pen G in a case of Syphilis. On day 2 of treatment he had fever, chills, tachycardia, hypotensive and profuse sweating. What do you call this condition?

A. anaphylaxis
B. tachyphylaxis
c. Stevens-Johnson
D. Jarisch- Herxheimer

A

D. Jarisch-Herxheimer

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14
Q

T. pallidum pallidum

A

Venereal syphilis

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15
Q

T. pallidum pertenue

A

Yaws

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16
Q

T. pallidum endemicum

A

endemic syphilis (bejel)

17
Q

T. carateum

A

Pinta

18
Q

Transmitted by HUMAN BODY LOUSE (Pediculus humanus)

A

Borrelia recurrentis

19
Q

Fever characteristic of Borrelia recurrentis

A

Relapsing Fever

rapid antigenic changes d.t. PROGRAMMED REARRANGEMENTS of bacteria DNA encoding surface proteins

20
Q

Largest medically important bacterium

A

Borrelia burgdorferi

21
Q

Reservoir of Borrelia burgdorferi

A

White footed mouse

White tailed deer

22
Q

Vectors of Borrelia burgdorferi

A

Deer ticks (Ixodes ticks)

23
Q

Lyme Disease

Stage 1 (early localized stage)

A

Erythema Chronicum Migrans (ECM) - target like lesion

24
Q

Lyme Disease

Stage 2 (early disseminated stage)

A

multiple smaller ECM

neurologic: aseptic meningitis, CN palsies (BELL’S PALSY) and peripheral neuropath
cardiac: transient AV block or myocarditis

DOXYCLINE
Amoxicillin
Cefuroxime

25
Q

Lyme Disease

Stage 3 (late stage)

A

autoimmune migratory polyarthritis (ONION SKIN LESION)

acrodermatitis chronica atrophicans

encephalopathy

IV PENICILLIN
CEFTRIAXONE

26
Q

Borrelia burgdorferi is cultured on

A

Barbour-Stoenner-Kelly (BSK) medium

27
Q

The LARGEST BACTERIA ever discovered (not medically important)

A

Thiomargarita namibiensis

28
Q

Direct contact w/ infected urine or animal tissue

History of wading in flood water

History of exposure to animals (butcher)

A

Leptospira interrogans

29
Q

The resting site for leptospires jn the natural host

A

Lumen of the Nephron Tubules

30
Q

Obligate aerobe (Other spirochetes - microaerophiles)

A

Leptospira interrogans

31
Q

Organisms in BLOOD and CSF

High spiking temp, chills, intense headache

A

ACUTE LEPTOSPIREMIC PHASE

  • rapid multiplication of leptospires in MUSCLES w/ HIGH OXYGEN TENSION – CALF TENDERNESS
  • damaged and leaky conjuctival vessels - CONJUNCTIVAL SUFFUSION (painful and itchy but w/ minimal tearing)
32
Q

Correlates w/ emergence of IgM

A

IMMUNE LEPTOSPIRURIC PHASE

*ASEPTIC MENINGITIS
CSF pleocytosis w/ or w/o meningeal symptoms
coincides w/ appearance of antibody titer

*PULMONARY INVOLVEMENT
snowflake lesions on CXR

  • HEPATIC NECROSIS
  • GLOMERULONEPHRITIS
33
Q

Main pathophysiology of Leptospirosis

A

Systemic Vasculitis

34
Q

Most severe form of leptospirosis

A

WEIL’s SYNDROME

  • bleeding
  • jaundice
  • uremia

respiratory failure d.t. massive pulmonary hemorrhage - MCC of DEATH

35
Q

Spiral shaped w/ HOOKS ON BOTH ENDS (“ice tongs”) – SHEPHERD CROOK APPEARANCE

A

Leptospira interrogans

36
Q

Leptospira interrogans is grown in

A

Ellinghausen-McCullough-Johnson-Harris (EMJH) or Fletcher’s medium

37
Q

Treatment for MILD Leptospirosis

A

Doxycycline 100 mg BID

Ampicillin

Amoxicillin

38
Q

Treatment for SEVERE leptospirosis

A

Penicillin G

Ampicillin

Ceftriaxone 1 g IV

Cefotaxime