spirochetes

Question 1

what is a spirochete ?

Answer 1

a bacteria with a long corkscrew shape

Question 2

what are the three spirochetes ?

Answer 2

leptospira
borrelia
treponema

Question 3

where is leptospira found ?

Answer 3

found in contaminated water with rat urine
lives in rodent

Question 4

what is the presentation of leptospirosis ?

Answer 4

flu like symptoms
conjunctival suffusion
aseptic meningitis
Weils disease - liver damage presents with jaundice

Question 5

what does borrelia cause ?

Answer 5

lyme disease which is caused by tick bites

Question 6

what is the reservoir for borrelia ?

Answer 6

mice

Question 7

what is the association between deer and borrelia ?

Answer 7

infected adult ticks feed on deer

Question 8

how long must the tick be attached to transmit bacteria

Answer 8

at least 48 hours

Question 9

what are the stages of lyme disease ?

Answer 9

stage 1 - erythema chronicum migrans , an expanding bulls eye rash along with flu like symptoms

stage 2 - neurologic findings, facial nerve palsy along with AV block

stage 3 - arthiritis of the knee , neuropathy , mild encephalopathy

Question 10

what does the european version of leptospirosis look like ?

Answer 10

a blue red discoloration rash
acrodermatitis chronica atrophicans

Question 11

what is the first line treatment for lyme disease ?

Answer 11

doxycycline

Question 12

what is the cause of relapsing fever ?

Answer 12

borrelia recurrentis

Question 13

what is borrelia recurrentis transmitted by ?

Answer 13

louse

Question 14

what is the cause of the recurrent fever caused by borrelia recurrentis ?

Answer 14

antigenic variation which evades the immune response

Question 15

what is the bacteria causing syphillus ?

Answer 15

treponema syphillus

Question 16

what type of microscopy is used to see syphillus ?

Answer 16

dark field microscopy

Question 17

what are the three stages of syphillus ?

Answer 17

primary - 2-3 weeks after exposure , painless chancres

secondary syphillus - maculopapular rash involving the palms and soles along with flu like symptoms , condyloma lata

tertiary syphillus- gummas , a type of granuloma ,aortitis , neurosyphilis

Question 18

what are the rashes that involve the palm and the sole ?

Answer 18

coxsackie virus
secondary syphillus
rocky mountain spotted fever

Question 19

what does condyloma lata look like and where are they found ?

Answer 19

cauliflower like lesion usually appear in the same place that the chancre was
found in moist areas like them perineum and the inside of the mouth

Question 20

what are the special manifestations of tertiary syphillus ?

Answer 20

argyll robertson pupils - do not constrict to light but constrict to accommodation

tabes dorsalis - wide based gait ataxia ( involvement of the spinal cord)

Question 21

how is the diagnosis of syphillus done ?

Answer 21

VDRL and RPR
they are screening tests , must follow up after

Question 22

how does VDRL work ?

Answer 22

serum of the patient reacts with cardiolipin antigen

Question 23

what test must be done for patients who have neurosyphillus ?

Answer 23

CSF sample must be taken

Question 24

what is the more specific test for syphillus ?

Answer 24

FTA-ABS treponemal test

Question 25

what are the findings of congenital syphillus ?

Answer 25

hepatomegaly
runny nose
long bone x rays
maculopapular rash

Question 26

what are the late findings associated with congenital syphillus ?

Answer 26

saddle nose
hearing loss
saber shins ( bowed legs)

Question 27

what is the treatment for syphillus ?

Answer 27

penicillin

Question 28

what happens after the treatment of syphillus ?

Answer 28

a flu like reaction occurs
called jarisch herxheimer reaction
self limiting and expected