Spirochetes

Question 1

Treponema

spp (4)

Answer 1

4 indistinguishable:
pallidum pallidum (syphilis)
pallidum pertenue (yaws)
pallidum endemicum (bejel)
carateum (pinta)

Question 2

Treponema

epidemiology

Answer 2

non-venereal:
person-person in unhygiene
venereal:
bumpin’ uglies

Question 3

Treponema

pertenue/yaws

Answer 3

humid Africa, Asia
skin-skin, then dissemination
sx: 1) lesions on extremities
2) general lesions
3) latent
4) hyperkeratosis of palms/soles, nodules

Question 4

Treponema

carateum/pinta

Answer 4

arid Latin America
skin-skin, then dissemination
sx: 1) pruritic papules on face/neck/UE/LE
2) scaly papules
3) latent
4) depigmented lesions

Question 5

Treponema

endemicum/bejel

Answer 5

“sytemic syphillis”
Africa, W. Asia
skin-skin, utensils
1) oral mucosal lesion
2) mucous patches, periostitis, adenopathy
3) latent
4) gummatous (fibrotic) lesions on extremities

Question 6

Treponema

non-VD Dx

Answer 6

dark-field microscopy on lesion samples

serology

Question 7

Treponema

non-VD Tx

Answer 7

Penicillin!

Question 8

Borrelia

general/morphology

Answer 8

flagella, highly motile
no microtubules in cytoplasm
arthropod-borne

Question 9

Borrelia
relapsing fever
(pathophys)

Answer 9

1) bacteremic: febrile
2) retreat to organs: afebrile
3) return ANTIGENICALLY DIFF: febrile

Question 10

Borrelia
relapsing fever
(causative agents)

Answer 10

1) louse-borne: recurrentis
spread when lice are crushed
East Africa, South America
usually only one relapse
2) tick-borne: 15 spp
rats are reservoir
Worldwide

Question 11

Borrelia
relapsing fever
(clinical)

Answer 11

sx: fever chills, headache,
myalgia, arthralgia, truncal rash,
conjunctival suffusions, petchiae, hepatomegaly
death: myocarditis, CNS hemorrhage, liver failure

Question 12

Borrelia
relapsing fever
(diagnosis)

Answer 12

1) peripheral blood of febrile pt
OR
2) dark-field microscopy

Question 13

Borrelia
relapsing fever
(treatment)

Answer 13

tetracycline or erythromycin

1 dose louse, longer tick

Question 14

Borrelia
Lyme dz
(causative agent)

Answer 14

Borrelia burgdorferi

Question 15

Borrelia
Lyme dz
(vectors)

Answer 15

ticks that feed on rodents, deer
transimitted in summer
1) scapularis in the NE
2) pacificus in the West
3) ricinus in Europe

Question 16

Borrelia
Lyme dz
(pathogenesis)

Answer 16

spreads via blood, lymph
IgM response at 3-6 wks
IgG response at over months

Question 17

Borrelia
Lyme dz
(clinical)

Answer 17

1) eryth. chron. migrans at site (3-30 days)
2) dissem: MSK sx at 2 wks, 2* lesions
3) 5% pts get cardiac sx w/in wks of infx’n
4) CNS fx mos to yrs after infx’n

Question 18

Borrelia
lyme dz
(diagnosis)

Answer 18

1)clinically+serologically
results stronger over time
2) ELISA C6 Ab test

Question 19

Borrelia
Lyme dz
(treatment)

Answer 19

1) doxycycline or amoxicillin

2) if neuro or cardiac sx: ceftriaxone

Question 20

Leptospira
leptospirosis
(causative)

Answer 20

Leptospira interrogans

Question 21

Leptospira
leptospirosis
(transmit/epi)

Answer 21

zoonotic
worldwide
persist in renal tubules symbiotically

Question 22

Leptospira
leptospirosis
(severe form)

Answer 22

5-10%, "Weill's Dz"
*jaundice
renal failure
meningitis
uveitis (aqueous humor)

Question 23

Leptospira
leptospirosis
(mild)

Answer 23

fever, headache, severe myalgias x7 days

might have some later severe sx

Question 24

Leptospira
leptospirosis
(diagnosis)

Answer 24

fluid and tissue samples, ELISA

Question 25

Leptospira
leptospirosis
(treatment)

Answer 25

penicillin
ampicillin
doxycycline
augmentin