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Term 4: Infectious Diseases > Spirochetes > Flashcards

Spirochetes Flashcards

1
Q

What are the three genera of spirochetes?

A

-Treponema -Borrelia -Leptospira

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2
Q

What organism causes syphilis?

A

-Treponema pallidum

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3
Q

Why can’t we see Treponema pallidum on light microscopy? What kind of microscopy is needed to see them?

A

-they are too narrow -Need darkfield microscopy or EM

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4
Q

What is the outermost amorphous layer of Treponema pallidum?

A

-Glycosaminoglycans

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5
Q

What diagnostic tests do we use to detect Treponema pallidum?

A

Non-treponemal antibody tests: -VDRL (venereal disease research lab of CDC) -RPR (Rapid Plasma Reagin) Treponemal antibody tests: -MHA-TP (MIcrohemagglutination antibody to T. pallidum) -EIA (Enzyme immunoassay)

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6
Q

Where does Treponema pallidum get phosphatidylcholine?

A

-can’t make its own -takes it from mammalian host =cardiolipin

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7
Q

What tests detect cardolipin in Treponema pallidum?

A

=non-treponemal antibody tests -VDRL test (venereal disease research laboratory) -RPR (rapid plasma reagin test)

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8
Q

What is the epidemiology of Treponema pallidum?

A

-Natural spread only among humans -Sexual transmission

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9
Q

What disease does Treponema pallidum cause?

A

Syphilis

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10
Q

What is weird about the flagella of spirochetes?

A

They are located underneath the outer membrane

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11
Q

What is the first sign of syphilis?

A

Primary syphilis = lesion called chancre -incubation of 7-21 days before papule appears

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12
Q

Why is primary syphilis harder to detect in women and homosexual men?

A

-chancre often in vaginal canal or rectum -syphilis usually diagnosed in second stage

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13
Q

What happens to the primary syphilis chancre without treatment?

A

-Disappears in 3-4 weeks -reflects development of some immunity

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14
Q

What is secondary syphilis?

A

-organisms have disseminated widely throughout body -Lesions appear all over skin, truck>extremitis and **involves palms of the hands and soles of the feet” -partial immunity prevents these lesions from turning into a chancre

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15
Q

What is seen in the CSF of patients with secondary syphilis?

A

-Treponemes

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16
Q

What kind of patient will develop early neurological symptoms of syphilis?

A

AIDS patient

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17
Q

What is latent syphilis?

A

-organism is in body, but not causing any signs of disease -Occurs in absence of treatment of secondary syphilis

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18
Q

What are the three things that can happen once syphilis becomes latent?

A

1/3 eradicate disease 1/3 remain with latent disease; keep reactive RPR 1/3 develop tertiary syphilis

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19
Q

What are the three types of tertiary syphilis?

A

-Benign -Cardiovascular -Neurologic

20
Q

What is benign tertiary syphilis?

A

-Gummas: large, immunologically mediated, granulomatous lesions of skin, liver testis, hard palate ***RARE

21
Q

What is cardiovascular tertiary syphilis?

A

-Aneurysm of ascending aorta due to invasion of vasa vasorum *RARE

22
Q

What is neurologic tertiary syphilis?

A

Wide variety of sx’s -tabes dorsalis -strokes -dementia -paresis *CSF is usually abnormal

23
Q

What is the most reliable diagnosis of primary syphilis?

A

-detection of treponemes in the canchre by darkfield exam *difficult in secondary lesions

24
Q

What is the treatment for syphilis?

A

-Long acting penicillin b/c of slow dividing time

25
Q

What is the Jarisch-Herxheimer reaction?

A

-Treatment of syphilis with penicillin is followed in 4 hours by a fever that may be high and the worsening of lesions

26
Q

What organism causes Lyme disease?

A

-Borrelia burgdorferi

27
Q

What is the natural reservoir and vector of Borrelia burgdorferi?

A

Reservoir: White-footed mouse Vector: hard tick (Ixodes)

28
Q

What are the tree stages of Lyme disease?

A

1) Localized infection 2) disseminated infection 3) Persistent destructive arthritis & cardiac disease

29
Q

What is stage 1 of Lyme disease?

A

-localized infection -nonspecific generalized symptoms -Erythema migrans

30
Q

What is stage 2 of lyme disease?

A

-disseminated infection (multiple smaller erythema migrans) -arthritis (large joints), carditis (heart block), neurologic disease (Bell’s Palsy) “outbreak” of acute arthritis

31
Q

What is stage 3 of lyme disease?

A

-Persistent destructive arthritis -cardiac disease

32
Q

What is the cause of leptospirosis?

A

-Leptospira

33
Q

Which species of Leptospira infects humans?

A

-interrogans

34
Q

What is the epidemiology of Leptospira?

A

-Warm climates -rare in USA -infects mammals (rodents, dogs) -US soldiers in Panama *work in or around bayous, contact with sewage or farm animals, presence of rats on property

35
Q

What is the clinical presentation of leptospirosis?

A

-Non-specific febrile illness -muscle aches -fatal jaundice -renal failure -hemorrhage

36
Q

What is Weil’s disease?

A

-combined renal and liver failure seen in leptospirosis

37
Q

What is Tabes Dorsalis?

A

-seen in tertiary syphilis -damage to posterior columns and dorsal roots of spinal cord -disrupts sensory perception

38
Q

What is general paresis of tertiary neurologic syphilis?

A

-progressive disease of the nerve cells in the brain leading to mental deterioration and psychiatric symptoms

39
Q

What disease is caused by Borrelia recurrentis?

A

-Relapsing fever

40
Q

“Tick/louse bites on campers sleeping in cabins in western U.S.”

A

Borrelia recurrentis or Borrelia hermsii= relapsing fever

41
Q

What is the reservoir and vector of Borrelia recurrentis?

A

Reservoir = human Vector = louse

42
Q

What is the reservoir and vector of Borrelia hermsii?

A

Reservoir = rodents and small mammals Vector = tick (humans infected incidentally)

43
Q

What is the clinical presentation of relapsing fever caused by B. recurrentis and B. hermsii?

A

-Fever, headache, muscle pains (nonspecific) -persists for 4-10 days, then controlled by humoral response -recurrence of symptoms keeps occuring, milder each time

44
Q

Why is relapsing fever caused by B. recurrentis and B. hermsii able to relapse?

A

-organism changes its outer membrane proteins, escaping humoral immunity repeatedly

45
Q

What kind of heart block can be caused by Borrelia burgorferi?

A

Atrioventricular heart block

46
Q

What is the easiest way to prevent Lyme disease?

A

-if a tick bites you, take it off within 18-24 hours so it can’t puke on you

47
Q

How are humans typically infected with Leptospira interrogans?

A

-swallowing water contaminated with animal urine -more common in tropical regions

Term 4: Infectious Diseases (21 decks)

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