Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ICM lectures > Tick > Flashcards

Tick Flashcards

1
Q

lyme disease

A

Deer tick
borreilia burgdorferi
hyperendemic regions of eastern US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

RMSF

A

dog tick
-rickettsia rickettsia
trophism for vascular endothelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ehrilichiosis

A

lone star tick

-ehrlichia chaffeensis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

stage 1 lyme disease

A

Localized (incubation 3-32 days)

Rash (Erythema migrans)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

stage 2 lyme disease

A 
Disseminated
	Multiple annular skin lesions
	Meningitis (headache, fever, stiff neck)
	Cranial neuritis (Cranial Nerve 7)
	Carditis (AV block)
	Arthralgia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

stage 3 lyme disease

A

Persistent
Oligoarticular arthritis (knee joints)
Encephalopathy (mood, memory, sleep disturbance)
Axonal Polyneuropathy (tingling feet, weakness)
Acrodermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

rashes of lyme disease

A

“target rash” or bulls eye rash

-central clearing and necrotic center

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

chronic lyme disease

A
  • Pain syndrome (arthralgias)
    • chronic fatigue
    • neurocognitive symptoms
  • Symptoms occur for years after eradication of infection.
  • Symptoms may be indistinguishable from chronic fatigue syndrome, fibromyalgia.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

testing for lyme disease

A

serology: IgM and IgG
- often retrospective diagnosis using paired sera (acute and convalescent, draw at presentation and 2-4 weeks later)
- ELISA with Western blot verification- similar to older HIV testing methods
- PCR of joint fluid from arthrocentesis done in patient with arthritis
- PCR has low sensitivity in CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

treatment for lyme disease

A

doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

tick prevention tips

A
  • Examine self after potential exposure, remove ticks
    • Use insecticides with DEET
    • Tuck pants into socks
    • Pre-treat clothes with permethrin insecticides
    • Insect-Shield clothing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

incubation time of RMSF

A

1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

basic pathophsyiology of RMSF

A 
vasculitis
Increased vascular permeability
	Edema, hypovolemia
	Hyponatremia d/t compensatory ADH release
	Thrombocytopenia is common
	DIC is rare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

clinical presentation of RMSF

A 
Triad: fever, rash, history tick exposure 
Symptoms
		fever
		headache
		malaise 
		myalgia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how does rash evolve in RMSF

A

Progresses to vasculitic rash

- petechiae
- may involve palms and soles - does not appear until several days after onset of fever - does not bleach
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

some more severe symptoms of RMSF

A

Hypovolemia, hypotension, fluid third spacing
Respiratory failure
Cardiac Dysrhythmia
CNS symptoms- confusion, lethargy, encephalopathy
ATN (acute tubular necrosis)
Shock
Elevated transaminases- acute hepatitis/liver failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

lab testing for RMSF

A

Thrombocytopenia (low platelets)
Hyponatremia (low sodium)
Azotemia (increased BUN, potentially increased Cr if ATN develops)

Skin biopsy of lesion with direct immunofluorescence staining (obtain before or within 12 hours of antibiotic therapy)

18
Q

serology testing for RMSF

A

Serologic testing of IgM and IgG (first set of sera after five days of illness, second set 14-21 d after symptom onset)

19
Q

what are common ways for physicians to miss RMSF diagnosis

A

●Absence of a skin rash
●Presentation within the first three days of illness
●Presentation between 1 August and 30 April
-can be fatal if delayed treatment

20
Q

drugs of choice for RMSF

A

-Doxycycline is drug of choice in adults and children
Except for pregnant women
Doxycycline can cause dental staining in children <9 yrs old, but the risk is minimal if a short course is used.
Risk of bad outcome with RMSF outweighs risk of side effects from drug.

-Chloramphenicol is treatment of choice in pregnant 
women
	-difficult to obtain
	-less effective
	-in some cases benefits of doxycycline 
		outweigh risks in pregnancy
21
Q

incubation period of ehrilichiosis

A

8 days

22
Q

symptoms of ehrilichiosis

A

Fever
Headache
Myalgias

23
Q

lab findings of ehrilichiosis

A

Leukopenia
Thrombocytopenia
Elevated transaminases

24
Q

treatment of ehrilichiosis

A

doxycycline

25
Q

most severe malaria

A

P. falciparum

  • high parasitemia
  • end organ damage and death can occur
26
Q

less severe malarais

A

P. ovale, vivax( can have end organ damage), malariae

27
Q

patients with rash, fever and tick exposure can possible have

A 
Meningococcal Disease
Tick borne disease- RMSF
Enteroviral disease
Secondary Syphilis
Rubella
Drug eruption
Kawasaki disease
Coxsackie virus (hand foot and mouth disease)
28
Q

Key points after bite from infected mosquito

A
  1. Plasmodium sporozoites have trophism for hepatocytes
  2. Asexual reproduction in hepatocytes
  3. Release into bloodstream
  4. Hijacking of RBC and degradation of hemoglobin, formation of ring forms
  5. Lyse RBC and release merozoites to invade more RBC, or gametocytes to reinfect mosquitoes {hemolytic anemia
    - > direct hyperbilirubinemia = jaundice}
  6. P vivax and P ovale can produce dormant hypnozoites in hepatocytes, can reactivate in 3-12 months
29
Q

clinical features of malaria

A

Exposure to endemic area
Lack of prophylactic treatment used by travelers
Headache, fatigue, myalgias, abdominal pain
FEVER

30
Q

what usually suggests P. falciparum

A

-Seizures suggest P falciparum infection

Paroxysmal chills, fever, rigors suggest P vivax or ovale (hepatic sequestration and re-release)

31
Q

physical findings of malaria

A 
Fever
Mild anemia
Mild hepatomegaly
Mild icterus (jaundice)
Palpable spleen
rash-> unusual, think other diagnosis
32
Q

what can P. falciparum do to CNS

A

Can cause sequestration and agglutination in vasculature, including CNS

33
Q

severe symptoms from P. falciparum

A 
Cerebral malaria (seizures, encephalopathy, coma)
Hypoglycemia (poor prognostic sign.  Due to decreased hepatic gluconeogenesis and increased systemic glucose utilization)
Metabolic acidosis (due to hypoperfusion, lactic acidemia)
Noncardiogenic pulmonary edema (ARDS= adult respiratory distress syndrome)
Renal impairment (ATN)
Hematologic abnormalities (anemia)
Liver dysfunction (cholestasis, acute hepatitis)
34
Q

diagnostic testing for malaria

A

Light microscopy of Giemsa-stained blood smear
Thick and Thin blood smears- pathologist eval for ring forms and estimation of parasite load
Thick blood smears concentrate parasites, increases diagnostic sensitivity

-rapid diagnostic testing: antigen detection

35
Q

lab findings from malaria

A

Normocytic normochromic anemia

Increased acute phase reactants (ESR= sed rate, CRP= c-reactive protein)

36
Q

treatment for malaria

A

For non-falciparum malaria (chloroquine sensitive)

Chloroquine is treatment of choice

37
Q

treatment for P. falciparum

A

If chloroquine sensitivity is a certainty, chloroquine

If any question about chloroquine sensitivity, Arteminsin-based combinations are preferred

38
Q

preventive drugs for malaria

A

Malarone- easy to tolerate, short lead up and follow up, generic, inexpensive
Doxycycline- was inexpensive
Chloroquine- generic, inexpensive, easy to tolerate

39
Q

bad prevention drugs for malaria

A

Mefloquine – CNS side effects

40
Q

non-pharmacological prevention of malaria

A

Mosquito tents
Insect repellents
Preventive treatment in travelers

ICM lectures (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions