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Knowledge Rehab > Tick Borne Disease, HIV > Flashcards

Tick Borne Disease, HIV Flashcards

1
Q

Match the disease with the correct organisms
A. Lyme Disease
B. Babesiosis
C. Granulocytic Anaplasmosis
D. Monocytic Ehrlichiosis
E. Rocky Mountain Spotted Fever

  1. Anaplasma phagocytophilum
  2. Borrelia burgdorferi
  3. Ehrlichia chaffeensis
  4. Rickettsia rickettsii
  5. Babesia microti
A

A: 2 |B: 5 |C: 1 |D: 3 |E: 4

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2
Q 
All of the following are characteristics of theprimary stageof Lyme Disease EXCEPT:
A.Erythema migrans lesion
B. Constitutional symptoms
C. Malaise, MSK symptoms
D. May resolve without treatment
A

C. Symptom of thesecondary stages

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3
Q

All of the following are characteristics of the secondary phaseof Lyme Disease EXCEPT:
A. Few weeks after tick bite
B. Erythema migrans at different site than primary lesion
C. AV conduction abnormalities
D. Bell’s palsy, aseptic meningitis
E. Persistent infection

A

E. Symptom oftertiarystage

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4
Q

All of the following are characteristics of the tertiary phaseof Lyme Disease EXCEPT:
A. Systemic febrile symptoms
B. Persistent infection
C.Migratory, recurrent oligoarticular arthritis large joints
D. Tick bite > 6 months ago

A

A

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5
Q

T/F: Erythema migrans is a clinical diagnosis of primary and secondaryLyme Disease.

A

True

Don’t wait for tests to come back before treating

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6
Q

Tertiarystage of Lyme disease diagnosed by:

A

ELISA (sensitive, not specific)
Immunoblot (detect true positives)
Serology

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7
Q

Oral treatment of Lyme Disease is treated for all of the following EXCEPT:
A. Bell’s palsy w/o meningitis
B. Primary and secondary Erythema migrans
C. Cardiac manifestations
D. Meningitis

A

D. Treated with IV

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8
Q 
All of the following are antibiotics used to treat Lyme Disease EXCEPT:
A. Amoxicillin
B. Vancomycin
C. Doxycycline
D. Cefuroxime
A

B

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9
Q 
Which of the following is NOT a symptom of Babesiosis?
A. Fatigue
B. Rash
C. Low Hemoglobin, platelets
D. Hemolysis, organ failure
E. Fever, chills, malaise
A

B

D. Presents in splenectomized patients

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10
Q

Diagnosis of Babesiosis

A

Blood smear

PCR

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11
Q

Treatment of Babesiosis

A

Atovaquone + Azithromycin

Quinine + Clindamycin

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12
Q

T/F: Babesiosis can be co-infected with Lyme Disease or Ehrlichiosis.

A

True

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13
Q

Intracellular rickettsia-like organisms infecting WBC

A

Human Granulocytic Anaplasmosis (HGA) caused by Anaplasma phagocytophilum
Human Monocytic Ehrlichiosis (HME) caused by Ehrlichia chaffeensis

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14
Q

T/F: Human Granulocytic Anaplasmosis and Human Monocytic Ehrlichoisis present clinically the same except HMA has a rash in 30% of cases.

A

Human Granulocytic Anaplasmosis and Human Monocytic Ehrlichoisis present clinically the same except HMEhas a rash in 30% of cases.

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15
Q 
Common clinical presenation of HME and HGA include all of the following EXCEPT:
A. Fever
B. Severe headache
C. Rash
D. Dry cough
A

C. Rash only seen in HME in 30% of cases

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16
Q

T/F: Thrombocytopenia is part of the diagnosis of HME and HMA.

A

True

17
Q

Treatment of HME and HMA

A

Doxycycline 100 BID x 1-2 weeks
Will also treat Lyme if co-infected

Alternatives: rifamipin, quinolones

18
Q

Rocky Mountain Spotted Fever most seen where geographically?

A

Midwestern/southeastern states

Cases in every state except Maine and Vermont

19
Q

T/F: Most cases of Rocky Mountain Spotted Fever resolve on their own.

A

False. 25% mortality if untreated

20
Q

T/F:Rocky Mountain Spotted Fever is mostly seen in the elderly.

A

False. 2/3 of cases occur in children under 15 y/o

21
Q

Rocky Mountain Spotted Fever pathogenesis

A

Endothelial cells = major target of infection
Enter –>replicate –>assemble actin tails to propel to neighboring cells
Diffuse organ dysfunction –>Loss of normal endothelium function

22
Q

T/F: Treatment of Rocky Mountain Spotted Fever should be initiatedimmediatelyAbx?

A

True

Doxycycline 100 mg q 12 hr x 7 days or until afebrile x 2 days

23
Q 
Lxodes scapularis can transmit all except:
A.Borrelia burgdorferi
B.Anaplasma phagocytophilum
C.Ehrlichia chafeesis
D.Babesia microti
A

C.Ehrlichia chageensisis transmitted by Amblyamma americanum (Lone Star tick)

24
Q

Most tick-associated infection are treated with ____Except ____ which is treated with ____

A

Most tick-associated infection are treated withdoxycycline

Exceptbabesiosiswhich is treated with atovaquone + azithormycin OR quinine + clindamycin

25
Q 
All of the following should get screened for HIVEXCEPT:
A. Pt in heath care setting
B. MSM
C. Pregnant women
D. Person in monogamous relationship
E. IV drug user
A

D. Moral of the story: You’ll get HIV if you cheat on your partner.

26
Q

T/F: Serology is a poor screening tool to catch HIV.

A

False. Serology is good at catching almost everyone.

27
Q

Median time for HIV to AIDS

A

10 years

28
Q

AIDS diagnosis = Category ___(#) + ___(letter)

A

3: CD4+ less than 200

C

29
Q

All of the following are characteristics of primary HIV infection EXCEPT:
A. CD4 > 500
B. Symptoms include rash and neurological symptoms
C. Antibodies positive during illness
D. Duration: 1-8 weeks

A

C. Except newer ab/ag tests should test positive

30
Q

Oral hairly leukoplakia, CA pneumonia, non-hodgikins lymphoma, oral/vaginal candidiasis is associated with what CD4 level?

A

CD4 = 200-500

31
Q

Pneumocystis Carinii Pneumonia associated with whatCD4 level?

A

CD4 = 100-200

32
Q

CMV, disseminated TB and dementia associated with whatCD4 level?

A

CD4 less than 100

33
Q

All of the following are associatedwithImmune Reconstitution Inflammatory Syndrome EXCEPT:
A. Low CD4 counts
B. Worsening HIV disease when treatment starts
C. Low microbial burden
D. Unrecongized opportunistic infection

A

C.Highmicrobial burden

34
Q

T/F: cART is a highly effective treatment with minimal side effects.

A

False

cART is a highly effective treatment with LOTS OFside effects.

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