tick borne diseases

Question 1

lyme disease is caused by

Answer 1

borreliella transmitted by ixodes ticks

Question 2

what type of bug is borreliella. burgo and miyamoto

Answer 2

spirochetes

Question 3

how do ticks adapt to host?

Answer 3

changes in gene expression

Question 4

identifying ticks

Answer 4

polyclonal ab

Question 5

lyme disease course (3)

Answer 5

1. early and localized- days to 2 weeks “regional erythema”
2. early, disseminated- days to months “AV block”
3. late- months to years “arthritis”

Question 6

immune evasion by Borreliella. burgo

Answer 6

antigenic variation

Question 7

preferred way to diagnosis of Lyme

Answer 7

serology however, do not use if there is a clinical diagnosis of lyme disease

Question 8

lyme disease serology

Answer 8

Both IgM and IgG may remain positive for years after treatment of infection

Question 9

lyme disease serology process/test

Answer 9

2 step:

1. elisa
2. western blot

Question 10

treatment for lyme disease (4)

Answer 10

1. tetracyclines
2. penicillin
3. cephalosporins- cefuroxime and ceftriaxone
4. macrolides

Question 11

SE of antibotic use for lyme disease

Answer 11

Jarish herxheimer

Question 12

prevention of lyme disease

Answer 12

1. tick avoidance

2. antibiotic prophylaxis

Question 13

BORRELIA MIYAMOTOI

Answer 13

relapsing fever causing meningitis in immuno-compromised patients

Question 14

BORRELIA MIYAMOTOI

testing

Answer 14

cross react with borrelia. burgo

Question 15

BORRELIA MIYAMOTOI

treatment

Answer 15

same as Borrelia burgo

Question 16

two very related intracellular infections of white cells

Answer 16

ehrlichiosis and anaplasmosis

Question 17

lone star tick

Answer 17

Human monocytic ehrlichiosis

Question 18

• Present in the South central and South eastern U.S.

Infects monocytes

Answer 18

HME= Human monocytic ehrlichiosis

Question 19

Present in Northeastern and upper midwestern U.S.

Infects neutrophils

can be co-transmitted with B. burgdorferi and B. microti

Answer 19

HGA= human granulocytic anaplasmosis

Question 20

best way to diagnose EHRLICHIOSIS/ANAPLASMOSIS

Answer 20

PCR of blood

Question 21

treatment of EHRLICHIOSIS/ANAPLASMOSIS

Answer 21

doxycycline

Question 22

______ are small intra-erythrocytic parasites

Occurs primarily in U.S. and Europe

Transmitted by Ixodes ticks, blood transfusion

Major species causing disease are B. microti and B. divergens

Answer 22

Babesia

Question 23

best way to diagnose babesiosis

Answer 23

visualization of parasites on blood smear

Question 24

treatments for babesiosis

Answer 24

typically not necessary

1. azithromycin
2. clindamycin
3. exchange transfusion

Question 25

Can be spread by either lice (epidemic) or ticks (endemic)
Tick borne RF occurs sporadically throughout North and South America, Asia and Africa
Louse borne disease occurs in areas of poor sanitation
Epidemic-Borrelia recurrentis
Endemic- Borrelia hermsii, B. parkerii, B. turicatae

Answer 25

relapsing fever

Question 26

clinical syndrome for relapsing fever

Answer 26

cyclical fevers with relapses.

Question 27

why in relapsing fever are relapsing?

Answer 27

throught to be due to escape of the bacteria from immune containment by antigenic variation

Question 28

best diagnosis for relapsing fever

Answer 28

direct visualization from blood

Question 29

treatment for relapsing fever

Answer 29

1. Tetracyclines (e.g. doxycyline)
2. Penicillin (or Amoxicillin)
3. Cephalosporins (e.g. Ceftriaxone)
4. Macrolides

Question 30

Caused by Rickettsia rickettsii

Other Rickettsia causing human disease include: R. akari (rickettsialpox), R. prowazeki (typhus), Orientia tsutsugamushi (scrub typhus)

Closely related to Ehrlichia and Anaplasma

Answer 30

rocky mountain spotted fever

Question 31

rocky mountain spotted fever affect that ares of the body

Answer 31

palm and soles

Question 32

classic triad for rocky mountain spotted fever

Answer 32

1. fever
2. headache
3. rash

Question 33

best diagnosis for rocky mountain spotted fever

Answer 33

serology but only use it if you have a high suspicion

Question 34

treatment of rocky mountain spotted fever

Answer 34

1. doxycyline

2. chloramphenicol