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Paige - ID Module! > Tick lecture > Flashcards

Tick lecture Flashcards

1
Q

what are the general sx of tick-borne diseases?

A

fever/chills, aches/pains, +/- rash

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2
Q

what tick disease is a multisystem inflammatory disease

A

lyme disease

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3
Q

how does lyme disease spread

A

by tick (“Ixodes”) bites via spirochetes (“burrelia burgdoferi”)

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4
Q

what is the preferred host of ticks?

A

white tailed deer

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5
Q

what is the life cycle of the tick?

A

egg –> 6-legged larva –> eight-legged nymph –> adult

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6
Q

at which stage of the tick life cycle do ticks feed on humans? what time of year does this occur?

A

nymph stages - may to july

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7
Q

how long do ticks have to feed on you for to transmit lyme disease?

A

at least 24 hours

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8
Q

why is it that we don’t discover the tick when it first starts feeding?

A

small, and ticks have barbed beaks that release anesthetics once they penetrate the skin

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9
Q

what diseases are transmitted by the deer tick (ixodes scapularis)?

A

anaplasmosis, babesiosis, and lyme disease

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10
Q

when a person is bitten by a tick, what almost always develops and isn’t indicative of a tick-borne disease?

A

a small raised red itchy bump at the site of the bite

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11
Q

what disease does the agent anaplasma phagocytophilum carry?

A

anaplasmosis

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12
Q

what is the animal reservoir for anaplasmosis?

A

deer and white-footed mouse

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13
Q

what is anaplasmosis/HGA?

A

human granulocytic anaplasmosis - a bacterial infection that infects WBCs (granulocytes)

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14
Q

how long does it take for a tick to transmit anaplasmosis?

A

24-48 hours

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15
Q

what other disease does anaplamosis very closely mimic?

A

ehrlichiosis

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16
Q

What is STARI?

A

southern tick associated rash illness of unknown cause

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17
Q

what are the sx of STARI?

A

rash similar to lyme disease, but no arthritic, neurologic, or chronic sx

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18
Q

what tick carries STARI and where can it be found?

A

the lonestar tick - in southeast america

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19
Q

how long is the incubation period for anaplasmosis once contracted?

A

1-2 weeks

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20
Q

what are the sx of anaplasmosis?

A

fever/chills, HA, malaise, myalgias, arthralgia. may have cough, stiff neck, GI upset

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21
Q

what lab findings will you find with anaplasmosis?

A

mild anemia, thrombocytopenia, leukopenia with left shift, elevated LFTs

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22
Q

how do you dx anaplasmosis (and babesiosis)?

A

PCR

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23
Q

how do you treat anaplasmosis?

A

doxycycline

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24
Q

what is babesiosis?

A

a parasitic infection from a tick, caused by protozoa, and infects RBCs and causes hemolysis

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25
Q

what is the reservoir for babesiosis?

A

rodents and small mammals

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26
Q

where does babesiosis occur?

A

northeast coast of US

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27
Q

how long is the incubation period for babesiosis?

A

1-3 weeks.

if from infusion, 6-9 weeks

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28
Q

what are the sx of babesiosis?

A

fever/chills/sweats, myalgias, arthralgias, fatigue, N/V (surprise!)

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29
Q

what will you find on physical exam of babesiosis?

A

splenomegaly, hepatomegaly, jaundice

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30
Q

what are the risk factors for babesiosis?

A

over 50, immunocompromised

31
Q

how do you treat a person with asx babesiosis?

A

none, monitor 4-6 weeks if you want

32
Q

how do you treat babesiosis?

A

clindamycin/quinine or atovaquone/azithromycin

33
Q

what are the sx of lyme disease?

A

erythema migrans (bullseye rash), muscle/joint pain, fatigue, chills/fever, HA, swollen lymph nodes

34
Q

what is the early presentation of lyme disease in a person who doesn’t have a rash?

A

arthralgias, HA (occipital), paresthesias

35
Q

what is lyme carditis?

A

a fluctuating AV block caused by lyme disease

36
Q

what neurological sx might you get with lyme disease?

A

cranial neuritis AKA bell’s palsy,
lymphocytic meningitis,
radiculoneuritis

37
Q

what sx show up in late lyme disease (> 6 mos)

A

arthritis and more severe neuro sx

38
Q

how do you dx lyme disease?

A

serologic tests - confirm dx;

Elisa and Western blot

39
Q

what can you give in the early phases of lyme disease that might prevent seroconversion?

A

abx

40
Q

what Ab do you look for if

A

IgM and IgG

41
Q

what Ab do you look for if >4 weeks of illness?

A

IgG

42
Q

how long do lyme Ab stay in blood?

A

many years - can’t determine relapse vs reinfection

43
Q

how do you treat lyme disease?

A

doxycycline

44
Q

if a person has extremely severe lyme disease sx, what do you treat with?

A

IV ceftriaxone

45
Q

what are the 3 long-term sequellae of treated lyme disease?

A
  1. persistent arthritis (usually knee) for 4-5 years
  2. residual neurologic impairment
  3. post-lyme syndrome for >6 months with MSK pain, cognitive complaints, fatigue
46
Q

if a person is having lyme symptoms and has a positive lyme titer, does that mean lyme is causing the symptoms?

A

No. Most people who get lyme have no symptoms. If a person has non-specific symptoms with a + lyme titer, it doesn’t necessarily mean that the person is having these sx due to lyme.

47
Q

what are the 4 conditions when you would give tick bite prophylaxis (e.g. a person was bitten but doesn’t have lyme sx)

A

(1) tick has been identified as an engorged deer tick and has been attached over 36 hours
(2) it’s a high exposure area
(3) it has been within 72 hours of the bite
(4) doxy is not c/i in the patient

48
Q

what does the bacteria rickettsia ricketsiae cause?

A

rocky mountain spotted fever

49
Q

what animals carry rocky mtn spotted fever?

A

dogs

50
Q

if untreated, what is the prognosis?

A

high mortality

51
Q

what are the sx of rocky mtn spotted fever

A

a fine skin rash, high fever, HA, muscle pain, GI sx

52
Q

what 2 drugs do you use to treat rocky mtn spotted fever?

A

doxycycline and chloramphenicol

53
Q

where is the MC place to get rocky mtn spotted fever?

A

maryland

54
Q

what months do cases of rocky mtn spotted fever occur?

A

april to sept

55
Q

in what population is rocky mtn spotted fever MC in?

A

children, males

56
Q

what are long-term sequellae of rocky mtn spotted fever?

A

CNS issues, amputations, death

57
Q

which type of tick transmits tularemia?

A

american dog tick, lone star tick, and rocky mountain wood tick

58
Q

how can tularemia be transmitted?

A

deer fly bites, inhalation, ingestion, skin contact with infected animals

59
Q

what animals carry tularemia?

A

rodents

60
Q

what vectors carry tularemia?

A

ticks, biting flies, mosquitoes

61
Q

is tularemia common

A

no

62
Q

how can you contract tularemia?

A

ingestion, inhalation, direct contact, arthropods, animal bites

63
Q

can you spread tularemia person to person?

A

no

64
Q

if this is so rare, why are we talking about it?

A

HIGHLY infectious; tick-borne; bioterrorism agent

65
Q

what will you see on PE with tularemia?

A

ulcers

66
Q

how do you dx tularemia?

A

PCR

67
Q

how do you tx tularemia?

A

streptomycin, gentamicin, FQs

68
Q

what is the definition of relapsing fevers?

A

recurrent cycles of febrile episodes, separated by asx intervals of apparent recovery

69
Q

what organism causes relapsing fevers?

A

borellia

70
Q

what are the 3 main causes of relapsing fever?

A

(1) louse-borne relapsing fevers
(2) trench fever
(3) epidemic typhus

71
Q

what are the 3 types of lice?

A

(1) head lice
(2) body lice* spreads disease!
(3) pubic lice

72
Q

how do you pull a tick off of the skin?

A

tweezers, apply antiseptic to the bite

73
Q

can you touch a tick with your bare hands?

A

you shouldn’t (even though my mom just picks them off my dogs with her fingers and pops it between her fingernails……. ew)

Paige - ID Module! (7 decks)

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