Ticks

Question 1

List the causative agent and vector of Lyme

Answer 1

Borrelia burgdorferi via Ixodes

Question 2

List the causative agent and vector of Relapsing fever

Answer 2

Borrelia via Ornithodoros

Question 3

List the causative agent and vector of Tularemia

Answer 3

Francisella tularenis via Dermatocentor/Amblyomma

Question 4

List the causative agent and vector of RMSF

Answer 4

Rickettsia rickettsii via Dermacentor

Question 5

List the causative agent and vector of Erlichiosis

Answer 5

Erlichia chaffeensis via Dermacentor/Amblyomma

Question 6

List the causative agent and vector of Colorado tick fever

Answer 6

Coltivirus via Dermacentor

Question 7

List the causative agent and vector of Babesiosis

Answer 7

Babesia via Ixodes

Question 8

List the causative agent and vector of Tick paralysis

Answer 8

Toxin via Dermacentor/Amblyomma

Question 9

Lyme disease cutaneous manifestations

Answer 9

1. Erythema migrans (annular lasting 3-4 weeks)
2. Borrelia lymphocytoma (bluish-red nodule early in infection on ear-lobe/nipple)
3. acrodermatitis chronica atrophicans (more common in europe, late in infection)

Question 10

Early manifestations of lyme

Answer 10

erythema migrans and prodrome of fatigue, fever, HA, arthralgias, myalgias. Tick has to be attached for 48hrs.

Question 11

Late manifestations of lyme

Answer 11

Musculoskeletal involvement (arthritis of large joints like knee), nervous system (think CN nerve palsies), and CV dz (AV blocks)

Question 12

Testing for Lyme

Answer 12

2 step diagnosis. 1st: Enzyme immunoassay or immunofloresnce assay 2nd: IgM or IgG (based on less than or greater than 30 days of symptoms) Western blot. Can have false negatives in first few weeks

Question 13

When can you see false positive ELISA titer in Lyme

Answer 13

Syphillis, Mononucelosis, RMSF, rheumatoid arthritis, SLE

Question 14

Treatment of lyme

Answer 14

Doxycycline unless a child/pregnant and then amoxicillin/cefuroxime

Question 15

STARI

Answer 15

Southern Tick associated rash illness post lone star tick bite (amblyomma americanum). Also tx with doxy. Unknown etiologic agent even though vector known.

Question 16

RMSF pathology

Answer 16

Infects the endothelium and vessel wall (see thrombocytopenia to DIC)

Question 17

RMSF clinical presentation

Answer 17

1 week after bite, viral prodrome. Rash around day for that starts on wrists and ankles then palms and soles. Petechial and blanchable. Can see splenomegaly

Question 18

Poor prognostic indicators in RMSF

Answer 18

Acute renal failure

Question 19

RMSF treatment

Answer 19

Doxycycline regardless of age

If pregnant, consider chloramphenicol

Question 20

Tick bite paralysis

Answer 20

Acute ascending flaccid paralysis
Tick has to remain for 5-7 days
Treat via removal of tick

Question 21

Tick bite granuloma

Answer 21

Residual tick bits left over causing a foreign body reaction-> nodule