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MICRO > Ch2: Skin, Musculoskeletal, Blood and Lymph Part I > Flashcards

Ch2: Skin, Musculoskeletal, Blood and Lymph Part I Flashcards

1
Q

What is Borrelia?

A

Extracellular, irregularly, loosely coiled spirochete

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2
Q

What are the 3 infections caused by Borrelia?
Reservoir for each?
Vector for each?

A

Relapsing Fever Epidemic: Humans (Body Louse)

Relapsing fever endemic: Rodents, soft ticks (Soft ticks)

Lyme disease: Rodents, deer, pets, hard ticks (Hard ticks)

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3
Q

Why does borrelia show up in waves in blood smears over time?
Clinically how do this present?

A

Antigenic variation

Relapsing fever

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4
Q

Both types of relapsing fever have what symptoms? (5)

A
  1. Acute onset of high fever with rigors
  2. Severe headache
  3. Myalgias
  4. Arthralgias
  5. Lethargy
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5
Q

Diagnosis of borrelia hermsii is done how?

Specifically how? 2

A

Identification of spirochetes in blood smears

  1. Look for outer membrane with flagella in periplasmic space
  2. Corkscrew motion of flagella
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6
Q

If Borrelia hermsii stains at all in gram stain, how will it stain?

A

Positive

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7
Q

Control for borrelia?

A

Avoid habitat of the vectors

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8
Q

treatment of borrelia hermsii? (4)

A
  1. Tetracycline (#1)
  2. Chloramphenicol
  3. Doxycycline
  4. Erythromycin
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9
Q

Borrelia burgdorferi (Lyme disease) is different from B. hermsii how?

A

Smaller

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10
Q

Reservoirs for B. burgdorferi? (3)

A

Deers
Deer mice
Birds

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11
Q

Vector for B. burgdorferi?

A

Deer tick/Hard tick

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12
Q

What form of ticks is small, overloked and feeds on many types of animals?

A

Nymphs

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13
Q

The longer the tick is attached, the better what is?

A

Chance of transmission

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14
Q

Who engorge faster, nymphs or adults?

A

Nymphs

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15
Q

Who has a painless bite, adults or nymphs?

A

Nymphs

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16
Q

Nymphs are prevalent during what months?

A

Spring and summer

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17
Q

What are the steps for tick transmission?

A
  1. Engorge slowly

2. Transmit afterawhile

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18
Q

What are the 3 stages of b. burgdorferi disease/lyme disease?

A

Stage 1: Acute lyme disease
Stage 2: Chronic lyme disease
Stage 3: Chronic monoarthritis and migratory polyarthitis

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19
Q

Acute lyme disease/stage1 has what two components? 2

A
  1. Target shaped rash: Erythema migrans

2. Flu-like symptoms

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20
Q

How long does erythema migrans last?

A

A week

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21
Q

Chronic lyme disease has what manifestations? 3

A
  1. Cardiac
  2. Neurologic
  3. Skin
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22
Q

The stage 3 arthritis is due to what?

A

Immune complex mediated Hypersensitivity Type III

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23
Q

Laboratory diagnosis has what 3 parts?

A
  1. Characteristic symptoms
  2. Exposure in endemic area
  3. Positive Ab response to B. burgdorferi OR Erythema migrans
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24
Q

What do you culture B. burgdorferi in to determine diagnosis?

A

Barbour-Stoenner-Kelly (BSK) medium

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25
Q

How is PCR used in diagnosing B. burgdorferi?

A

Detect in joint fluid

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26
Q

What is most important feature in diagnosig b. burgdorferi?

A

Antibody positive test

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27
Q

Control and treatment for borrelia burgdorferi? (4)

Most important?

A
  1. Doxycycline: Most important
  2. Amoxicillin
  3. Erythromycin
  4. Ceftriaxone: later manifestations
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28
Q

Rickettsia species is what size?
Gram stain result?
Shape?

A

Small

Gram negative

Coccobacilli

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29
Q

What metabolic feature is unique to Rickettsia?

A

Unique transport systems for NAD and ATP

30
Q

What can some species of Rickettsia polymerize?

A

Actin

31
Q

Are all Rickettsia zoonoses?

Exception?

A

Yes

Rickettsia prowazekii

32
Q

Are all Rickettsia vector borne?

A

Yes: Lice, ticks, fleas, mites

33
Q

Rocky mountain spotted fever is caused by what?
Vector?
Reservoir?

A

R. rickettsii
Tick
Tick and wild rodents

34
Q

Rickettsialpox is caused by what?
Vector?
Reservoir?

A

R. akari
Mites
Mites and wild rodents

35
Q

Scrub typhus is caused by what?
Vector?
Reservoir?

A

O. tsutsugamushi
Mite
Mites and wild rodents

36
Q

Epidemic typhus is caused by what?
Vector?
Reservoir?

A

R. prowazekii
Louse
Humans, squirrel fleas, flying squirrels

37
Q

Murine endemic typhus is caused by what?
Vector?
Reservoir?

A

R. typhi
Fleas
Wild rodents

38
Q

All Rickettsia preferentially infect and replicate within what?
How does this show up?

A

Endothelial cells lining small blood vessels

Vascular leakage and red dots

39
Q

Clinical manifestations of Rickettsia result from what?

A

Infection of endothelial cells –> Vasculitis (Primary reason for signs)

40
Q

What determines symptoms of Rickettsia?

What is prominent in all? 2

A

Organs involved

Skin rashes
Pneumonia is common

41
Q

When does Rickettsia typically turn deadly?

A

After getting pneumonia

42
Q

Laboratory diagnosis of Rickettsia? 5

Which is most common?

A
  1. Culture embryonated eggs or tissue culture
  2. Immuno staining of tissue samples for Rickettsia antigens
  3. Serology: Most common
  4. PCR
  5. Stain with Giemsa or Gimenez stain
43
Q

Control of Rickettsia?

A

Limiting exposure (avoid the vector habitat)

44
Q

Treatment of Rickettsia?

A

Tetracyclines

45
Q

What are the four members of the spotted fever group of Rickettsia?
Species with each?

A

Rocky mountain spotted fever: R. rickettsii
Mediterranean spotted fever: Rickettsia conorii
Rickettsialpox: Rickettsia akari
Others: R. sibirica, australis, japnoica

46
Q

What symptom dominates in spotted fever group?

A

Rash

47
Q

The members of the typhus group of Rickettsia? 2

Species for each

A

Epidemic typhus: R. prowazekii

Endemic murine typhus: Rickettsia typhi

48
Q

What symptom dominates typhus group?

A

Fever

49
Q

R. Rickettsii can polymerize what?

Allows it to do what?

A

Actin

Move intracellularly from cell to cell

50
Q

Reservoirs of r. Rickettsia?

Vectors?

A

Wild rodents

Ticks (Dermacentor species) Wood ticks, dog ticks

51
Q

Rocky mountain spotted fever is seen most where? (2)

A
  1. Eastern seaboard

2. SE USA

52
Q

Describe the rash in R. Rickettsia?

A

Hemorrhagic rash starting with palms and soles and spreads centripetally (From extremities to torso)

53
Q

What respiratory manifestation is seen commonly in R.Rickettsia causing death?

A

Pneumonia

54
Q

In Classic RMSF, death occurs when?

A

7 to 15 untreated days after onset of symptoms

55
Q

In fulminant (fast) RMSF, death occurs when?

A

First 5 days

56
Q

What is the reservoir for rickettsia akari?

What is the vector?

A

House mouse

Mite ectoparasite

57
Q

Human disease caused by rickettsia akari?
Similar to what?
Is it fatal?
What is the triad of symptoms in r. akari?

A

Rickettsial pox

Chicken pox

Not fatal

Fever, Rash, Eschar

58
Q

Diagnosis and treatment for r. akari?

A

Same as other rickettsia (Tetracycline)

59
Q

Ricketssia prowazekii has what reservoir? 2

Vector for humans? (2)

A

Humans and Flying squirrels

Human head and body louse

60
Q

How does ricketssia prowazekii get into blood stream?

A

Louse gets on human skin –> Rickettsiae shed in louse feces –> Human scratches

61
Q

Human disease from rickettsia prowazekii?

A

Epidemic typhus

62
Q

Two main symptoms of epidemic typhus?

A
  1. Skin rash of macules that disappear on pressure and maculopapules with petechiae that do NOT involve face, palms, or soles and spreads centrifugally (Torso –> Outward)
  2. Pneumonia: Fatal
63
Q

What is the recurrent form of epidemic typhus called?

A

Brill-Zinsser disease

64
Q

Laboratory diagnosis for epidemic typhus is what?

And when is this detected?

A

Detection of a 4X rise in Ab titer in convalescence

Second week of illness

65
Q

Rickettsia typhi
Reservoir?
Vector?
Human disease name?

A

Rats
Rat fleas
Endemic murine typhus

66
Q

How does r. typhi caused endemic typhus compare to epidemic typhus?

A

Similar but not as severe

67
Q

Diagnosis and treatment for R. typhi?

A

Same as R. prowazekii

68
Q

What causes scrub typhus?

A

Orientia tsutsugamushi

69
Q

Orientia tsutsugamushi
Size and shape?
Gram stain?
Type of metabolism?

A

Small coccobacillus

Gram negative

70
Q

Orientia tsutsugamushi
Reservoir?
Vector?
Habitat of vector

A

Rodents
Chiggers
Scrub

MICRO (22 decks)

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