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Y2S1 - SAM I > Exam 2 - more infectious diseases > Flashcards

Exam 2 - more infectious diseases Flashcards

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1
Q

What is the etiology of plague?

A

Yersinia pestis

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2
Q

What is the reservoir and transmission for plague?

A

Flea-rodent-flea reservoir
Transmission by ingestion of infected prey / flea bites
Cats highly susceptible

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3
Q

What clinical signs are consistent with plague?

A
  1. Bubonic (rodent ingestion)
    pyrexia, dehydration, lymphadenopathy, hyperesthesia
  2. Septicemic
    hematogenous spread to organs (esp lungs)
    fatal within 1-2 days
  3. Pneumonic
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4
Q

How is plague diagnosed?

A

Sample: Needle aspirates from affected tissues
Gram stain - monomorphic population of gram neg organisms (safety pin morphology)
Serology - 4x increase to confirm

REPORTABLE: submit culture samples and fixed slides

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5
Q

How is plague treated?

A

Isolate 48-72 hours and handle carefully (zoonotic)
Aminoglycosides (eg. amikacin) DOA
-chloramphenicol if CNS affected
-doxy/fluoroquinolones if aminoglycosides contraindicated

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6
Q

What is the etiology for leptospirosis?

A

Leptospira interogans sensu lato

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7
Q

What is the reservoir for leptospirosis? How is it transmitted?

A

Rats/other rodents/water sources
Viable for months in soil saturated by urine
Seen in late summer/early fall
Transmission by urine (and others)

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8
Q

What is the pathogenesis for leptospirosis?

A

Leptospires penetrate intact mms / abraded, scratched, water-softened skin.
7 day incubation and spread
*Renal colonization (renal tubular epithelial cells) - shedding in urine by 2 weeks post-infection
*Hepatic injury

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9
Q

What clinical signs are associated with leptospirosis infection?

A

Acute kidney disease
Hematemesis, hematochezia, epistaxis, petechial hemorrhages
Lung injury (‘lepto lungs’) - vasculitis with fluid exudate/pulmonary hemorrhage

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10
Q

How is leptospirosis diagnosed?

A

*Microscopic agglutination test (MAT)
Lab findings - leukocytosis, thrombocytopenia, azotemia, liver elevation
Imagine - renomegaly, interstitial to nodular alveolar densities

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11
Q

How is leptospirosis treated?

A

Parenteral ampicillin/amoxicillin (1-2 weeks)

+Doxycycline (PO for 2-3 weeks) to eliminate carrier state

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12
Q

What is the etiology for lyme disease?

A

Borrelia burgdorferi sensu stricto

Motile spirochete

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13
Q

How is lyme disease transmitted? What time of year does it occur?

A

Ixodes scapularis

Late spring/early summer infection of new hosts

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14
Q

What is the pathogenesis of lyme disease?

A

Lives in tick midgut - during blood meal OspC upregulated - movement to salivary glands - skin injection (~48 hours of attachment
Infects synovial tissue - joint fluid inflammation

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15
Q

What is lyme nephritis? What signs are seen? How is it treated?

A

Glomerulonephritis with immune complex deposition
Leads to protein loss in urine (UPC >5)
Most common in young labs and goldens
Tx as other kidney dz + immune suppression
(methylpred, ACE inhibitors, low dose aspirin, renal diet)

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16
Q

What clinical signs are associated with lyme disease?

A

Develop 2-5 months after tick bite

Fever, inappetance, polyarthritis (shifting leg lameness), generalized lymphadenopathy

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17
Q

How is lyme disease diagnosed?

A

4DX or QuantC6 (detects C6 Ab production)

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18
Q

How is lyme disease treated?

A

Doxycycline for 1 month (should respond in 1-2 days)

amoxicillin alternatively

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19
Q

What abnormality is found in ALL rickettsial diseases?

A

Thrombocytopenia

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20
Q

How are ALL rickettsial diseases treated?

A

Doxycycline

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21
Q

How are rickettsial diseases diagnosed? Which is the exception?

A

4DX

Except R. ricketsii (no in house test)

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22
Q

What is the etiology of CME? Which cells does it infect? What is its vector?

A

Ehrlichia canis
Monocytes/macros
Rhipicephalus sanguineous

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23
Q

What is the pathogenesis of CME?

A

Incubation 8-20 days
Acute phase: replication within reticuloendothelial tissues, vasculitis, PLT dysfunction, thrombocytopenia
Subclinical phase: sequestration of E. canis in spleen
Chronic phase (not all dogs): pancytopenia, death d/t hemorrhage and SBIs

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24
Q

What clinical signs are consistent with CME?

A

Acute: bleeding, neuro signs, hyphema, dyspnea, lameness
Chronic: +edema, PU/PD, SBIs

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25
In which rickettsial diseases can morulae be seen?
CGE (E. ewingii) and CGA (A. phago) | Cannot be distinguished!
26
What are the negative prognostic indicators of CME?
severe leukopenia severe anemia increased aPTT
27
What are the gold standard screening test and confirmatory tests for CME?
IFA (rarely done, 4DX easier) | Confirmation by immunoblot (at least 21 days post-infection) or PCR (4-10 days post-infection)
28
What is the etiology of CGE? Which cells does it infect? What is its vector?
Ehrlichia ewingii Neutrophils Amblyomma americanum
29
What is the pathogenesis and CS of CGE?
3-4 week incubation | Acute disease only - fever, polyarthritis, thrombocytopenia
30
What is the etiology of CGA? Which cells does it infect? What is its vector?
Anaplasma phagocytophilum Neutrophils Ixodes
31
What is the pathogenesis and CS of CGA?
Incubation 1-2 weeks Most dogs not clinical! Self-limiting febrile illness
32
What is the etiology of canine cyclic thrombocytopenia? Which cells does it infect? What is its vector?
Anaplasma platys Platelets Rhipicephalus sanguineous
33
When is canine cyclic thrombocytopenia suspected?
Thrombocytopenia with NO other signs
34
What is the etiology of RMSF? Which cells does it infect? What is its vector?
Rickettsia rickettsii Endothelial cells Rhipicephalus / Amblyomma / Dermacenter
35
Which rickettsial disease is reportable in humans, and in some places dogs?
RMSF
36
What is the pathogenesis of RMSF?
Transfer of organism in HOURS | Epithelial cell infection - vasculitis - clotting/thrombosis - DIC
37
What CS are consistent with RMSF?
``` Fever Retinal hemorrhages Neutrophilic polyarthritis Respiratory / GI signs Edema, petechiation ```
38
Describe the life cycle of toxoplasma.
- Infection by ingestion of sporozoites/bradyzoites or transplacental/translactational of tachyzoites - Rapidly dividing tachyzoites disseminate throughout host (intracellular) - Bradyzoites encyst in tissues (chronic infection) - Cat excretes oocysts with sporozoites (2 weeks)
39
What clinical signs are associated with toxoplasmosis?
Adult cats - self-limiting diarrhea Kittens/immunosuppressed - disseminated disease Dogs - neuromuscular dz or disseminated dz (puppies, rapidly fatal)
40
How is toxoplasma diagnosed?
Serology + CS (many animals are seropositive)
41
How is toxoplasma treated?
Clindamycin x4 weeks TMS if CNS infection Topical steroids for uveitis
42
Describe the life cycle/pathogenesis of neospora.
Canine ingests feces/undercooked meat (transplacental also) Acute infection (tachyzoites) Encysted bradyzoites in muscle and neuro tissue Sporulated oocysts excreted
43
What clinical signs are associated with neospora infection?
Puppies (<6 months) -Ascending paralysis, typically alert/mentally appropriate Adult dogs -multifocal CNS involvement
44
How is neospora diagnosed?
Serology
45
How is neospora treated?
Clindamycin x4-8 weeks | Treat ALL pups in a litter
46
What are the etiologies of babesia?
B. canis - dogs, large piroplasm B. gibsoni - dogs, small piroplasm B. felis - cats, Africa only
47
Describe the transmission and pathogenesis of babesia.
Ixodes tick feeds 1-3 days Sporozoites in tick saliva injected Attach to RBC and endocytosed Intracellular replication and RBC rupture
48
What clinical signs are associated with babesia infection?
``` Hemolytic anemia (many dogs subclinical) -lethargy, depression, pallor, icterus, hemoglobinuria ```
49
DDx for babesia infection?
IMHA Zinc toxicity PK/PFK deficiencies
50
How is babesiosis diagnosed?
PCR
51
How is babesiosis treated?
B. canis - Imidocarb (SLUD side effects) | B. gibsoni - Azithromycin
52
Describe the transmission and pathogenesis of cytauxzoon.
Felid host Transmitted by Amblyomma ticks Phase 1: tissue phase -Merozoites inoculated via ticks, invade mononuclear cells, infected macros occlude vessels, multi-organ failure Phase 2: erythrocytic phase -Merozoites infect RBCs (piroplasm), destruction and phagocytosis of RBCs
53
What clinical signs are associated with cytauxzoon?
Weakness, anorexia, fever Icterus, pallor Dyspnea CNS signs RAPID course (<7 days) and high fatality
54
How is cytauxzoon diagnosed?
PCR
55
How is cytauxzoon treated? What is the survival rate?
Atovaquone + azithromycin | 60% survival
56
Which species of hepatozoon is found in America? How is it transmitted?
H. americanum | Amblyomma maculatum - ticks ingested by dogs
57
Describe the transmission and pathogenesis of hepatozoon.
Dog ingests tick Sporozoites released and penetrate gut Invade mononuclear cells - organ dissemination Infection of skeletal and cardiac muscle Pyogranulomatous myositis +/- periosteal reaction (puppies)
58
What clinical signs are associated with hepatozoon infection?
Fever, progressive weight loss with good appetite Hyperesthesia and pain, rear limb ataxia Ocular discharge PU/PD
59
How is hepatozoon diagnosed?
Histo, PCR, serology | Marked leukocytosis and neutrophilia
60
What ddx should be considered for hepatozoon-associated periosteal bony changes in puppies?
Hypertrophic osteodystrophy
61
How is hepatozoon treated?
TMS + clindamycin + pyrimethane (x2 weeks) Docoquinate (x2 years) to decrease relapses *NO tx eliminates tissue phase
62
Describe the life cycle and pathogenesis of leishmaniasis
Promastigotes in female sandfly gut injected into host Amastigotes infect macrophages Dissemination to hemolymphatics Sandfly ingests amastigotes in blood
63
What clinical presentations are associated with leishmaniasis?
1. May clear organisms and become resistant 2. Asymptomatic carriers 3. Progressive immunosuppression (T-lymphoid) and immune-complex deposition lymphadenopathy, splenomegaly generalized skin lesions, NON pruritic polyarthritis, GN, vasculitis, uveitis
64
How is leishmania diagnosed?
PCR
65
How is leishmania treated and prevented?
``` Pentavalent antimonials (eg. allopurinol) *relapse very common, often tx lifelong K9 advantix repels sandflies ```
66
What is the etiology of Chagas disease?
Trypanosoma cruzi
67
Describe the pathogenesis of Chagas/trypanosoma
Kissing bug defecates into bite wound Trypomastigote (blood form) enters host and disseminates hematogenously Infects macrophages (amastigote) Migration to cardiac and skeletal muscle 2-3 weeks, trypomastigotes rupture from host cells Progressive myocardial degeneration (DCM)
68
What clinical signs are associated with Chagas/trypanosoma?
Acute disease: myocarditis (R sided failure with ascites/pleural effusion) Chronic disease: DCM
69
How is trypanosoma infection diagnosed?
Cytology, serology, PCR
70
How is Chagas/trypanosoma treated?
Anti-parasitics (eg nifurtimox / benzinidazole) *Does not stop DCM! Poor prognosis, 1-5 years
71
Which systemic mycosis is reportable in Minnesota?
Blastomycosis
72
Which species does blastomyces infect?
Dogs and humans
73
Describe the pathogenesis of blastomyces
Saprophytic mycelial form in environment - makes spores Inhalation of spores Body temp triggers transformation into yeast Incubation 1-3 months Asexual repro in body and dissemination via vessels and lymphatics
74
What are the common sites of infection for blastomyces, and which CS are expected?
Lungs (primary), eyes, skin, bone Pyrexia, anorexia, weight loss, lymphadenopathy Mycotic pneumonia
75
How is blastomycosis diagnosed?
``` Rads are variable -Diffuse interstitial miliary (classic) -Alveolar (ddx aspiration pneumonia) -Mass pattern (ddx neoplasia) Cytology: broad-based budding Antigen testing (urine sample) ```
76
How is blastomycosis treated?
Itraconazole (microencapsulated) for 6 months | NSAIDS and gluocorticoids for first few days
77
What is the prognosis for blastomycosis and what are the poor prognostic indicators?
``` 25% mortality, 20% relapse within first year PPI: -severe pulmonary involvement -CNS involvement -more than 3 body systems involved ```
78
Where is histoplasma found? What species does it infect?
Warm, humid environments (SE) | Humans, dogs, cats
79
Describe the pathogenesis of histoplasma
``` Saprophytic mycelial form Spore formed - ingested or inhaled Incubation ~2 weeks Yeast conversion in body Phagocytized by mononuclear cells Disseminates via vessels and lymphatics ```
80
What are the common sites of infection for histoplasma, and which CS are expected?
``` Lungs or intestine (primary), spleen, liver, LNs, eyes, BM, adrenals Subclinical infection common Pyrexia, anorexia, weight loss Mycotic pneumonia Diarrhea (rare in cats) ```
81
How is histoplasma diagnosed?
Diffuse interstitial miliary lung pattern Intestines may be thickened, friable, hemorrhagic Cytology - small, round yeast found intracellular (macros and neutrophils)
82
How is histoplasma treated?
Itraconazole +/- amphotericin B 4-6 months | Steroids NOT recommended
83
What is the prognosis for histoplasma and what are the poor prognostic indicators?
Good for localized respiratory Poor to fair for disseminated PPI: BNS, ocular, or bone involvement
84
Where is coccidioidomycosis found? Which species does it infect?
``` SW states (valley fever), rainfall followed by draught Dogs more often than cats ```
85
Describe the pathogenesis of coccidioidomycosis.
Saprophytic mycelial form Infective spores (arthoconidia) inhaled) Incubation 1-3 weeks Conversion to spherule, releases endospores
86
What clinical signs are consistent with coccidioidomycosis?
Most cases subclinical or mild respiratory Pregnancy/immunosuppression/massive exposure leads to severe pulmonary infection -pulmonary abscesses, fibrosis, bronchiectasis -hilar lymphadenopathy -osteomyelitis (ddx osteosarcoma) Skin lesions common in cats (relatively immune)
87
How is coccidioidomycosis diagnosed?
Tube precipitation test (IgM) - 2-3 weeks post-exp | Complement fixation Abs (IgG) - 4-6 weeks post-exp
88
How is coccidioidomycosis treated?
Any azole for 12 months (frequent relapses off therapy, may need lifelong tx)
89
What is the prognosis for coccidioidomycosis?
Good for local respiratory | Poor to fair for disseminated
90
Where is cryptococcus found? What species does it infect?
Ubiquitous and worldwide, common in bird droppings | Cats more than dogs
91
What clinical signs are consistent with cryptococcosis?
Nasal/facial deformities in cats (ddx neoplasia) | CNS signs most common in dogs
92
How is cryptococcus diagnosed?
Cytology - thick capsule
93
How is cryptococcus treated? How is tx monitored?
Itraconazole - fluconazole for CNS dz - amphotericin B if unresponsive Ag agglutination test (serum or CSF) for monitoring -tx until titer negative (6-18 months) or forever if FeLV+
94
What is the prognosis for cryptococcus? What is a favorable indicator?
Good to excellent, except if CNS dz | Decrease in titer 10x over 2 months = favorable
95
What breed develops SYSTEMIC aspergillosis?
German Shepherds
96
What is the pathogenesis for systemic aspergillosis?
Inhaled then hematogenously spread Branching fungal hyphae Multiorgan infiltrate
97
How is systemic aspergillosis diagnosed?
Cytology | Serum and urine Ag test
98
How is systemic aspergillosis treated? What is the prognosis?
Azoles, amphotericin B | Grave prognosis - no cure, 0-25 months

Y2S1 - SAM I (3 decks)

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