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Flashcards in Lecture 12 Deck (58):
1

Types of spirochetes

treponema, borrelia, leptospira

2

What is a causitive organism for syphilis

Treponema pallidum

3

What does treponema pallidum look like?

thin walled flexible spiral roda with axial filaments which causes undulating movements

4

Is treponema pallidum grown in a culture?

NO- not grown in culture media/in cell culture

5

Transmission of Treponema pallidum

through intimate contact of skin and mucous membranes

6

Is treponema pallidum transmitted to fetus?

YES- through the placenta

7

How is Treponema pallidum related to the world?

world wide in distribution, increasing incidence, notifiable disease

8

Path of transmission of treponema pallidum

no toxins or enzymes produced. Not very invassive, not much inflammation

9

While treponema run a chronic course if not treated?

YES

10

How many stages of treponema pallidum>

3

11

Primary stage of treponema pallidum

organism multiply at site of infection- 2-10 weeks after inoculation, pt develops painless ulcer on genitals- heals spontaneously

12

Secondary stage of treponema pallidum

1-3 months later, pt develops papular rashed in palms and soles - verrucae like growth of skin + mucous membranes in genitals

13

what are condyloma lata rich in?

spirochetes

14

WHat is condyloma lata?

verrucae like growth on skin and mucous membranes of genitals

15

Will the secondary stage heal on its own?

YES

16

Part portion of people in second stage progress to third stage?

1/3

17

latent stage of 2nd stage

symptoms occur 2-3 years later

18

Tertiary stage of syphilius

granuloma formation on skin and bones, CNS manifestation, tabes dorsailes, CVS lesions

19

What is tabes dorsal is?

pt will have abnormal sensation in coordination of walking and loss of knee jerk

20

Define CVS lesions

aortitis and aneurism formation of ascending aorta

21

congenital syphilis

Organism transmitted through placenta and can cause this disease in children

22

features of congenital syphilis

depressed nose, notched teeth, interstitial keratits, nerve deafness

23

3 features of congenital syphilis are known as what...?

Hutchinson's triad

23

RPR test

rapid plasma reagin test- nonspecific antibodies (reagin) bind cardiolipin (Ag) and reagin is a mixture of IgG &IgM

24

WHen will the RPR test be positive and when will it be negative?

Positive in primary and secondary stages
Negative after treatment

25

When do you have false positives in RPR?

occurs in leprosy, Hep B/infectious mononucleosis

26

When do you have false negatives in RPR?

if Abs are in too high concentration and no flocculation can result

27

Specific Serological Tests are what?

immuno fluorescent or haemaglutinin tests

28

Treatment for syphilis

Pen G- single dose- affords total cure
for pts allergic to Penicillin, take TC/Erythromycin for prolonged period

29

What happens in the treatment of secondary syphilis with Penicillin ?

Because bacteria is so high, you will have a rxn- fever, chill, myalgia flu like symptoms because of all the dead bacteria - Jerish Herxheimer rxn

30

Prevention for Syphilis

condoms, - individuals and contact person should be treated

31

Where does Leptospira grow?

in bacteria media containing serum

32

What are reservoirs for leptospira?

mainly rats, rodents, domestic livestock, US dogs- animal urine contaminate the soil and water

33

How can you contact leptospira?

wimming in contaminated water, consuming contaminated food or drinks (common in sewage), human infection occurs through skin and mucous membrane or ingestion

34

What does leptospira affect?

any organ!- liver (jaundice), kidney (uremia), lung (hemorrhage), CNS (meningitis)- first it produces fever and later attaches organ

35

clinical manifestations in leptospira

biphasic- fever, chills, severe headache- disappear then re appear after a week with all systemic manifestations

36

What is the multi organ failure phase called?

immune phase

37

Treatment for leptospira

Penicillin G (no resistance) / doxycycline

38

What does Borrelia burgdorferi cause?

causes lyme disease

39

What medium can you see lyme disease on?

motile spirochetes can be seen with Geirmsa stain and can be grown

40

Main reservoir of lyme disease?

small mammals like white footed mouse, deer transmission among animals by tick bite

41

What states is lyme disease common in?

NY, CT, Penn, NJ

42

What is the most common vector borne disease in US?

lyme disease

43

How long does the nymph have to feed on the skin to produce infection of lyme disease?

24-48 hours

44

What parts of the body are affected by lyme disease?

heart, joints, CNS

45

How many stages of lyme disease?

3!!

46

Stage 1 of lyme disease

circular red rash at site- clear white center described as Bull's Eye- accompanied with flu like symptoms

47

Stage 2 of lyme disease

Occurs weeks or months later - cardiac and neurological involvement in this stage, cerebral palsy

48

Stage 3 of lyme disease

Arthritis of large joints (knee), chronic progressive CNS disease follows

49

lab diagnosis of lyme disease

culture not done, serological exam for IgM Ab or raising IgG Ab by ELISA test

50

Treatment of lyme disease

stage 1-doxycycline/amoxicillin
severe form- Pen G/Ceftrioxone

51

Prevention of lyme disease

protective clothing, insect repellent, examination of skin for ticks, vaccine available

52

How is Borrellia recurrent is transmitted?

from person to person by human body louse

53

What does Borrellia recurrentis produce?

relapsing fever, chills, headache, multiorgan dysfunction

54

What happens to the antigens of this organism during infection?

Ags of this organism undergo variations and cause relapse 3-10 times- each attack terminates with rising Ab

55

Diagnosis of Borrellia recurrentis

large spirochete in peripheral smear

56

Treatment of Borrellia recurrentis

Tetracycline

57

List the most common vector borne bacterial diseases in the US?

lyme disease, RMS fever, relapsing fever and Tularemia