Lecture 177

Question 1

What pathogen causes bubonic and pneumonic plague?

Answer 1

Yersinia pestis

Question 2

What pathogen causes enterocolitis and pseudoappendicitis?

Answer 2

Yersinia enterocolitica

Question 3

What zoonotic microbe is a gram-negative, facultative anaerobic rod that is resistant to cold?

Answer 3

Yersinia

Question 4

What type of secretion system injects proteins into host cells, resisting phagocytosis and inhibiting cytokine production/inflammation?

Answer 4

Type III secretion system

Question 5

What type of secretion system does Yersinia species display?

Answer 5

Type III secretion system

Question 6

What is the reservoir for Y. pestis?

Answer 6

Rodents/cats

Question 7

How does Y. pestis spread to humans?

Answer 7

Via infected flea bites

Question 8

How is Y. enterocolitica acquired?

Answer 8

Contaminated meat, milk, or water

Question 9

What zoonotic disease is characterized by fever and painful, swollen lymph nodes (buboes), typically in the axilla/groin?

Answer 9

Bubonic plague (Y. pestis)

Question 10

What high mortality zoonotic disease results in fever and pulmonary symptoms within 1 day?

Answer 10

Pneumonic plague (Y. pestis)

Question 11

What zoonotic disease is characterized by diarrhea, fever, abdominal pain lasting 1-2 weeks; affects the terminal ileum and mesenteric lymph nodes?

Answer 11

Enterocolitis (Y. enterocolitica)

Question 12

What zoonotic pathogen must be grown on cefsulodin-irgasan-novobiocin (CIN)?

Answer 12

Yersinia

Question 13

What zoonotic pathogen presents as an encapsulated, gram-positive, obligate aerobe that forms long chains of rods?

Answer 13

Bacillus anthracis (anthrax)

Question 14

What bacillus anthracis toxin binds to cells, allowing entry of edema factor and lethal factor?

Answer 14

Protective antigen (PA)

Question 15

What bacillus anthracis toxin combines with protective antigen to form edema toxin?

Answer 15

Edema factor (EF)

Question 16

How does bacillus anthracis edema toxin cause edema?

Answer 16

Increases intracellular cAMP

Question 17

What bacillus anthracis toxin targets MAP kinases to inhibit innate immunity, causing necrosis?

Answer 17

Lethal factor (LF)

Question 18

Bacillus anthracis is primarily a disease of ____

Answer 18

Herbivores (livestock)

Question 19

What zoonotic disease begins as a painless papule that ulcerates and becomes surrounded by vesicles, developing into a characteristic black, necrotic eschar, often with painful edema and LAD?

Answer 19

Cutaneous anthrax

Question 20

Necrosis in cutaneous anthrax is caused by ____

Answer 20

Lethal factor (LF)

Question 21

What zoonotic infection causes upper GI involvement of regional LAD, sepsis, and edema and lower GI involvement of nausea, vomiting, and malaise?

Answer 21

Gastrointestinal (GI) anthrax

Question 22

What zoonotic infection is taken up by alveolar macrophages and is transported to mediastinal lymph nodes where it progresses rapidly to mediastinal widening/LAD and death within days?

Answer 22

Inhalation anthrax

Question 23

What zoonotic microbe appears as non-hemolytic colonies with a ‘ground-glass’ surface on standard media and reveals a capsule under India ink stain?

Answer 23

Bacillus anthracis

Question 24

What does empiric therapy for anthrax often include?

Answer 24

Ciprofloxacin or doxycycline

Question 25

What zoonotic disease does borrelia burgdorferi cause?

Answer 25

Lyme disease

Question 26

What zoonotic disease does borrelia recurrentis cause?

Answer 26

Relapsing fever

Question 27

What is the shape of borrelia?

Answer 27

Spirochetes (spiral-shaped)

Question 28

How is B. burgdorferi transmitted?

Answer 28

Ixodes ticks

Question 29

How is B. recurrentis transmitted?

Answer 29

Human body louse

Question 30

How does B. recurrentis evade host immune response and cause recurring episodes of fever?

Answer 30

Undergoes antigenic variation

Question 31

Expanding skin rash, creating a bulls-eye appearance

Answer 31

Erythema migrans (EM)

Question 32

Zoonotic microbe described as a thin, flexible spirochete with characteristic hooked ends with flagella

Answer 32

Leptospira

Question 33

Where do Leptospira reservoir hosts carry the bacteria?

Answer 33

Renal tubules

Question 34

Where do over half of leptospirosis cases occur in the USA?

Answer 34

Hawaii

Question 35

What is the incubation period of leptospirosis?

Answer 35

1-2 weeks

Question 36

What zoonotic infection involves a biphasic illness where the second phase emerges after a brief remission, with return of fever and earlier symptoms and development of more severe illness?

Answer 36

Leptospirosis

Question 37

Weil disease is a severe form of what zoonotic infection?

Answer 37

Leptospirosis

Question 38

What form of leptospirosis presents as an icteric form, involving hepatic and renal dysfunction, hemorrhage, vascular collapse, and potentially respiratory distress?

Answer 38

Weil disease

Question 39

How is leptospirosis antibody detection performed?

Answer 39

Microscopic agglutination test (MAT)

Question 40

How are moderate/severe cases of leptospirosis treated?

Answer 40

IV penicillin or doxycycline

Question 41

What antibiotic can be used for short-term prevention of leptospirosis in high-risk exposure situations?

Answer 41

Doxycycline

Question 42

What disease does Rickettsia rickettsii cause?

Answer 42

Rocky mountain spotted fever (RMSF)

Question 43

What zoonotic pathogen is an obligate intracellular gram-negative rod that targets endothelial cells lining blood vessels?

Answer 43

Rickettsia rickettsii

Question 44

What is the vector for Rickettsia rickettsii?

Answer 44

Hard ticks

Question 45

Adherence of Rickettsia rickettsii of endothelial cells is mediated by ____

Answer 45

Outer membrane protein A (OmpA)

Question 46

What zoonotic infection presents with a rash that starts as small, flat, pink, non-itchy spots (macules) on wrists, forearms, and ankles which spreads centrally to the trunk?

Answer 46

Rocky mountain spotted fever

Question 47

What characteristic of rocky mountain spotted fever is a poor prognostic sign?

Answer 47

The presence of petechial rash

Question 48

What is the drug of choice for treatment of Rocky Mountain Spotted Fever?

Answer 48

Doxycycline

Question 49

What zoonotic microbes causes Epidemic typhus?

Answer 49

Rickettsia prowazekii

Question 50

What zoonotic microbe causes Brill-Zinsser disease?

Answer 50

Rickettsia prowazekii

Question 51

What is the vector of Rickettsia prowazekii?

Answer 51

Human body louse

Question 52

What zoonotic disease presents with abrupt onset fever, headache, chills, and rash that starts on the trunk and spreads outwards, often sparing palms and soles?

Answer 52

Epidemic typhus

Question 53

What zoonotic disease is a recurrent form of epidemic typhus occurring months to years after primary infection?

Answer 53

Brill-Zinsser disease

Question 54

How is Brill-Zinsser disease treated?

Answer 54

Doxycycline

Question 55

Anaplasma and ehrlichia infect white blood cells and form characteristic clumps known as ____

Answer 55

Morulae

Question 56

Ehrlichia chaffeensis primarily infects ____

Answer 56

Monocytes

Question 57

Anaplasma phagocytophilum primarily infects ____

Answer 57

Granulocytes (neutrophils)

Question 58

What is the vector for Ehrlichia?

Answer 58

Lone star tick

Question 59

What is the vector for Anaplasma?

Answer 59

Ixodes tick

Question 60

High fever, headache, malaise, and muscle aches and lab findings of leukopenia, thrombocytopenia, and elevated liver transaminases are suggestive of what two zoonotic infections?

Answer 60

Human monocytic ehrlichiosis (HME) and human granulocytic anaplasmosis (HGA)

Question 61

How is HME and HGA treated?

Answer 61

Doxycycline

Question 62

What zoonotic infection exists in small-cell variants and large-cell variants?

Answer 62

Coxiella burnetii

Question 63

What disease does coxiella burnetii cause?

Answer 63

Q fever

Question 64

Where in sheep, goats, and cattle is Coxiella burnetii highly concentrated?

Answer 64

Birth products

Question 65

What zoonotic infection is typically asymptomatic and or mild, but when symptomatic it presents with high fever, debilitating fatigue, severe headache, and muscle aches?

Answer 65

Acute Q fever

Question 66

What is the most common manifestation of chronic Q fever?

Answer 66

Endocarditis

Question 67

How is acute Q fever treated?

Answer 67

2 weeks doxycycline

Question 68

How is chronic Q fever treated?

Answer 68

Prolonged combination therapy, doxycycline plus hydroxychloroquine for at least 18 months

Question 69

What disease is caused by Francisella tularensis?

Answer 69

Tularemia

Question 70

Francisella tularensis requires specific media enriched with ____ for growth

Answer 70

Cysteine

Question 71

What is the vector for francisella tularensis?

Answer 71

Ticks and biting flies

Question 72

What is the most common clinical form of tularemia?

Answer 72

Ulceroglandular

Question 73

What clinical form of tularemia results from skin inoculation, leading to an ulceration with painful regional lymphadenopathy, fever, chills, headache, and malaise?

Answer 73

Ulceroglandular

Question 74

What clinical form of tularemia is similar to the ulceroglandular type but without the skin ulcer; lymphadenopathy is the primary feature?

Answer 74

Glandular

Question 75

What clinical form of tularemia results from bacteria entering the right, resulting in painful conjunctivitis, ulceration, and regional lymphadenopathy?

Answer 75

Oculoglandular

Question 76

What clinical form of tularemia results from ingestion, leading to a sore throat, pharyngitis, tonsillitis, swollen cervical lymph nodes, or abdominal pain, vomiting, and diarrhea?

Answer 76

Oropharyngeal/GI

Question 77

What clinical form of tularemia results from inhalation of aerosols, leading to pneumonia, chest pain, and cough?

Answer 77

Pneumonic

Question 78

What clinical form of tularemia presents as a systemic illness without clear localization?

Answer 78

Typhoidal

Question 79

What is the treatment of choice for tularemia?

Answer 79

Gentamicin

Question 80

What disease does streptobacillus moniliformis cause?

Answer 80

Rat bite fever

Question 81

What zoonotic infection presents as abrupt onset of irregular fever, chills, HA, vomiting, migratory polyarthralgia, and a maculopapular, petechial, or purpuric rash involving the extremities, including palms and soles?

Answer 81

Rat bite fever

Question 82

What is the drug of choice for rat bite fever?

Answer 82

Penicillin

Question 83

What disease does brucella cause?

Answer 83

Undulant fever

Question 84

What is the most common route of transmission of brucella?

Answer 84

Consumption of unpasteurized/raw dairy products

Question 85

Where does brucella typically reside in the human body?

Answer 85

Reticuloendothelial system (macrophages)

Question 86

What causes recurrent symptoms in brucellosis?

Answer 86

Periodic release from infect cells into the bloodstream

Question 87

What zoonotic illness presents as non-specific flu-like illness with profuse night sweats, and a characteristic waxing and waning fever pattern, often rising in the afternoon/evening and falling by morning?

Answer 87

Brucellosis

Question 88

What is the standard regimen for treating brucellosis?

Answer 88

Doxycycline plus rifampin for 6 weeks

Question 89

How are pregnant women and children treated for brucellosis?

Answer 89

TMP-SMX