Multisystem II: Tick-Borne Infections

Question 1

Rickettsiae are (G+ve/G-ve?), (motile/non-motile?) bacteria

Answer 1

Rickettsiae are G-ve, non-motile bacteria

Question 2

the major endemic areas of Rickettsia rickettsii are which 5 states?

Answer 2

• NC
• Oklahoma
• SC
• Tennessee
• Arkansas

Question 3

after entering through the skin, R. rickettsii spread via bloodstream to infect ____/____ cells

Answer 3

after entering through the skin, R. rickettsii spread via bloodstream to infect endothelium/vascular smooth muscle cells

Question 4

after R. rickettsii infects ____ cells, ___ leak from breaks in vessels which results in ____

Answer 4

after R. rickettsii infects endothelial cells, RBCs leak from breaks in vessels which results in rash & petechial lesions

Question 5

which 2 clinical features strongly suggest RMSF diagnosis?

Answer 5

thrombocytopenia and hyponatremia

Question 6

the red-to-purple spotted (petechial) rash of RMSF is usually not seen until ____

Answer 6

the red-to-purple spotted (petechial) rash of RMSF is usually not seen until the 5th day/later after onset of symptoms

Question 7

list further complications of RMSF

Answer 7

Question 8

____ test is an immunohistochemical antigen detection test for diagnosing infection with R. rickettsii

Answer 8

Weil-Felix test is an immunohistochemical antigen detection test for diagnosing infection with R. rickettsii

Question 9

Lyme disease is caused by ___ (organism)

Answer 9

Lyme disease is caused by Borrelia burgdoferi

Question 10

B. burgdorferi produces ____ that mediate binding to ____ & ____

Answer 10

B. burgdorferi produce adhesins that mediate binding to GAGs & integrins

Question 11

spirochetes can evade host response due to its resistance to ___ via ___ proteins and _____

Answer 11

spirochetes can evade host response due to its resistance to complement-mediated killing via Factor H proteins and antigenic variation

Question 12

infection with B. burgdoferi induces synthesis of ___ and ___

Answer 12

infection with B. burgdoferi induces synthesis of proinflammatory & anti-inflammatory cytokines and chemokines (Type I IFNs)

Question 13

the initial tick bite causes a rash called ____

Answer 13

the initial tick bite causes a rash called erythema chronicum migrans (ECM) which is a slowly expanding red ring (Bull’s eye rash)

Question 14

describe further complications of Lyme disease

Answer 14

Question 15

describe the diagnosis of Lyme disease

Answer 15

Question 16

in diagnosing Lyme disease,

the first test is ____

and the second test for confirmation is ____

Answer 16

in diagnosing Lyme disease,

the first test is enzyme immunoassay (EIA)/immunofluorescence assay (IFA)

and the second test for confirmation is Western blot

Question 17

Answer 17

Question 18

the vector for Leishmania is ____

Answer 18

the vector for Leishmania is sand fly

Question 19

the infective stage of Leishmania is the ___ stage

while

the diagnostic stage of Leishmania is the ____ stage

Answer 19

the infective stage of Leishmania is the promastigote stage

while

the diagnostic stage of Leishmania is the amastigote stage

Question 20

list the 3 basic outcomes of Leishmaniasis

Answer 20

1. self-limiting infxn
2. fulminating rapidly fatal disease
3. chronic debilitating process

Question 21

in Leishmaniasis, parasites invade ____ which causes marked enlargement of ___ and ____

Answer 21

in Leishmaniasis, parasites invade RES which causes marked enlargement of liver and spleen

Question 22

successful treatment of Leishmaniasis can lead to _____ on the skin which is also called “post _____”

Answer 22

successful treatment of Leishmaniasis can lead to depigmented granulomatous eruptions on the skin on the skin which is also called “ post-kala-azar dermal leishmaniasis”

Question 23

____ is the best tool for parasitic identification

Answer 23

microscopic identification is the best tool for parasitic identification

Question 24

Answer 24

Question 25

the vector for Trypanosomiasis is \_\_\_\_

Answer 25

the vector for Trypanosomiasis is **Reduviid bug aka Kissing bug**

Question 26

infection in Trypanosomiasis occurs when infected bug feces are \_\_\_\_\_

Answer 26

infection in Trypanosomiasis occurs when infected bug feces are **rubbed into the conjunctiva, bite site, or break in the skin**

Question 27

amplification of T. cruzi occurs in ___ or \_\_\_\_

Answer 27

amplification of T. cruzi occurs in **muscle** or **nerve fibers**

Question 28

in Trypanosomiasis, \_\_\_ is the infective stage \_\_\_\_ is the diagnostic stage

Answer 28

in Trypanosomiasis, **trypomastigotes** is the infective stage **amastigotes** is the diagnostic stage

Question 29

in the acute phase of Trypanosomiasis, there are skin lesions and ____ swellings of the \_\_\_\_, aka ____ sign

Answer 29

in the acute phase of Trypanosomiasis, there are skin lesions and **purple** swellings of the **eyelid**, aka **Romana sign**

Question 30

why is it difficult to diagnose Trypanosomiasis during the chronic phase?

Answer 30

few or no parasites are found in the blood

Question 31

describe the cardiac disorders seen in chronic Trypanosomiasis

Answer 31

* DCM * cardiac arrythmias * heart failure

Question 32

list the GI disorders seen in chronic Trypanosomiasis

Answer 32

* esophagus → **achalasia** * colon → **megacolon**

Question 33

\_\_\_\_ is the best tool for parasitic identification what is seen in Trypanosomiasis?

Answer 33

**microscopic identification** is the best tool for parasitic identification ## Footnote **large "C" shaped appearance of cells = kinetoplast in nucleus**

Question 34

Answer 34