Spirochetes

Question 1

bacterial taxonomy - spiral?

Answer 1

spirochetes (Borrelia, Leptospira, Treponema)

Question 2

spirochetes - bugs and appearance

Answer 2

spiral - shaped bacteria with axial filaments

1. Borrelia 2. Leptospira 3. Treponema

Question 3

big size spirochete?

Answer 3

Borrelia

Question 4

spirochetes - visualized in light microscopy

Answer 4

only Borrelia, using aniline dyes (Wright or Giemsa), due to size

Question 5

visualization of treponema

Answer 5

dark field microscopy
and
fluorescent antibody staining

Question 6

Leptospira interrogans - found in

Answer 6

water contaminated with animal urine

Question 7

Leptospira interrogans causes

Answer 7

1. leptospirosis

2. Weil disease (icterohemorrhagic leptospirosis)

Question 8

Leptospirosis - symptoms

Answer 8

1. flu like
2. myalgias (classically in calves)
3. jundice
4. photophobia with conjuctival suffusion (erythema without exudate)

Question 9

Leptospirosis - myalgias / prevelance

Answer 9

classically in calves

prevelant among surfers and in tropics (eg. Hawaii)

Question 10

icterohemorrhagic leptospirosis is also called

Answer 10

Weil disease

Question 11

Weil disease vs Leptospirosis - severe form?

Answer 11

Weil disease icterohemorrhagic leptospirosis

Question 12

Weil disease (icterohemorrhagic leptospirosis) - symptoms

Answer 12

1. jaundice
2. azotemia (from liver and kidney dysfunction)
3. fever
4. hemorrhage
5. anemia

Question 13

Lyme disease is caused by

Answer 13

Borrelia burgdorferi

Question 14

Borrelia burgdorferi is transmitted by

Answer 14

the Ixodes deer tick

Question 15

Ixodes deer tick is the vector of

Answer 15

1. Borrelia burgdorferi
2. Anaplasma
3. protoza Babesia

Question 16

Borrelia burgdorferi - natural reservoir (relevance)

Answer 16

the mouse

mice are important to tick life cycle

Question 17

Borrelia burgdorferi is common in

Answer 17

northeastern United States

Question 18

Lyme disease - symptoms

Answer 18

Stage 1: early localized: erythema migrans + flu like sympoms
Stage 2: early disseminated: secondary lesions, carditis, AV block, facial nerve palsy, migratory myalgias/transiet arthritis
Stage 3: late disseminated: encephalopathies, chronic arthritis

Question 19

Lyme disease - treatment

Answer 19

1. doxycycline

2. ceftriaxone

Question 20

syphilis is caused by

Answer 20

Treponema pallidum

Question 21

syphilis is divided to (and time)

Answer 21

1ry syphilis (3-6 weeks after infection)
2ry syphilis (6 weeks after resolution of 1ry)
3ry syphilis (6-40 years after infection)
Congenital syphilis
latent syphilis

Question 22

How is syphilis transmitted

Answer 22

sexually or transplacentally

Question 23

1ry syphilis - when / manifestation

Answer 23

localized disease presenting with painless chancre (3-6 weeks after infection)

Question 24

1ry syphilis - how to diagnose

Answer 24

1. use dark-field microscopy to visualize treponemes in fluid from chancre
2. VDRL (positive in 80%)

Question 25

1ry syphilis - VDRL

Answer 25

positive in 80%

Question 26

2ry syphilis - when

Answer 26

6 weeks after resolution of 1ry

Question 27

2ry syphilis - manifestations

Answer 27

1. disseminated disease with constitutional symptoms 2. maculopapular rash (including palms and soles) 3. condylomata lata (smooth, moist, painless, wart-like white lesions on genitals) 5. lymphadenopahy, patchy hair loss

Question 28

2ry syphilis - diagnosis

Answer 28

1. dark-field microscopy 2. VDRL/RPR (nonspecific) 3. FTA-ABS (specific, to confirm)

Question 29

syphilis - which test remains positive after treatment

Answer 29

FTA-ABS

Question 30

2ry syphilis - maculopapular rash including

Answer 30

palms and soles

Question 31

latent syphilis

Answer 31

positive serology without symptoms

Question 32

3ry syphilis - manifestation

Answer 32

1. gummas (chronic granulomas) 2. aortitis (vasa vasorum destruction) 3. neurosyphilis (tabe dorsalis, general paresis) 4. Argyll Robertson pupil

Question 33

tabes dorsasis - spinal cord lesion?

Answer 33

degeneration (DEMYELINATION) of dorsal columns and roots

Question 34

3ry syphilis - signs

Answer 34

1. broad based ataxia 2. positive Romberg 3. absence of Deep Tendon Reflexes 4. Stroke without hypertension

Question 35

diagnosis for neurosyphilis

Answer 35

test spinal fluid with VDRL, FTA-ABS and PCR

Question 36

Congenital syphilis - symptoms

Answer 36

OFTEN RESILTS IN STILLBIRTH, HYDROPS FETALIS 1. facial abnormalities 2. snuffles (nasal discharge) 3. saddle nose 4. notched (Hutchinson) teeth 5. mulberry molars 6. short maxilla 7. saber shins 8. CN VIII deafness

Question 37

how to prevent congenital syphilis

Answer 37

treat mother early in pregnancy, as placental transmission occurs after first trimester

Question 38

VDRL detects

Answer 38

nonspecific antibody that reacts with beef cardiolipine

Question 39

VDRL - characteristics

Answer 39

inexpensive, non-specific, widely available, quantitative

Question 40

VDRL - false positive - conditions

Answer 40

Mnemonic: VDRL 1. Viral infection (mono, hepatitis) 2. Drugs 3. Rheumatic fever 4. Lupus and Leprosi

Question 41

FTA-ABS detects

Answer 41

antibodies against Treponema Pallidum

Question 42

Jarisch-Herheimer reaction??

Answer 42

flu like syndrome (fever, chills, headache, myalgia) after antibiotics

Question 43

Jarisch-Herheimer reaction after antibiotics due to

Answer 43

killed bacteria releasing (usually spirochetes) endotoxins

Question 44

Borrelia recurrentis causes

Answer 44

Relapsing fever

Question 45

Why does relapsing fever relapse?

Answer 45

antigenic variation: Borrelia recurrentis changes its surface proteins to evade the immune system