TIck Borne Diseases

Question 1

frequent clinical manifestations of ricketsiia

Answer 1

fever, headache, myalgias, malaise

Question 2

What are the species of rickettsia

Answer 2

Spotted fever-R. Rickettsii, R Conorii, R. Slovaca, R. Africae, R. Parkeri
Typhus: R Prowazekii, R. Typhi

Question 3

What does R. Rickettsii cause, where is it found

Answer 3

Rocky Mountain Spotted Fever, Americas

Question 4

What does R. Conorii cause, where is it found

Answer 4

Mediterranean spotted fever, Africa, Asia Mediterranean

Question 5

What does R. Africae cause, where is it found

Answer 5

African tick bite fever, sub-saharan africa

Question 6

high fevers, severe disease, rash

Answer 6

Rocky Mountain Spotted Fever-Rickettsia rickettsii

Question 7

How does RMSF cause gangrenous skin/digits

Answer 7

damage to microcirculation–>hypovolemia–>gangrene

Question 8

What is the classic rash of R. Rickettsii

Answer 8

Starts on wrists and ankles, progresses to the trunk, commonly involves palms and soles. Will NOT see an inoculation eschar

Question 9

Which rickettsia causes painless inoculation lesion (eschar); which tick is it?

Answer 9

Rickettsia Conorii; brown dog tick (rhipicephalus sanguineus) -Mediterranean spotted fever

Question 10

Which rickettsiae are the least and most pathogenic

Answer 10

African Tick Bite Fever -R Africae (LEAST)–>Mediterranean spotted fever (R. Conorii)–>Rocky Mountain spotted fever (r. Rickettsii)

Question 11

traveler from south africa, amblyomma tick

Answer 11

Rickettsia Africae-african tick bite fever

Question 12

What tick causes typhus

Answer 12

Rickettsia Prowazekii

Question 13

What ist he brill zinsser disease

Answer 13

Recrudescence of rickettsia prowazekii; the susceptible people are advanced age, etoh, immunosuppression, physical stress, malnutrition

Question 14

What is the vector of Rickettsia Prowazekii

Answer 14

Pediculus Humanus Corporis-lives in clothing

Question 15

What ist he transmission of R. Prowazekii

Answer 15

Lice bite, feces, invade through the bite–but if you are febrile, they will move to their neighbors

Question 16

What is the urban and the suburban cycle of R. Typhi transmission

Answer 16

Urban: Rattus species–>xenopsylla cheopis (oriental rat flea)
Suburban cycle: Didelphis (Opossum)–>Ctenocephalides felis (Cat Flea)

Question 17

What is and where do you find murine typhus

Answer 17

Rickettsia Typhi-Latin America (mexico, peru, brazil, colombia)

Question 18

What are the symptoms of Murine typhus

Answer 18

rickettsia typhi-Fever, Headaches, Myalgias, +/- Nausea vomiting, LATE rash; no eschar

Question 19

How to diagnose rickettsia

Answer 19

Recognition, serology IFA, ELISA; PCR (Eschar/buffy coat) ((You wont have ABs int he first week)

Question 20

Treatment of R. Ricketsii and R. Typhus

Answer 20

Doxycycline or chloramphenicol

Question 21

How to treat murine typhus

Answer 21

doxycycline or chloramphenicol +/- ciprofloxacin, levofloxacin, azithromycin

Question 22

south indian tamil farmer with 7 days of fever, headache, vomiting, SOB x 24 hours, no recent travel, small black scab in the left groin-no other rash; CSF Protein 103, Glu 56, WBC 65

Answer 22

Scrub Typhus: Orientia Tsutsuguamushi

Question 23

What is the scrub typhus name, vector, reservoir

Answer 23

Orientia Tsutsugamushi
Vector: chiggers (larva of mite)
Reservoir: Chiggers & Rats

Question 24

patient with papule at bite site of tick, ulcerates, forms an eschar, adenopathy, bite fever, HA, Myalgias and a maculopapular rash

Answer 24

Scrub typhus: Papule forms at bite site, papule ulcerates, forms an eschar, local adenopathy

Question 25

O. Tsutsugamushi life cycle

Answer 25

6 legged larvae-->8 legged nymphs-->8 legged adults lays eggs-->6 legged larvae-->O. Tsutsugamushi (incubation period is 8-10)

Question 26

What is the epidemiology of scrub typhus

Answer 26

Seasonal: warmer months in temperate; dry season in india, year round in tropical; mainly rural village and suburban areas

Question 27

Where is the eschar usually located in Scrub typhus

Answer 27

axilla, chest (under breast), abdomen, groin, genitalia

Question 28

South indian man, dry season, eschar under breast

Answer 28

Scrub typhus

Question 29

how do you diagnose scrub typhus

Answer 29

real time PCR of buffy coat, RDT or ELISA for IGM

Question 30

tx of scrub typhoid

Answer 30

doxycycline or tetracycle

Question 31

eschar, hearing loss, pneumonitis, sepsis, CNS involvement with fever in SE Asia

Answer 31

Scrub Typhus

Question 32

Rancher with fever, chills, fever, delirium, HA, RLL Crackles; AST is elevated

Answer 32

Coxiella BUrnetti, Q favor

Question 33

What is Q fever? What is the source of infection? WHo is at risk?

Answer 33

Caused by coxiella burnetti; small gram negative coccobacillus; infected caattle, sheep, goats; has high concentration in placenta; inhaled by humans; Vets, farmers are at risk

Question 34

transmission of coxiella (Q fever)

Answer 34

aerosol, farming, slaughtering animals

Question 35

What are the clinical symptoms of Q fever

Answer 35

CAP, Hepatitis, Flu-like illness, endocarditis, vasculopathy, osteomyelitis ; elevated ESR, Thrombocytopenia, hepatitis, elevated LFTs

Question 36

how do you diagnose Q fever

Answer 36

Serology, PCR

Question 37

Treatment of Q fefver

Answer 37

doxycycline

Question 38

Tick Borne Zoonotic viral hemorrhagic fever from India

Answer 38

Kyasunar Forest Disease -tick borne viral hemorrhagic fever; single stranded RNA -->high mutations

Question 39

Incubation period of KFD

Answer 39

3 days, sudden onset febrile illness, GI symptoms, bleeding

Question 40

What is the common flavivirus presentation

Answer 40

BiPhasic course

Question 41

What is the prevention for KFD

Answer 41

Formalin inactivated vaccine (vax 5km radius) Deet

Question 42

What is the vector for murine typhus

Answer 42

rat flea feces

Question 43

R prowazekii vector

Answer 43

pediculus humanus (feces)

Question 44

Rickettsial Pox

Answer 44

Akari

Question 45

Rickettsia Conorii

Answer 45

Africa, Europe, America, mediterranean

Question 46

Rickettsia typhi-vector

Answer 46

FLEA Feces

Question 47

Ricketssia Akari Vector

Answer 47

Mite

Question 48

Rickettsia Conorii Vector

Answer 48

ticks