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Paige - ID Module! > Tick lecture > Flashcards

Tick lecture Flashcards

1
Q

what are the general sx of tick-borne diseases?

A

fever/chills, aches/pains, +/- rash

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2
Q

what tick disease is a multisystem inflammatory disease

A

lyme disease

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3
Q

how does lyme disease spread

A

by tick (“Ixodes”) bites via spirochetes (“burrelia burgdoferi”)

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4
Q

what is the preferred host of ticks?

A

white tailed deer

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5
Q

what is the life cycle of the tick?

A

egg –> 6-legged larva –> eight-legged nymph –> adult

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6
Q

at which stage of the tick life cycle do ticks feed on humans? what time of year does this occur?

A

nymph stages - may to july

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7
Q

how long do ticks have to feed on you for to transmit lyme disease?

A

at least 24 hours

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8
Q

why is it that we don’t discover the tick when it first starts feeding?

A

small, and ticks have barbed beaks that release anesthetics once they penetrate the skin

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9
Q

what diseases are transmitted by the deer tick (ixodes scapularis)?

A

anaplasmosis, babesiosis, and lyme disease

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10
Q

when a person is bitten by a tick, what almost always develops and isn’t indicative of a tick-borne disease?

A

a small raised red itchy bump at the site of the bite

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11
Q

what disease does the agent anaplasma phagocytophilum carry?

A

anaplasmosis

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12
Q

what is the animal reservoir for anaplasmosis?

A

deer and white-footed mouse

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13
Q

what is anaplasmosis/HGA?

A

human granulocytic anaplasmosis - a bacterial infection that infects WBCs (granulocytes)

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14
Q

how long does it take for a tick to transmit anaplasmosis?

A

24-48 hours

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15
Q

what other disease does anaplamosis very closely mimic?

A

ehrlichiosis

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16
Q

What is STARI?

A

southern tick associated rash illness of unknown cause

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17
Q

what are the sx of STARI?

A

rash similar to lyme disease, but no arthritic, neurologic, or chronic sx

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18
Q

what tick carries STARI and where can it be found?

A

the lonestar tick - in southeast america

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19
Q

how long is the incubation period for anaplasmosis once contracted?

A

1-2 weeks

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20
Q

what are the sx of anaplasmosis?

A

fever/chills, HA, malaise, myalgias, arthralgia. may have cough, stiff neck, GI upset

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21
Q

what lab findings will you find with anaplasmosis?

A

mild anemia, thrombocytopenia, leukopenia with left shift, elevated LFTs

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22
Q

how do you dx anaplasmosis (and babesiosis)?

A

PCR

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23
Q

how do you treat anaplasmosis?

A

doxycycline

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24
Q

what is babesiosis?

A

a parasitic infection from a tick, caused by protozoa, and infects RBCs and causes hemolysis

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25
what is the reservoir for babesiosis?
rodents and small mammals
26
where does babesiosis occur?
northeast coast of US
27
how long is the incubation period for babesiosis?
1-3 weeks. | if from infusion, 6-9 weeks
28
what are the sx of babesiosis?
fever/chills/sweats, myalgias, arthralgias, fatigue, N/V (surprise!)
29
what will you find on physical exam of babesiosis?
splenomegaly, hepatomegaly, jaundice
30
what are the risk factors for babesiosis?
over 50, immunocompromised
31
how do you treat a person with asx babesiosis?
none, monitor 4-6 weeks if you want
32
how do you treat babesiosis?
clindamycin/quinine or atovaquone/azithromycin
33
what are the sx of lyme disease?
erythema migrans (bullseye rash), muscle/joint pain, fatigue, chills/fever, HA, swollen lymph nodes
34
what is the early presentation of lyme disease in a person who doesn't have a rash?
arthralgias, HA (occipital), paresthesias
35
what is lyme carditis?
a fluctuating AV block caused by lyme disease
36
what neurological sx might you get with lyme disease?
cranial neuritis AKA bell's palsy, lymphocytic meningitis, radiculoneuritis
37
what sx show up in late lyme disease (> 6 mos)
arthritis and more severe neuro sx
38
how do you dx lyme disease?
serologic tests - confirm dx; | Elisa and Western blot
39
what can you give in the early phases of lyme disease that might prevent seroconversion?
abx
40
what Ab do you look for if
IgM and IgG
41
what Ab do you look for if >4 weeks of illness?
IgG
42
how long do lyme Ab stay in blood?
many years - can't determine relapse vs reinfection
43
how do you treat lyme disease?
doxycycline
44
if a person has extremely severe lyme disease sx, what do you treat with?
IV ceftriaxone
45
what are the 3 long-term sequellae of treated lyme disease?
1. persistent arthritis (usually knee) for 4-5 years 2. residual neurologic impairment 3. post-lyme syndrome for >6 months with MSK pain, cognitive complaints, fatigue
46
if a person is having lyme symptoms and has a positive lyme titer, does that mean lyme is causing the symptoms?
No. Most people who get lyme have no symptoms. If a person has non-specific symptoms with a + lyme titer, it doesn't necessarily mean that the person is having these sx due to lyme.
47
what are the 4 conditions when you would give tick bite prophylaxis (e.g. a person was bitten but doesn't have lyme sx)
(1) tick has been identified as an engorged deer tick and has been attached over 36 hours (2) it's a high exposure area (3) it has been within 72 hours of the bite (4) doxy is not c/i in the patient
48
what does the bacteria rickettsia ricketsiae cause?
rocky mountain spotted fever
49
what animals carry rocky mtn spotted fever?
dogs
50
if untreated, what is the prognosis?
high mortality
51
what are the sx of rocky mtn spotted fever
a fine skin rash, high fever, HA, muscle pain, GI sx
52
what 2 drugs do you use to treat rocky mtn spotted fever?
doxycycline and chloramphenicol
53
where is the MC place to get rocky mtn spotted fever?
maryland
54
what months do cases of rocky mtn spotted fever occur?
april to sept
55
in what population is rocky mtn spotted fever MC in?
children, males
56
what are long-term sequellae of rocky mtn spotted fever?
CNS issues, amputations, death
57
which type of tick transmits tularemia?
american dog tick, lone star tick, and rocky mountain wood tick
58
how can tularemia be transmitted?
deer fly bites, inhalation, ingestion, skin contact with infected animals
59
what animals carry tularemia?
rodents
60
what vectors carry tularemia?
ticks, biting flies, mosquitoes
61
is tularemia common
no
62
how can you contract tularemia?
ingestion, inhalation, direct contact, arthropods, animal bites
63
can you spread tularemia person to person?
no
64
if this is so rare, why are we talking about it?
HIGHLY infectious; tick-borne; bioterrorism agent
65
what will you see on PE with tularemia?
ulcers
66
how do you dx tularemia?
PCR
67
how do you tx tularemia?
streptomycin, gentamicin, FQs
68
what is the definition of relapsing fevers?
recurrent cycles of febrile episodes, separated by asx intervals of apparent recovery
69
what organism causes relapsing fevers?
borellia
70
what are the 3 main causes of relapsing fever?
(1) louse-borne relapsing fevers (2) trench fever (3) epidemic typhus
71
what are the 3 types of lice?
(1) head lice (2) body lice* spreads disease! (3) pubic lice
72
how do you pull a tick off of the skin?
tweezers, apply antiseptic to the bite
73
can you touch a tick with your bare hands?
you shouldn't (even though my mom just picks them off my dogs with her fingers and pops it between her fingernails....... ew)

Paige - ID Module! (7 decks)

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