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Disease Final
Rickettsia and Spirochetes
| Question | Answer |
|---|---|
| Rickettsia causes a tick-borne illness resulting in fever and petechial rash | Rocky Mountain Spotted fever |
| reference standard in RMSF serology, currently used by CDC and most state labs | indirect immunofluoroscopy assay |
| what titers show up in the pt by the end of the first week of illness | IgM antibody |
| which antibodies are more specific and reliable since other bacterial infections can also cause elevated rickettsial ___ Ab titers? | IgG are reliable; others show IgM Abs. |
| Obligate intracellular, not well gram stain, transmitted by vectors. | Rickettsia |
| Characteristics of contracting rickettsia | summer, tick bite, invades blood vessels, vasculitis, fever, chils, HA, myalgia, N/V, mac rash from peripheral to core |
| what is fastest to detect antigen in skin punch biopsies? | Fluorescent Ab test, but only available in reference laboratory. |
| primary diagnostic tool for rickettsia | serology, indirect immunofluoroscopy |
| mechanism of widespread purpura? | Organism invasion and destruction of endothelial cells |
| how does rickettsia infect epithelial cells lining blood vessels? | by parasite-induced phagocytosis |
| illness associated with animal scratches, chronic swelling of lymph nodes, the most common cause of chronic lymph swelling in kids | cat scratch dz. |
| cause of cat scratch fever, ID in an area of necrosis in suppurative granuloma | Bartonella henselae |
| how to diagnose RMSF | clinical and epidemiologic criteria, vector of ticks, ab therapy immediately |
| gram (-) envelope but are not gram stainable, spiral shaped, thin, silver stain visualized | spirochetes |
| spirochete virulence factor | induces inflamm rxn w or w/o tissue destruction |
| dx based on material from lesions (chancres), clinical presentation, serology for non-___antibodies and antibodies | Treponema pallidum |
| multistage disease, primary, secondary, tertiary caused by Treponema pallidum | Syphilis |
| tests: inexpensive, high sens, low spec, nonspecific antigen | Non-treponemal tests (reaginic) |
| Non-trep tests for screening | VDRL-Venereal disease research lab test and RPR-rapid plasma reagin test -> false+ on OB, elderly, viral |
| Treponemal Antibody Tests: expensive, high sens/better spec, confirmation | FTAP-ABS (fluorescent trep Ab-absorption test) MHA-TP (microhemagglutination-Trep pallidum test) |
| Non tender indurated chancre with smooth margins, highly infectious; regional lymphadenopathy, heals spontaneously | primary syphilis |
| rash, condylomata, alopecia, consistent serologic pattern, rise/fall RPR before/after tx | secondary syphilis |
| late symptomatic with + trep test in association with typical neurologic or CV signs; +serology and +CSF-VDRl | tertiary syphilis |
| diffuse maculopapular rash on trunk, bilateral mac rash on both feet, perianal condyloma lata | secondary syphilis |
| if mother is affected less than 2 years, still birth, abortion or neonatal death possible from | congenital syphilis |
| what would be the gram stain of an intial lesion of primary syphilis? | no identifiable lesion: trep is not a great gram stain: too small to show up |
| the serum from a would be actress is positive for VDRL and FTA-ABS test. What is likely causative organism? | treponema pallidum for syphilis |
| cause of lyme disease by deer tick bite or ixodes tick | Borrelia burgdorferi |
| symptoms: polyarthritis, neuro impairment, fatigue | late lyme disease |
| what causes yaws, syphilis, endemic syphilis and pinta ? | Treponema |
| flexible, spiral-shaped, G(-) nonstaining spirochete with internal flagella that causes recurrent febrile bacteremia | Borrelia spp. |
| pleomorphic organism, lacks cell wall, not need a host, common cause community acquired PNA; gliding motility, filamentous tips | Mycoplasma pneumoniae |
| Non staining bacteria: | Rickettsia, Chlamydia, Mycoplasma pneumoniae, Borrelia |