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What antimicrobial reaction can occur in syphilis?
What bacteria causes Lyme disease? What kind of tick (scientific and common)? What are the stages of Lyme disease? What test do you do to screen for Lyme disease? What test do you use to verify Lyme disease?
Borrelia burgdorferi
the hard tick (Ixodes) aka deer tick
Stage 1: erythema chronicum migrans bulls eye rash in 60% of patients at 2-3 weeks after the tick bite at site of tick bite Stage 2: acute disseminated infection, secondary skin lesions, neurologic and cardiac pathology Stage 3: chronic, chronic cardiac and neurologic symptoms, arthritis
Screen: ELISA Verify: Western Blot
What is given to newborns to prevent chlamydia conjunctivitis?
erythromycin eye drops
Who do STDs need to be reported to?
The state health department
What organism causes syphilis?
Trepomonas pallidum subs. pallidum
What % of pneumonias does Chlamydophilia pneumoniae cause? What secondary disease can occur? What are the phases of its biphasic clinical course?
10%
Guillain-Barre syndrome (myelin sheath disintegrates)
Phase 1: a sore throat 5-7 days, flulike lower respiratory tract symptoms 8-15 days
Phase 2: pneumonia and bronchitis
What organism causes RMSF (rocky mountain spotted fever)?
What two ticks can cause it? What regions are they found in?
What are the important clinical manifestations?
R. rickettsii
D. variabilis(dog tick) Southeastern US and the D. andersoni (wood tick) rocky mountain and Southwestern US
Rash erythematous patch on ankles or wrists may extend to hands and sole of the feet BUT NOT THE FACE
What Leptospirosis is the only one that causes human infections?
How is it spread?
What are the two forms/phases of the disease?
What specimen is/are collected?
How is it identified in the lab?
L. interrogans
Contact with the urine of rats, can survive months in water
Initial/anicteric phase: a headache, malaise, severe myalgia
Late/icteric phase: aka Weil's disease causes severe systemic disease of kidneys, liver, and intravascular systems
CSF or blood if first-week urine after first week
MAT (microscopic agglutination test) and IgM ELISA (enzyme-linked immunosorbent assay)
What are the phases of syphilis? What are their key characteristics?
Primary syphilis: chancre at site of infection
Secondary syphilis: occurs 2-12 weeks after chancre appears, widespread macular rash (syphilitic roseola) *particularly on palms and soles of feet, Secondary Lesions Condylomata lata (moist gray-white plaques teeming with spirochetes)
Latent syphilis: early latent phase initial 4-year relapse, Late latent phase indefinite duration
Late syphilis (tertiary): complications in many organ systems many years later especially CNS and cardiac issues
What are diseases that C. trachomatis cause?
ocular trachoma- could result in blindness
urethritis with purulent discharge, cervicitis, salpingitis( fallopian tubes)
passed from mom to baby: inclusion conjunctivitis and neonatal pneumonia
What do C. trachomatis serovars L1, L2, L2a, L2b, and L3 cause? What cells does it survive in? How is it transmitted? What is involved in the three stages?
Lymphogranuloma Venerum(LGV)
survives in mononuclear cells
STD (sexually transmitted disease)
1st stage: brief appearance of genital lesion
2nd stage: involves inguinal lymph nodes, enlarged or matted together forming a large are of groin swelling aka bubo
Chronic/3rd stage: more often in women, genital hyperplasia, rectal fistulas, draining sinuses
What are the general characteristics of chlamydiae? What are the two forms?
Obligate intracellular parasites
Elementary body: infectious, major outer membrane protein (MOMP)
Reticulate body: noninfectious
True or false. Mycoplasmas are always considered significant when isolated?
True
Which Borreliae species cause epidemic relapsing fever? Which causes endemic relapsing fever? What are they transmitted by?
How are does the lab diagnose them? Why do you have to be careful about the dose of antibiotics?
Epidemic: B. recurrentis and B. duttonii caused by Pediculus humanus or louse-borne infection transmitted by crushing or scratching lice into skin Endemic: B. hermsii tick-borne infection (ornithodoros ticks)transmitted by saliva during the bite
diagnose by direct examination of spirochetes in blood, death of spirochetes can cause sudden endotoxin release aka (Jarisch-Herxheimer reaction)
What causes Q or query fever? What biosafety level is required?
Coxiella burnetii
BSL 3
How are spirochetes differentiated? What are their general characteristics?
Number of axial fibrils
Number of insertion disks
biochemical tests
metabolic features
Characteristics: helical gram-negative bacilli
What is the drug of choice for syphilis?
Penicillin G
What organism is known as the smallest self-replicating organism in nature? What does it lack? What class of antibodies does that make it resistant to?
Mycoplasma, Cell wall, ones that work on cell walls ie penicillins
What do mycoplasmas require to grow? What disease do they cause?
Fatty acids and triglycerides, WALKING PNEUMONIA
What does chlamydia psittaci cause? Who gets it?
Bird chlamydia causes pneumonia in humans
occasionally in turkey processing plants and pigeon lovers aficionados
What two types of Rickettsias cause typhus? What are the two forms? What are their vectors? How is it spread? What is the typhus caused by Orientia tsutugamushi called? What are its vectors and symptoms?
Rickettsias: Endemic or Murine Typhus caused by r. typhi, oriental rat flea (xyenosplylla cheopis) or the cat flea (Ctenocephalides felis), occurs when flea defecates on skin and person scratches it into skin Epidemic or Louse-borne Typhus: R. prowazekii Human louse (pediculus humanus), Squirrel flea (orchopeas howardii) or squirrel louse (neohaematopinus sciuripoteri) spread when bug defecates
Orientia: Scrub typhus vector is the chigger reservoir is the rat symptoms: tache noire at site of inoculation and rash that does not involve the palms soles of the feet or face
What is the host for Rickettsiae? Where do they multiply? How are they transmitted? What is the exception?
Arthropod-borne
multiply intracellularly
transmitted transovarial in ticks infection through feeding
R. prowazekii: humans are reservoir transmitted by body lice
What are the other three subspecies of treponemas pallidum? What do they cause?
pertenue: yaws chronic non-venereal disease
endemicum: endemic syphilis
careteum: Pinta ulcerative or papulosquamous skin lesions that depigment
How is C. trachomatis diagnosed in the lab?
Molecular methods: Mainly DNA probes and nucleic acid amplification tests and PCR in US
Direct detection: cytologic methods
Antigen detection: ELISA and direct fluorescent antibody (DFA) and serology
How does the laboratory diagnose syphilis? What antigen is used in two of the tests?
Nontreponemal tests(primary or secondary stage)
Venereal disease research laboratory (VDRL) CARDIOLIPIN (flocculates=positive)
RPR (Rapid plasma reagin) CARDIOLIPIN (agglutinates=positive)