MIC 541-Lecture 23

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MIC 541-Lecture 23
2013-03-22 15:29:57
MIC 541 Lecture 23 Creighton Pharmacy

MIC 541-Lecture 23, Creighton Pharmacy
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  1. Spirochetes include:
    • Treponema
    • Borrelia
    • Leptospira
  2. Treponema causes what disease?
  3. A treponema species that causes syphilis is:
    Treponema pallidum
  4. Treponema Pallidum causes:
  5. Which Spirochete group causes relapsing fever and Lyme disease?
  6. Which Borrelia species causes relapsing fever?
    Borrelia hermsii
  7. Borrelia hermsii causes what disease?
    relapsing fever
  8. Borrelia burgdorferi causes what disease?
    Lyme Disease
  9. Lyme disease is caused by what spirochte?
    Borrelia burgdorferi
  10. Which Spirochete group causes infectious jaundice?
  11. Leptospira interrogans causes what disease?
    infectious jaundice
  12. Infectious jaundice is caused by what spirochete?
    Laptospira interrogans
  13. Characteristics of Spirochetes are:
    • long slender
    • helical
    • motile via axial filaments
    • G- (diff. to determine)
    • Can be detected by Dark feild microscopy
  14. Axial filaments that are responsible for movememnt of spirochetes, the configuration is:
    they wrap around the cell
  15. Detection of spirochetes is best carried out by gram stain (T/F)?
    False, dark feild microscopy is preferred
  16. Dark feild microscopy is preferentially used to detect spirochetes (T/F)?
  17. Dark feild microscopy, the spirochete shows up what color?
    dark colored
  18. Antibody satins are what color:
    Glowing green
  19. An axial fibril is also known as a:
  20. Periplastic flagella lie between ________ and __________
    The cell wall and the outer envelope
  21. Treponema palladium is transferred via ________ to cause syphilis
    direct contact with lesions
  22. 90% of syphilis is contracted through what behaviour?
    sexual contact
  23. Sexual contact is teh most common transfer of syphilis, what is the next most common?
    congenital transfer
  24. Symptom stages of Syphilis are:
    • primary
    • secondary
    • latent
    • and tertiary or late
  25. Primary syphilis is found where?
    on any cutaneousor mucous mebrane surface
  26. Syphilis primary lesions appear and disappear at what points?
    3 weeks after infection they appear and 4-12 weeks after infection they disappear
  27. There is more than one test for syphilis available (T/F)?
    False, there is only one (dark field microscopy)
  28. What are the Characteristics of Chancres associated with Primary syphilis?
    base is hard but painless
  29. Chancres of syphilis can occur on what body parts?
    Any cutaneous or mucus membrane
  30. Secondary syphilis occurs at what period?
    6 weeks to several months
  31. symptoms of secondary syphilis are:
    cutaneous and mucous membrane lesions
  32. Secondary Syphilis is or is not contagous?
    Is, there are live treponemes
  33. The majority of Secondary Syphilis infections have what symptom?
    macular skin rash
  34. Secondary Syphilis have lesions on what body part?
    Cutaneous and mucous membrane lesions
  35. Latenet Syphilis occurs at what time period?
    • Early latent period = 2 years or less
    • Late latent period = over 2 years
  36. During the Early latent period infectious lesions may reappear (T/F)?
  37. During what period may infectous syphilitic lesions reappear?
    During the Early latent period
  38. During the late latent period of syphilis can be spread (T/F)?
    False, this is a non-infectous stage
  39. the syphilitic latent period ends at what time period?
    May last a lifetime
  40. Characteristics of the latent period of syphilis are:
    • over 2 years from infection
    • non-infectous stage
    • may continue for remainder of life
  41. Teriary of Late stage syphilis is an infectous stage (T/F)?
  42. Gummas are present in what stage of syphilis?
    tertiary or late stage
  43. Gummas of syphilis have these characteristics:
    • no treponomes
    • granulomatous found in skin SQ, deep tissue, bone (tibia = saber skin syndrome), neurosyphilis
  44. Which sex has a greater incidence of syphilis?
  45. Syphilis is increasing in the U.S. (T/F)?
  46. Syphilis hit its low point in:
  47. Syphilis is primarily found in what region?
    the south and arizona
  48. The greatest incidence of syphilis is found in what state?
  49. Diagnosis of Syphilis is by:
    • Examine exudate by dark field microscopy
    • immunoflourescence
    • Serological tests
  50. Serological tests for Syphilis are:
    • VDRL/ agglutination test for treponemal antibody
    • FTA (flourescent treponemal antibody)
    • TPHA (T. pallidum hemagglutination) = most sensitive
  51. Treatment of syphilis is by:
    primary secondary and ealry latent = benzathine penicillin (2.4 million U IM in each dose)
  52. Tretament for late latent syphilis and tertiary syphilis is:
    7.2 million U administered via 2.4 million U IM per week.
  53. Neurosyphilis is treated by:
    Aqueous crystalline penicillin 18-24 million Units a day for 10-14 days.
  54. Dark field microscopy is used to detect what syphilitic stages?
    primary, secondary and early latent
  55. VDRL is used to diagnose what stage of syphilis?
    Primary (no late)
  56. Borrelia is detected using:
    stained blood smear ot ELISA
  57. Treatment for Borrelia is:
    tetracycline and chloramphenicol
  58. Borrelia hermsii is transferred by:
  59. Borrelia hermsii is found in what geographical area?
    North America
  60. Symptoms of an infection fo Borrelia hermsii are:
    chills, fever, relapse (though some are asymptomatic)
  61. Some cases of Borrelia hermsii are asymptomatic (T/F)?
  62. Onset of symptoms for Borrelia hermsii occur at what time?
    3-4 days after infection
  63. relapse fo fever by B. hermsii is caused by:
    Subsequent infections by B. hermsii with mutated antigens
  64. Lyme disease is caused by:
    Borrelia burgdorferi
  65. Borrelia Burgdorferi is common in what state?
  66. Resovoirs for B. burgdorferi are:
    tick, deer, human and mice
  67. Lyme disease was decreasing in incidence (T/F)?
    False, the incidence continues to increase
  68. Most reported cases of Lyme disease are in what regions?
    Michigan and the atlantic coast from Maryland to Maine
  69. Nebraska has a high incidence of Lyme disease (T/F)?
    False, there are very few.
  70. The states with the four highest incidence of Lyme disease are (in order from highest to lowest INCIDENCE):
    • 1.) Connecticut
    • 2.) New Jersey
    • 3.) Massachusetts
    • 4.) New York
  71. WHat type of tick transfers Lyme disease?
    Black legged tick
  72. Black legged ticks are large (T/F)?
    False they are much smaller than other varieties
  73. Larval and nymph stages of black legged ticks are approx. what size?
    No bigger than a pin head
  74. Ixodes scapularis are also know as:
    black legged ticks
  75. Black legged ticks, genus species is:
    Ixodes scapularis
  76. Symptoms of Lyme disease include a rash that can be described as:
    Bull's eye or an erythema migrans
  77. The adult female black legged tick is approx. how many inches wide?
    2/10-3/10 of an inch
  78. Common symptom of late disseminated Lyme disease?
    Acrodermatitis chronica atrophicans - bluish red skin lesions
  79. Blueish red skin lesions are symptomatic of what disease?
    Late Lyme disease
  80. Treatment for early Lyme disease is:
    Doxycycline or amoxicillin for 3-4 weeks
  81. Lyme disease treatment for those allergic to penicillin is:
    Cefuroxime axetil or erythromycin
  82. Later disease treatment for Lyme disease is:
    IV ceftriaxone or penicillin for 4 weeks or more
  83. Tretament is almost always successful in all stages of Lyme disease (T/F)?
    False, late stage oftern fails at a rate of 10-20% and require retreatment
  84. Leptospira interrogans is transferred via:
    • animals
    • urine
    • water
  85. Leptospira interrogans causes what symptoms:
    • chills
    • headache
    • severe myalgia
    • infectous jaundice
  86. Diagnosis of Leptospira interrogans is performed by:
    microscopic agglutination test
  87. Treatment of a Leptospira interrogans infection is done with:
    penicillin and tetracycline
  88. How is Lyme disease spread?
    Through black legged ticks that carry the bacteria from human and deer where they ley eggs and then the larvae migrate to rodents where they grow into adults and reinfect humans and deer.
  89. What is a bull's eye lesion
    A round lesion a round the area of a tick bite. Also known as erythema migrans
  90. Is Lyme disease treatable?
    • Yes 
    • Early stage =
    • doxycycline or amoxacillin for 3-4 wks

    (Cefuroxime axetil or wrythromycin in those allergic to above)

    Late Stage = IV ceftriaxone or penicillin for 4wks +

    Treatment may fail on first try in 10-20%
  91. What are the characteristics of tertiary syphilis?
    • gummas
    • non-infectous stage