Infectious Dz - Blood Borne 3 Flashcards Preview

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Flashcards in Infectious Dz - Blood Borne 3 Deck (44)
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1

What causes Rocky Mountain Spotted Fever (RMSF)?

Rickettsia ricketsii, a gram negative, obligately intracellular bacteria

2

What type of illness is RMSF?

An acute, febrile illness

3

What is the vector (non-specific) for Rickettsia ricketsii?

Ticks

4

Where does RMSF commonly occur in US?

In southeastern and south central states - where the ticks are present

5

What cells does R. ricketsii infect?

endothelial cells by inducing phagocytosis by these cells

6

Once R. rickettsii infects endothelial cells, what does it do?

It causes damage to the endothelial cells leading to vasculitis and increased microvascular permeability. This permeability leads to tissue edema

7

Is RMSF an acute or chronic disease?

acute

8

What will you find on PE in patients with RMSF?

Fever (80% of naturally infected dogs), ocular signs, splenomegaly, lymphadenomegaly, nasal discharge, tachypnea, epistaxis, petechia, ecchymoses, peripheral edema, gangrenous necrosis, orchitis and scrotal edema, CNS signs, and generalized pain This is a lot of signs, but she specifically highlighted fever

9

What will you find on CBC in patients with RMSF?

Thrombocytopenia, leukocytosis, and mild non-regenerative anemia

10

What will you find on chemistry in patients with RMSF? UA?

Chemistry - Hypoalbuminemia (from vasculitis) UA - variable (proteinuria, hematuria, and bilirubinuria)

11

True or False: RMSF suspected patients should be treated before diagnostic test results are returned.

True - the tests take too long

12

How is RMSF diagnosed?

Serology (IFA) and PCR

13

How is RMSF treated?

Doxycycline and supportive care

14

What is the prognosis for RMSF?

Good to excellent if diagnosed and treated early

15

How is RMSF prevented?

with tick prevention

16

Can humans get RMSF from their dogs?

Not exactly, they can be sentinels of tick exposure. They personally cannot give it to humans, but the ticks on the dogs can.

17

Pete is a 7 YO MC Golden that has presented for a 3 day history of lethargy, inappetence, and vomiting. This is the first time in his life that he has not eaten. You practice in NC. He is on flea and HW prevention, not tick prevention. On his PE you note he has a 103.7 F fever, he is 5-7% dehydrated, there is ocular mucoid discharge in both eyes, and the fundic exam is WNL. There are prominent submandibular and prescapular LNs and a slightly stiff gait. His CBC reveals thrombocytopenia, and slight neutrophilia. The chemistry panel reveals albumin and the UA reveals a USG of 1.026 and 1+ protein.

What do you want to do next for pete?

a. He must have Babesia because he lives in the South. Start imidocarb right away.

b. Systemic workup including abdominal x-rays and ultrasound. Just because this is an infectious disease lecture doesn't mean he has an infectious disease.

c. Culture his urine because he has a fever and proteinuria.

d. Perform a 4Dx SNAP test.

B, C, and D

18

Which of the following doxycycline responsive infections is associated with a vasculitis that can lead to peripheral edema because the causative organism infects endothelial cells?

a. Mycoplasma haemofelis

b. Rickettsia rickettsii

c. Ehrlichia canis

d. Anaplasma phagocytophilum

e. Babesia canis vogeli

b. Rickettsia rickettsii

19

What causes Lyme Borreliosis?

Borrelia burgdorferi a motile corkscrew-shaped (spirochete) bacteria

20

What clinical signs are associated with lyme disease?

Most dogs have no signs of illness but they can have fever, arthritis, and renal disease

21

In endemic areas, what percentage of dogs have been exposed to Lyme?

up to 80%

22

What tick genus is responsible for transmitting Borellia burgdorferi?

Ixodes (specifically the ricinus-persulcatus complex) - this also transmits A. phagocytophilum

23

What animals are reservoirs for Borellia burgdorferi?

Peromyscus leucopus (white-footed mouse) in the NE and upper Midwest

24

How does B. burgdorferi adhere to the tick midgut?

Lipoprotein OspA expression

25

How does B. burgdorferi bind disseminate in the mammalian host?

Lipoprotein OspC expression which is upregulated when a tick ingests mammalian blood

26

What percentage of dogs will show overt illness signs of Lyme disease?

Only <10%

27

What are the clinical features of Lyme disease?

Fever, lameness (joint closest to tick bite is first affeced), mild to moderate thrombocytopenia, and Lyme associated nephritis

28

What is Lyme-associated nephritis?

Membranoproliferative glomerulonephritis

29

In patients that develop Lyme-associated nephritis, what is the prognosis?

poor

30

What will the chemistry and UA show in patients with Lyme-associated nephritis?

Chemistry - Hypoalbuminemia +/- azotemia UA - isosthenuria and proteinuria

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