ACVIM General Boards - 2022 > Infectious > Flashcards

Infectious Flashcards

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1
Q

What kind of bacteria is Ehrlichia?

A

Intracellular

Gram-negative

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2
Q

How is Ehrlichia transmitted in the vector (tick)?

A

Trans-stadial transmission

Pathogen remains with vector from one life stage to another (but not from parent to eggs).

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3
Q

Who causes canine monocytic ehrlichiosis

A

E. canis

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4
Q

Which tick carries E. canis?

A

Rhipicephalus sanguineous (Brown dog tick)

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5
Q

Who causes Canine granulocytic ehrlichiosis?

A

E. ewingii

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6
Q

What tick carries E. ewingii (Canine granulocytic ehrlichiosis)?

A

Amblyomma americanum (lone star tick)

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7
Q

Who causes human monocytic ehrlichiosis

A

E. chaffeensis

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8
Q

True or false: Ehrlichia, Anaplasma and Neorickettsia are in the same family?

A

True

Rickettsiae is a separate family

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9
Q

What dog breed is more susceptible to E. canis with a worse prognosis?

A

German Shepherds

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10
Q

What is the pathogenesis of E. canis? (Canine monocytic ehrlichiosis)

A
  1. Organism multiplies within vacules in monocytes - lyse cells
  2. Immune-mediated mechanism
  3. Presence of spleen contributes to severity of disease
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11
Q

What are the phases of the disease for canine monocytic ehrlichiosis (E. canis)?

A
  1. Acute 8-20 days after infection, may resolve spontaneously.
  2. Subclinical - Organisms sequestered in spleen
  3. Chronic phase
    • Can see pancytopenia from BM involvement
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12
Q

What are some secondary opportunistic infections with E. canis (canine monocytic ehrlichiosis)?

A
  1. Viral papillomatosis
  2. Protozoal infections
  3. Bacterial UTIs
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13
Q

What is a protein electrophoresis finding of E. canis?

A

Sometimes can have a monoclonal gammopathy => misdiagnosis of lymphocytic leukemia or multiple myeloma

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14
Q

What type of hypersensitivity reaction can you see with E. canis?

A

Type III hypersensitivity (Immune complex deposition) and protein losing nephropathy (glomerulonephritis)

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15
Q

What are some clinical signs of E. canis (canine monocytic ehrlichiosis)?

A

Fever, lethargy, splenomegaly, lymphadenopathy, anterior uveitis, neurologic CS

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16
Q

What are CBC findings of E. canis?

A

Thrombocytopenia!
Occasional mild leukopenia
Pancytopenia in chronic phase
Morulae in circulating monocytes

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17
Q

What are common chemistry findings of E. canis?

A
  1. Hyperglobulinemia (polyclonal most common, but can be monoclonal) with hypoalbuminemia.
  2. ALT/ALP elevations
  3. Azotemia if PLN
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18
Q

What is the gold standard diagnostic for Ehrlichia canis?

A

IFA (there is cross-reactivity)

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19
Q

What is the consensus treatment for E. canis?

A

Doxycycline 10mg/kg Q24h x 28d

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20
Q

Does Ehrlichia ewingii (Canine granulocytic ehrlichiosis) have a chronic phase?

A

NO

Only E. canis

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21
Q

What are symptoms for E. ewingii (Canine granulocytic ehrlichiosis)?

A

Usually NONE
Fever
Anorexia
Neutrophilic Polyarthritis

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22
Q

True or false: Dogs can be reservoir host for E. ewingii (canine granulocytic ehrlichiosis)

A

TRUE

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23
Q

What is the pathogen for human monocytic ehrlichiosis and what tick carries it?

A
  1. Ehrlichia chaffensis

2. Amblyomma americanum (lone star tick)

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24
Q

Diagnosis for E. ewingii is limited to:

A

ELISA, western blot, PCR

Can do IFA for E. canis only

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25
What organism causes granulocytic anaplasmosis?
Anaplasma phagocytophilum
26
What tick carries Anaplasma phagocytophilum (granulocytic anaplasmosis)
Ixodes ricinuspersulcatus complex
27
What cells are affected by Anaplasma phagocytophilum?
Neutrophils and eosinophils
28
What organism causes THROMBOCYTOTROPIC ANAPLASMOSIS?
Anaplasma platys - Aka….Canine Cyclical Thrombocytopenia
29
What cells does Anaplasma platys infect?
Platelets
30
What is A. phagocytophilum effect on neutrophils?
delays neutrophil apoptosis => allows longer survival periods within the neutrophil.
31
What is the most common symptoms with A. phagocytophilum?
No clinical signs
32
What is the most common CBC finding with A. phagocytophilum?
Thrombocytopenia in 90% of canine cases (+/- other cytopenias
33
What tick carries Anaplasma platys
Rhipicephalus sanguineus
34
What kind of organism is Babesia spp.
Intracellular protozoan
35
What cells does babesia spp infect?
RBC
36
What babesia cell stage is observed within RBC?
Merozoites
37
What type of immune response does babesia cause?
Induces immune-mediated destruction of erythrocytes Anti-erythrocyte antibodies may develop as well (self-antigen), contributing to IMHA
38
What kind of organism is Cytauxzoon?
Apicomplexan protozoal
39
What does Cytauxzoon use to invade cells?
apical complex
40
What are the vectors for Cytauxzoon?
Lone Star tick (Amblyomma americanum) | American dog tick (Dermacentor variabilis)
41
How does Cytauxzoon live in the blood?
Monocytes - Schizont Erythrocytic - Piroplasm
42
What is the pathogenesis of Cytauxzoon?
Schizogenous phase - FAT monocytes with schizonts > block blood vessels > microvascular hypoxia, SIRS/sepsis, DIC, organ failure Piroplasm phase - RBC hemolysis
43
What is the treatment for Cytauxzoon?
Atovaquone and azithromycin GIVE WITH FOOD - increased oral bioavailability for atovaquone
44
Is Cytauxzoon zoonotic?
NO - has not been known to infect people
45
Hepatozoonosis: Is it zoonotic? Does it affect the liver?
NO and rarely lol
46
How is Hepatozoon transmitted to the dog?
Ingestion of an infected tick (not from tick bite)
47
What is the life cycle of Hepatozoon americanum?
Sporozoites infect monocytes; Then monocytes go to the muscle; pyogranuloma forms in the muscle (Onion-skin cysts). Burst and release gamonts
48
What is the life cycle of Hepatozoon canis?
Does not invade the muscle like H americanum. Dog ingests infected tick, micromerozoites invade neutrophils and and monocytes. Transplacental transmission
49
Facts about feline Hepatozoonosis (Hepatozoon felis)
* Usually asymptomatic | * Usually cats with FIV/FeLV
50
What causes salmon poisoning?
Neorickettsia helminthoeca
51
What kind of microorganism is Neorickettsia helminthoeca?
Gram-negative coccobacillary organism
52
Describe the life cycle of Neorickettsia helminthoeca (salmon poisoning)
Vector is Nanophyetus salmincola - a trematode that infects snail, fish, then mammal
53
What is the pathogenesis of Neorickettsia helminthoeca?
1. Dog ingests fish with infected trematode 2. Adult fluke innoculates dog with Neorickettsia 3. Rickettsial organisms replicate initially in the epithelial cells of the intestinal villi or intestinal lymphoid tissue then enter the blood stream and spread to the lymph nodes, spleen, tonsils, thymus, liver, lungs, and brain
54
What is the vector of Neorickettsia helminthoeca?
Nanophyetus salmincola - A trematode/fluke
55
How do you diagnose Neorickettsia helminthoeca?
1. Fecal - May see Nanophyetus salmincola eggs. 2. Lymph node cytology - reactivity and histiocytic hyperplasia; Intracytoplasmic rickettsial organisms within histiocytes. 3. PCR
56
What is the treatment for Neorickettsia helminthoeca (Salmon poisoning disease)
Doxycycline for Neorickettsia | Praziquantel for Nanophyetus salmincola fluke
57
What is the geographic distribution of Neorickettsia helminthoeca (salmon poisoning)
Pacific northwest
58
Where does R. Rickettsii replicate in the host?
Endothelial cells
59
What is the mechanism for thrombocytopenia in rocky mountain spotted fever? (R. Rickettsii)
1. Immune-mediated destruction | 2. Coagulatory consumption
60
Which organism has been known to cause SIADH? What electrolyte disturbance does SIADH cause?
R. Rickettsii | Hyponatremia
61
What is the broad pathogenesis of RMSF?
1. Vasculitis, increased vascular permeability 2. Thrombocytopenia, hemorrhage, DIC 3. Edema (brain, lung)
62
How do you confirm a RMSF diagnosis?
Fourfold increase in IgG seroreactivity or Positive IgM seroreativity. There is 5-15% seroreactivity in healthy dogs across the Atlantic
63
What babesia species can cause red biliary syndrome?
B. canis rossi
64
What is red biliary syndrome regarding B. canis rossi?
Severe intravascular hemolysis AND hemoconcentration. Hemoglobinemia, hemoglobinuria (in some combination) and elevated HCT due to fluid shifts into extracellular spaces
65
How do you treat Babesia spp. (Other than B. gibsoni)?
Imidocarb diproprionate
66
How do you treat Babesia gibsoni?
Combination with azithromycin and atovaquone
67
In addition to Doxy, what drug do you ned to treat a patient with Neorickettsia helminthoeca?
Praziquantel for trematode vector (Nanophyetus salmonicola)
68
Which would be most specific for the diagnosis of toxoplasma in a cats with clinical signs? a. Oocysts in feces b. IgM > 1:64 in CSF c. IgG > 1:64 in serum d. Blood culture
b. IgM > 1:64 in CSF
69
What is the most accurate way to diagnose ocular or CNS toxoplasmosis in cats?
The combination of T. gondii–specific antibody | detection in aqueous humor or CSF and organism DNA amplification by PCR
70
Which one is acid fast and which one isn't? a. Nocardia b. Actinomyces
a. Nocardia - Acid fast | b. Actinomyces - Non-acid fast
71
What is the most common cause of pyothorax in cats?
Pasteurella
72
What is the most common cause of diskospondilytis?
Staph aureus
73
You have a cat with FIV. Four weeks ago, she gave birth to kittens who tested positive for FIV. What should you do with the kittens?
Isolate the kittens and test them again in 6 months.
74
Horses and dogs are reservoirs for humans for which pathogen?
Staph aureus
75
Which tick carries anaplasma phagocytophilum?
Ixodes spp. (co-transmitted with borrelia)
76
Which virus causes myocarditis in dogs, cerebellar hypoplasia in cats and diarrhea in pigs?
Parvovirus
77
How is rabies diagnosed?
IFA on the brainstem or cerebellum
78
How is cryptococcus diagnosed?
Latex agglutination test - Detects capsular antigen
79
How does leptospirosis cause azotemia?
Interstitial nephritis, renal swelling, and vasculitis => decreased renal perfusion Lepto also invades renal tubular cells
80
How is the MAT test for lepto performed?
The patient's serum is incubated with a suspension of live leptospires and evaluated by dark-field microscopy for agglutination
81
How is Hepatozoon americanum diagnosed?
Muscle biopsy
82
What percentage of cats with coronavirus develop FIP?
1/10
83
Where does the feline coronavirus replicate? Where does the FIP virus replicate?
Feline coronavirus - Enterocytes | FIP - Macrophages
84
What is the pathogenesis of FIP?
Infected monocytes attach to vascular endothelium Virus attracts complement - Release of vasoactive amines and vasculitis Major damage by antibody dependent enhancement
85
Which cats with coronavirus DO NOT get FIP?
The ones that DO NOT mount humoral response
86
What are the clinical findings for most uncomplicated Feline coronavirus infections?
Most subclinical, some develop URI, diarrhea and vomiting
87
What is the acute form of FIP?
Effusive
88
What is the chronic form of FIP?
Non-effusive
89
What are signs of chronic FIP (non-effusive)?
Ocular - Iritis, uveitis and keratitic precipitates Neurologic (25-33%) of cats - Ataxia, HYDROCEPHALUS Intestinal granulomas less common
90
What is the gold-standard for diagnosing FIP?
Immunohistochemistry of lesions (pyogranuloma, area of vasculitis)
91
What are the potential outcomes with FeLV infection?
1. Effective CMI eliminates virus completely 2. Transient viremia (<3 weeks)- Virus spreads to lymph nodes, thimus, spleen etc. Virus is shed. Potentially cleared by immune response 3. Bone marrow infection - Persistent viremia (>3 weeks). Incorporation into hosts' DNA. Cannot be cleared at this stage
92
What does the FeLV ELISA test for?
p27 antigen (FeLV core protein) - indicates viremic cat
93
How is Mycoplasma hemofelis transmitted?
Fleas and flea dirt
94
Can Mycoplasma haemofelis be opportunistic?
Yes - 40-50% of cats with mycoplasma have FeLV
95
How is mycoplasma hemofelis different from mycoplasma hemominutum?
M. hemominutum usually doesn't cause clinical signs (unless the cat has FeLV)
96
How is FIV transmitted?
Bites
97
What is the target cell for FIV?
Primarily CD4+ T lymphocytes Can also use CD8, B cells, macrophages, dendritics
98
What does the FIV ELISA test for?
ANTIBODIES to p24 core protein or gp40 transmembrane protein
99
What cats will have a false positive for FIV?
Vaccinated cats | Kittens <6 months of age (maternal antibodies)
100
How is a positive FIV test confirmed?
Western Blot
101
How is FeLV transmitted?
Salivary secretions - Licking, grooming, shared water and food dishes
102
What does E. canis look like on flow cytometry?
CD8+ T cell leukemia
103
Treatment of tritrichomonas in cats?
Ronidazole
104
What is the mechanism behind botulism toxin?
Inhibition of Ach release from presynaptic membrane
105
When should you treat salmonella?
When clinically necessary due to signs
106
For what organsim do you see morulae in neutrophils?
Anaplasma
107
Which cat is most likely to have toxoplasma? 1. Cat with high IgM and FIV 2. Cat that ingested contaminated meat 12 hours ago 3. Cat with diarrhea 4. Cat with increased but stable IgG titers
1. Cat with high IgM and FIV
108
What percentage of hospitalized patients develop nosocomial infections?
16%
109
Who sheds toxoplasma oocytes?
Cats that ingest bradyzoites in tissues of prey. Bradyzoites infect enterocytes and undergo sexual reproduction
110
What tick transmits lyme disease?
Ixodes
111
What does the Lyme ELISA test for?
Antibodies for C6
112
What type of gromerulonephritis does lyme disease cause?
Membranoproliferative GN
113
What organism transmits Leishmaniasis?
Sand flies
114
What are the clinical signs of leishmaniasis?
Fever Weight loss Cutaneous lesions Immune complex disease (e.g. nephrotic syndrome)
115
How do you treat leishmaniasis?
``` Meglumine antimoniate (antimoniate drugs) Allopurinol ```
116
Is Brucella zoonotic?
Yes
117
How is brucella diagnosed?
Rapid slide agglutination test
118
What is the treatment of brucella?
Doxy + aminoglycoside (castrate)
119
What tick carries Anaplasma phagocytophylum?
Ixodes spp
120
How can blastomycosis be transmitted?
Inhalation of spores Direct inoculation on skin with trauma
121
What contributes to the virulence of blastomycosis?
Dependent on BAD-1 (Blastomyces adhesion-1) Inhibits immune response (suppress TNF-a and CD4+ lymphocytes)
122
How is blastomycosis diagnosed?
``` Cytology or histopath Urine antigen (elisa) ```
123
What is the canine influenza variant?
H3N8 (originated from racing grayhounds)
124
What type of virus is FIV?
Lentivirus, retrovirus
125
What is the best test to detect rabies?
Direct fluorescence assay on brainstem/cerebellum
126
What is the MOA of rifampin?
Inhibits B-subunit of bacterial RNA polymerase
127
What is the MOA of doxycycline?
Inhibits 30S ribosomal subunit - inhibits protein synthesis
128
What is the MOA of TMS?
Inhibits folic acid metabolism | Affects purine/DNA synthesis
129
What is dermatophilus congolensis?
Gram + bacteria - Causes rain scald (horses, people, dogs)
130
What are dermatophytic mycetomas?
PERSIANS predisposed. Microsporum canis causing coalescing SQ granulomas. AKA granulomatous dermatitis; Majocchi's granuloma; pseudomycetomas
131
What percentage of dogs with E. canis have thrombocytopenia?
70%
132
Which organisms have morulae?
Monocytes - E. canis, E. chaffensis Granulocytes - A. phagocytophilum, E. ewengii
133
What part of the intestinal villi does parvo attack?
Crypt (more pathogenic viruses attack crypts)
134
What part of the intestinal
135
What part of intestinal villi does coronavirus infect?
Tip of villi
136
What part of intestinal villi does rotavirus infect?
top 1/3 of villi
137
Which intestinal organisms infect: a. Villi b. Crypts c. Both
a. Villi - Rotavirus, coronavirus, giardia, cryptosporidium, enteropathogenic E. Coli b. Crypts - Parvovirus, helicobacter c. Both - Salmonella, campylobacter
138
What kind of virus is canine hepatitis virus?
Adenoviridae
139
What kind of virus is distemper?
Paramyxoviridae; morbilivirus
140
What is the family of parvovirus and panleukopenia virus?
Parvoviridae
141
What is the family/genus of rabies virus?
Rhabdoviridae/lyssavirus
142
What is the family of rotavirus?
Reoviridae
143
What is phaeohyphomycosis?
Fungal infection caused by many species of dark, melanin-pigmented dematiaceous fungi
144
What is the treatment for phaeohyphomycosis?
Pigmented fungi are poorly responsive to medical therapy. SURGICAL RESECTION is tx of choice Itraconazole can be tried if non-surgical
145
Does babesia cause intra- or extravascular hemolysis?
Intravascular - When merozoites are released, the RBC will burst. Also complement mediated (Ag on RBC surface) Extravascular - There is some (Ag on surface of cell)
146
Is lyme zoonotic?
Yes, but most go through a tick vector
147
What is sporotrichosis? How is it transmitted?
Dimorphic, cigar-shaped fungus. Inoculated by punctur
148
How do you treat sporotrichosis?
Itraconazole Dogs - Can do supersaturated sln of potassium iodide with food (30 days post resolution)
149
What is the difference between E. canis and A. phagocytophylum?
E. canis - Monocytic. Can be chronic (e.g. BM involvement). Can have monoclonal gammopathy A. phagocytophylum - Granulocytic. Acute presentation (although most dogs show no signs)
150
What is the definitive way to diagnose FIP?
Histopath - The use of IHC or IFA on diseased tissue is typically the gold-standard for definitive diagnosis of FIP
151
How do you effectively treat cryptosporidium?
Azithromycin | Tylosin
152
What is the treatment for nocardia? (filamentous, acid-fast)
TMS
153
What are the causes for distempter-induced thrombocytopenia?
Virus-antibody complexes on platelet surface - first Direct infection of megakaryocytes - later
154
How do cats transplacentally infect the kittens with toxoplasma?
Tachyzoite stage infects fetus
155
What is the most sensitive test for bartonella?
Serology
156
What stage of Cytauxzoon lives in macrophages?
Schizonts - Live in macrophages and occlude blood vessels
157
Why is amphotericin B lipid-encapsulated less nephrotoxic when compared to the deoxycholate amphotericin B?
Decreased nephrotoxicity results from a reduced rate of transfer of amphotericin B to mammalian cell membranes and increased drug clearance from the blood by the mononuclear phagocyte system
158
Which one is less nephrotoxic? Lipid-encapsulated amphotericin B Amphoterixin B deoxycholate
Lipid-encapsulated amphotericin B is LESS nephrotoxic
159
How does FIP cause abdominal effusion?
Production of vascular endothelial growth factor (VEGF) - Increased vascular permeability Also complex deposition (Type III HS) around small venules
160
What is the most consistent clinicopathological finding of Hepatozoon americanum?
SEVERE neutrophilia Also periosteal bone reaction
161
What does the FeLV ELISA test for?
p27 antigen
162
What lungworms can you detect with a Baermann?
Aelurostrongilus sp Crenosoma sp
163
What tick carries hepatozoon americanum?
Amblyomma maculatum
164
How do you treat mycobacteria?
Enrofloxacin, rifampin, azythromycin
165
Cats with FIV and UTI - How do you treat UTI?
Always use a cidal drug
166
How is Neospora transmitted in the dog?
Ingest tissue cyst or transplacentally
167
What is the most common sign of lyme disease?
Polyarthropathy
168
How you treat mycoplasma in a cat?
Fluoroquinolone and doxycycline
169
How do you treat salmon poisoning?
Doxycycline
170
Which of the following are zoonotic? (Pythium, Staph aureous, sarcocystis, histoplasma)
Staph aureous
171
What is the best way to diagnose leptospirosis 5 days after exposure?
PCR - Do MAT after 7-10 days
172
Highested specificity test for Bartonella?
Culture | serology has highest sensitivity
173
What stage of babesia causes hemolysis? | merozoite, ookinete, sporozoite, trophozoite
Merozoite
174
Most sensitive bloodwork abnormality for Hepatozoonosis americanum?
High CK (pyogranulomatous inflammation from tissue phase)
175
In addition to doxycycline, what drug do you need to treat a patient with Neorickettsia helmintheca?
Praziquantel
176
Young cat with acute, hemolytic anemia with epicellular RBC parasites? How would you treat this cat?
Doxy +/- quinolone
177
Dog with pleural effusion, elevated temperature (104.5). On cytology of pleural fluid, you see non-acid fast filamentous organism. Aerobic culture is negative. What is the most likely cause?
Actinomyces
178
Most common cause of pyothorax in cat?
Pasteurella
179
3 year old dog with large bowel diarrhea. On rectal scrapings you see small (2-4 um) organisms inside macrophages. What is the diagnosis?
Histoplasma
180
Horses and dogs are a reservoir for humans for which of the following? a. Staph auerus b. Pythium c. Blasto d. Sarcocystis
Staph aureus
181
What tick carries Anaplasma phagocytophilum?
Ixodes
182
How do you diagnose Rabies?
IFA on brainstem, cerebellum
183
How can you definitely diagnosed hepatozoon americanum?
Muscle biopsy
184
When can spontaneous remission be seen with Tritrichomonas foetus?
In 2 years
185
Regarding treatment of prostatitis - What drug qualities do you need? ``` pKa (high/low) Protein binding (high/low) ```
``` Low pKa (weak base) allowing non-ionic form of the drug to cross lipid prostatic membrane ``` Low protein binding
186
What is the most likely bacteria to cause prostatitis?
E. coli
187
What abx are recommended for the treatment of prostatitis?
TMS, chloramphenicol, fluoroquinolones
188
What bacteria is not susceptible to clavamox?
Enterococci
189
In what percentage of healthy dogs can salmonella be found?
30%
190
What part of the small intestine does salmonella have predilection for?
Invades ileal epithelium and causes mucosa sloughing/secretory d+.
191
What kind of immune response is expected with leishmania?
Cell mediated immunity via Th1 CD4 cells
192
Cats are more likely to have (male/female) heartworm infections?
Male - more likely to miss antigen
193
What tick carries E. canis?
Rhipicephalus sanguineous
194
What tick carries E. ewengii?
Amblyoma americanum
195
How is the organism transmitted within ticks? Ehrlichia anaplasma, neorickettsia Rickettsia
Ehrlichia anaplasma, neorickettsia - transtadial Rickettsia - Transovarial
196
What is the host of anaplasma phagocytophilum?
Deer, rodents
197
What drug has been shown to decrease the burden of Trypanosoma cruzi infection?
Benznidazole
198
What are the common clinical signs of Trypanosoma cruzi infection?
Cardiomyopathy, arrhythmia, occasional neurologic disease and laryngeal paralysi
199
Which breed is commonly affected by Babesia gibsoni?
American pit bull terriers
200
Which antifungal crosses BBB?
Fluconazole Voriconazole (to a lesser extent)
201
What is the most efficacious treatment for cryptococcus?
Amphotericin B
202
How is coccidiodes acquired?
Inhalation
203
For coccidioidomycosis, is antigen or antibody testing recommended?
Antibody
204
What does the urine antigen test for blasto detect?
gallactomannan
205
As opposed to dogs, what group of cats are overrepresented in cases of upper respiratory tract aspergillosis?
Brachycephalic cats
206
What fungal organism can be highly zoonotic from infected patients to humans?
Sporothrix -- cat scratches
207
Which form of sporothrix is most common in cats?
Disseminated | dogs - cutaneous, cutaneolympatic
ACVIM General Boards - 2022
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