SPIROCHETES

Question 1

Spirochetes

Shape

Answer 1

Spiral-shaped bacteria with axial filaments

Question 2

Borrelia burgdorferi

Map distribution

Answer 2

Northeastern of USA

Question 3

Borrelia burgdorferi

Transmission

Vector

Answer 3

Ticks

Ixodes scapularis

Question 4

Borrelia burgdorferi

Main reservoir

Answer 4

White fooded mouse

Question 5

Borrelia burgdorferi

Obligatory host

Answer 5

White tailer deer

Question 6

Borrelia burgdorferi

Can be visualized with

Answer 6

Wright and Giemsa stain

DO NOT gram stain

Question 7

Borrelia burgdorferi

Stages

Answer 7

**Stage 1: **early localized: erythema migrans (bulls-eye), flulike symptoms
**Stage 2: **early disseminated: carditis, AV block, facial nerve (Bell) palsy
**Stage 3: ** late disseminated: encephalopathy, migratory chronic arthritis (large joints), peripheral neuropathy

Question 8

Borrelia burgdorferi

A Key Lyme pie to the FACE

Answer 8

F: Facial nerve palsy
A: arthritis
C: Cardiac block
E: Erythema migrans

Question 9

Borrelia burgdorferi

Treatment

Answer 9

Doxycycline
Amoxicilin (pregnancy, children < 8 y/o)
Ceftriaxone IV

Question 10

Treponema palladium

Grows in

Answer 10

It is microaerophilic, cannot be grown in culture

Question 11

Treponema palladium

Visualization

Answer 11

Dark field microscopy

Question 12

Treponema palladium

Transmission

Answer 12

Sexually transmitted

Question 13

Treponema palladium

Main screening test

Answer 13

VDRL
RPR

Not specific, detects antibodies

Question 14

Treponema palladium

Confirmatory test

Answer 14

FTA-ABS

Detects antigens

Question 15

Treponema palladium

Clinical presentation

Primary syphilis

Answer 15

Painless genital chancre

Heals in 3-6 weeks

Dark field microscopy to visualize it in fluid from chancre
VDRL (+) 80%

Question 16

Treponema palladium

Clinical presentation

Secondary syphilis

Answer 16

Maculopapular rash that occurs on palms and soles
Condyloma lata (painless, wartlike white lesions on genitals)
Lymphadenopathy

Dark-field microscopy
(+) serology

Question 17

Treponema palladium

Clinical presentation

Tertiary syphilis

Answer 17

Gummas: chronic granulomas
Aortitis: vasa vasorum destruction
Nuerosyphilis: tabes dorsalis
Argyll robertson pupil: contricts with accommodation but is not reactive to light
(+) Romberg
Charcot joint

Question 18

Treponema palladium

Clinical presentation

Congenital syphilis

Answer 18

Rhagades
Snuffles
Saddle nose
Notched (Hutchinson) teeth
Mulberry molars
Saber shins
Deafness

Question 19

Treponema palladium

False Positive results on VDRL

Answer 19

Pregnancy
Viral infection
Drugs
Rheumatic fever
Lupus and leprosy

Question 20

Treponema palladium

Treatment

Answer 20

Penicilin

Question 21

Treponema palladium

Reaction during treatment of spirochetal infections

Answer 21

Jarish-Herxheimer reaction

Flulike symptoms after antibiotics are started due to host responde to sudden release of bacterial antigens

Question 22

Leptospira interrogans

Where do you find it?

Answer 22

Water contaminated with animal urine

Question 23

Leptospira interrogans

Disease

Answer 23

Leptospirosis
Weil disease

Question 24

Leptospira interrogans

Leptospirosis

Answer 24

Flulike symptoms
Myalgias
Jaundice
Photophobia + conjuctivitis

Question 25

# Leptospira interrogans Weil disease

Answer 25

Jaundice + azotemia from liver and kidney dysfunction, fever, hemorrhage, anemia | Severe form