Diagnosis and Management of Rickettsial Diseases

1. What pathogen is associated with a rash that began peripherally and moved centrally, including palms and soles, 3-5 days after fever and headache, along with some edema and leuko/thrombocytopenia?

Borrelia burgdorferi (Lyme disease)

R. Rickettsii (rocky mt spotted fever)Vector: Dermacentor tick problems with AA c G6P defiency

Treponema pallidum (syphilis)

Plasmodium falciparum (malaria)

Rocky Mountain spotted fever is caused by Rickettsia rickettsii, which is transmitted through the bite of an infected Dermacentor tick. The clinical presentation includes fever, headache, rash starting peripherally and moving centrally to involve palms and soles, along with edema and leuko/thrombocytopenia.

Explanation

Rocky Mountain spotted fever is caused by Rickettsia rickettsii, which is transmitted through the bite of an infected Dermacentor tick. The clinical presentation includes fever, headache, rash starting peripherally and moving centrally to involve palms and soles, along with edema and leuko/thrombocytopenia.

2. Pt with fever, intense headache, and Tache noire, bit by a tick. Pt then developed severe disease because of hx of alcoholism and diabetes. Name two bacteria and the regions.

Borrelia burgdorferi: North America, Europe, Asia

Anaplasma phagocytophilum: North America, Europe, Asia

Rickettsia rickettsii: North America

This question is about identifying bacteria and their respective regions associated with tick-borne diseases. The correct answer includes R conorii in regions such as Mediterranean, middle east, and Africa, and R Africae in southern Africa. The incorrect answers provide other bacteria like Rickettsia rickettsii in North America, Borrelia burgdorferi in North America, Europe, and Asia, and Anaplasma phagocytophilum in North America, Europe, and Asia, which are not the bacteria mentioned in the question.

Explanation

This question is about identifying bacteria and their respective regions associated with tick-borne diseases. The correct answer includes R conorii in regions such as Mediterranean, middle east, and Africa, and R Africae in southern Africa. The incorrect answers provide other bacteria like Rickettsia rickettsii in North America, Borrelia burgdorferi in North America, Europe, and Asia, and Anaplasma phagocytophilum in North America, Europe, and Asia, which are not the bacteria mentioned in the question.

3. Pt comes in with chills, headache, and fever of abrupt onset. There is a vesiculopapular rash. The pt has been living in a shelter for three months. What is the vector, the etiological agent and the clinical name for the syndrome?

R akariRickettsialpoxmouse mitesHis Vesicle? he MITE be living in AKAR (akari)

C ulex, Celliitis, fleas

P elodalla, Petrauve, ticks

L allaphis, Licepsis, bed bugs

R akari (mouse mites) is the vector responsible for transmitting Rickettsialpox to the patient. The clinical name for the syndrome is Rickettsialpox, caused by the etiological agent R akari.

Explanation

R akari (mouse mites) is the vector responsible for transmitting Rickettsialpox to the patient. The clinical name for the syndrome is Rickettsialpox, caused by the etiological agent R akari.

4. War broke out in Poland. A refugee comes in with abrupt onset fever, chills, myalgia, headache and rash that began centrally and spread to limbs (not on face, palms or soles). Name the bacteria, clinical syndrome, vector. How do you diagnose? Is mortality high?

5. Ali is living in the port city SD, Cali (or Texas). She has a ton of cats who have rats and one opossum. She calls with a fever, headache, chills, and nausea. She has a rash that appeared everywhere at once. Name the bacteria, clinical syndrome, vector?

Salmonella typhi, Typhoid fever, tick

Yersinia pestis, Plague, mosquito

R typhiEndemic/murine typhusflea

Anthrax, Cutaneous anthrax, flea

The correct answer is R typhi, Endemic/murine typhus, flea. The symptoms described are characteristic of murine typhus caused by Rickettsia typhi, transmitted by fleas. The incorrect answers do not match the symptoms and vectors mentioned in the question.

Explanation

The correct answer is R typhi, Endemic/murine typhus, flea. The symptoms described are characteristic of murine typhus caused by Rickettsia typhi, transmitted by fleas. The incorrect answers do not match the symptoms and vectors mentioned in the question.

6. A patient traveling in Australia and SE Asia presents with an eschar and regional lymphadenopathy. The patient is now experiencing fever, headache, rash, and deafness. What is the name of the bacteria causing this clinical syndrome, the clinical syndrome itself, and the vector involved?

Borrelia burgdorferi, Lyme disease, Mosquito

Rickettsia rickettsii, Rocky Mountain spotted fever, Tick

Yersinia pestis, Bubonic plague, Flea

O tsutsugamushiScrub typhusChigger larval mite"Tsuk tsuk.. you deaf mate? chigger dont want no scrub, typhus."

Scrub typhus caused by O. tsutsugamushi presents with an eschar, regional lymphadenopathy, fever, headache, rash, and deafness. The vector in this case is the chigger larval mite.

Explanation

Scrub typhus caused by O. tsutsugamushi presents with an eschar, regional lymphadenopathy, fever, headache, rash, and deafness. The vector in this case is the chigger larval mite.

7. A farm vet delivered cattle placenta and inhaled ONE bacterium. A month later he had bilateral pneumonia and hepatitis. 6 mo later he has endocarditis (that is culture neg) and osteomyelitis. What is the bacteria, clinical syndome and resevoir? What cells does this bacteria attack?

Coxiella burnetii (Q fever)Resevoir: cattle, sheep and goats uniate in water-> contact or inhaleCells: live inside phagolysosome of macrophages

Salmonella enterica (Typhoid fever) - Reservoir: contaminated food or water - Cells: invade intestinal cells

Staphylococcus aureus (MRSA) - Reservoir: human skin and nasal passages - Cells: produce toxins and enzymes to damage host tissues

Mycobacterium tuberculosis (Tuberculosis) - Reservoir: infected individuals - Cells: primarily affect alveolar macrophages

8. Pt in southern US with fever chills, headache, vomiting/nausea and a rash. Labs show leukopenia and thrombocytopenia. Smear showing morulae inside of Monocytes. Name Bacteria, syndorme? 7 days ago pt was bit by a ___?

Anaplasma phagocytophilumHuman Granulocytic AnaplasmosisBlack-legged (Deer) tick: Ixodes scapularis.

Ehrlichia ChaffeensisHuman Monocytic Ehrlichiosis Lone star tick: A americanum

Borrelia burgdorferiLyme diseaseDeer tick: Ixodes scapularis.

Rickettsia rickettsiiRocky Mountain Spotted FeverDog or wood tick: Dermacentor variabilis.

The correct answer is Ehrlichia Chaffeensis which causes Human Monocytic Ehrlichiosis and is transmitted by the Lone star tick: A americanum. The three incorrect answers represent Anaplasma phagocytophilum (Human Granulocytic Anaplasmosis), Borrelia burgdorferi (Lyme disease), and Rickettsia rickettsii (Rocky Mountain Spotted Fever) which are also tick-borne diseases but have different causative agents and clinical presentations.

Explanation

The correct answer is Ehrlichia Chaffeensis which causes Human Monocytic Ehrlichiosis and is transmitted by the Lone star tick: A americanum. The three incorrect answers represent Anaplasma phagocytophilum (Human Granulocytic Anaplasmosis), Borrelia burgdorferi (Lyme disease), and Rickettsia rickettsii (Rocky Mountain Spotted Fever) which are also tick-borne diseases but have different causative agents and clinical presentations.

9. Pt presents with fever chills, headache and peripheral neuropathy. Labs show leukopenia and thrombocytopenia. Smear showing morulae inside of Granulocytes. Name Bacteria, Syndrome? What other disease should you check for, why?

Ehrlichia chaffeensis, Human Monocytic Ehrlichiosis, Check for Rocky Mountain Spotted Fever because it presents with similar symptoms.

Anaplasma PhagocytophilumHuman granulocytic Anaplasmosis Check for lyme and bebeiosis bc vecotor is Ixodes.

Borrelia Burgdorferi, Lyme disease, Check for Anaplasmosis and Babesiosis as they can be transmitted by the same vector.

Rickettsia rickettsii, Rocky Mountain Spotted Fever, Check for Ehrlichiosis as both are transmitted by ticks.

10. What is the hallmark of infected endothelial cells?

Halmark of infected endothelial cells?-> vasculitis

Edema

Fibrosis

Thrombosis

Infected endothelial cells commonly exhibit vasculitis, which is inflammation of blood vessels. This is a key indicator of endothelial cell infection.

Explanation

Infected endothelial cells commonly exhibit vasculitis, which is inflammation of blood vessels. This is a key indicator of endothelial cell infection.