 Welcome back to our meds smarter lecture series where we're taking a smarter approach to preparing future physician Before we get started if you'll take just a quick minute and click that like button and also Subscribe and turn the bell on so that you'll be notified when we post new videos Let's continue on with our discussion of gram-negative organisms and discuss spirokeets Spirokeets specifically are going to be spiral shaped bacteria that have an axial filament in them Three examples of spirokeets are going to be Borrelia, which you can think of that as big-sized Lepto spiro and treponema Treponema of course is going to be the most commonly known as syphilis Now we can remember these three particular organisms as spirokeets as BLT and Borrelia is big So you've got Borrelia as the BL as Lipto spiro and T is treponema of these three you can only see Borrelia Using an aniline dye under light microscopy and because it is big we can then see it However, Lipto spiro and treponema are unable to be seen because they are so small now What type of aniline dyes can we use these are going to be either your right or your game sustain? To be able to visualize treponema We're going to have to use dark field microscopy because they will not die with those aniline dyes Or we can use the direct fluorescent antibody microscopy. So let's discuss Borrelia first Borrelia is a spirokeet that causes Lyme disease We get this Borrelia transmitted to humans through the exodes deer tick So the natural reservoir originally became the mouse So it came from a mouse the deer became the intermediate host It doesn't harbor it. It's an intermediate host the deer tick or the exodes tick Then we'll bite the deer will become infected with the Spirokeet of Borrelia and then when they bite a human they transmit that disease to the humans it's most commonly seen in the northeastern United States and To be able to treat it. We're going to use to use doxycycline a very simple treatment. That's our first-line treatment there If it does become more severe if we don't catch it early We can jump on into amoxicillin and then if we do see any type of CNS Signs or severe illnesses heart blocks, then we will use seftriaxone Remember seftriaxone is a great cephalosporin for anything that is in the central nervous system because axe Will penetrate that blood-brain barrier. So seftriaxone will get into the CNS and help with that So we have three different stages of Lyme disease stage one is the early stage where we see that erythema migraines Which is that typical bullseye rash where you have that central reddened area Followed by a clear area and then another circle of reddening So that's erythema migraines and most of the time we see flu-like symptoms with Patients in that stage Moving on to stage two. This is where it becomes more disseminated. We can see secondary lesions associated with it Carditis is going to be very common to see with something like an AV block maybe Facial nerve palsy is one of the main things with Lyme disease that we see so that's stage two when you get that facial nerve palsy and migratory myalgias or transient arthritis So these can be muscle or joint pains that can move back and forth and not be consistent in one location And then stage three is our late disseminated stage where we get that encephalopathy or in chronic arthritis Stage three is definitely where we would be For sure using seftriaxone to treat Likely using seftriaxone in stage two as well due to some of those heart blocks So a way to remember Lyme disease and some of the main key aspects of it is you get a key Lyme Pi to the face so Lyme disease and you remember FACE So F is facial nerve palsy a is arthritis C is cardiac block and then E is erythema migraines or that characteristic bullseye rash If you found this material helpful for your studying Please like and consider subscribing to the channel also share this video so that more people can benefit from it like you have