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228 Cards in this Set
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Any person, animal, arthpod, plant, soil, substances or combination of; in which an infectious agent normally lives, multiples, or which depends on primarily for survival and where it reproduces itself
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Reservior
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What are the three modes of Transmission?
a. direct, communicable, indirect b. Airborne, direct, indirect c. direct only d All of the above |
b.
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What is the definition of Susceptible?
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Having little resistance (immunity) to a disease or foreign protein
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Infectious disease occuring suddenly in numbers clearly in excess of normal expectancy?
a. host b. epidemic c. outbreak d. Endemic |
Epidemic
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The period of development of an infecious disease from inoculation to the onset of clinical symptoms?
a. incubation b. Host c. Causative agent d. endemic |
Incubation
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The initial onsetof infectious disease in a particular host population?
a. host b. incubation c. outbreak d. endemic |
outbreak
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A specific infectious disease that is present or usually present in a population or geographical area at all times?
a. outbreak b.endemic c. incubation d. epidemic |
b. endemic
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What are the five sections of the Medic CD rom?
a. Envi., infectious, FHP, Medical, Security b. Envi. Infectious, FHP, MEdical, Disease c. FHP, Disease, Enviro., Medical, PHA |
b.
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What are the parts of Enviornmental Health?
a. key judgementys b. Hazardoius plants/animals c. Envir. contamination d. all the above |
d. + physical envirnmental overview, listing information, such as climate, temp.
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What 3 things is covered under the INfection disease section of Medic CD?
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1. Key judgments
2. Supplents to risk 3. Disease of potential risk |
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FHP provides a summary of preventive practices to prevent the spread of disease including the following?
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major infectious disease countermeasure focus
FHP prior to deployment FHP during deployment FHP after deployment FHP prevmed guide |
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Provides a list of vector relatied disease as well as recommendiations for vector control on a selected country?
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Disease vector profiles
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What 5 medical capabiliites are there that provides synopsis of the selected countries ability to furnish medical services and suppor tto operational forces?
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Civilian and Military capabiliites
Disaster and emergency response Social factors Medical treatment and evacuation facilities |
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What disease is caused by the orthomyxoviurs, has incubation period of 1-4days with PE findings of Non productive cough, sore throat, constitutional signs and effect mainly young and elderly?
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Influenza
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What is the definition of influezna?
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Acute viral upper respiratory infection caused by influenza type A, B, C
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What are the main constitutional symptoms for viral illness?
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Fever
Chills Myalgia Prostartion Anorexia |
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What is rare but severe complication when aspirin is used on children suffering from an influeza/ viral infection?
a. Joe syndrome b. Triad syndrome c. Reyes syndrome d. cushing syndrome |
c.
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What is the disposition of pt with influenza?
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a. bed rest 24-48 hrs or until afebrile
b. RE-check status QD c. Prognoisi: Duration of uncomplicated cases last from 1-7 days with an excellent . |
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Acute systemic paramyxocial infection affecting the skin?
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Rubeloa (measles)
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What is the etiology of Rubeloa?
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Transmitted by the infected droplets, which infected the respiratory epithelium and tehn dissemintates to the skin and other organs via monocytes.
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What are some Physical findings of r Rubeloa (measles)?
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Incubation 10-14 days
prodrome phase begins 2-4days after infection (fever, malaise, Photophobia ***enathem (koplik's spots) |
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Prodrome phase begins 2-4 days after infection and presents with what signs?
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fever
Classic triad: brassy cough, coryza and conjunctivits Enanthem)koplike spots) white 1-2mm papules appearing on teh buccal mucosa. |
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Exanthem phase occurs when and shows what type of symptoms?
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4 days
Increasing fever peaks 105 degrees and will decline over 24 hrs. Rash lasts 3-7 day leaving a copper brown crust that desquamtes Progresses in down and out pattern starting as pin size and brick red, irregular , blocthy and maculopapular, affecting the entire body including the hands and feet |
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What are some treatments for Rubeloa (measles?
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Isoloation
Vit A 200,000 units daily x 2days Supportive care Antibiotics for secondary bacteria infections |
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What are some complications of Rubeloa?
a. splenomegaly endocarditis, COPD b. Encephalitis, SSPE, Immunocomprised pts/ c. epidymitis, ochitis, vaginitis d. death, coma, hemorrhagic fever |
b.
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What is the dispostion of Rubeloa (measles)?
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Bed rest for duration of fever
REcheck pt status Q4-6hrs, PRN Confirm with MO for MEDEVAC |
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25y/o female in first trimester of pregnancy, with constitiutional symptoms, Conjuncitivits, Lymphadenopathy and rash that develop 4 days after with Palatal macules with exanthema?
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Rubella (german)
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What is the incubation period of Rubella (german measles)?
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14-21 days
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What causes Rubella (german measles)?
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mild systemic diseas caused by TOGAVIRUS
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What are some complications of Geman measles (rubella)?
a. deafness b. catracts c. Retinopathy d. Intrauterine growth retardation e. Encephalitis f. all the above |
they are all apart of the complications
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What is the dispostion of German measles?
a. Iso 3-4 days, Contact MO, MER b. Iso 10 days, MER and contact MO c. Contact MO, A&I, Iso 3-4 days d. Contact MO, Iso 5-7 days, MER |
a. Iso to bed rest 3-4days, contact MO, MER
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What is acute Generalized paramyxoviral disease causing inflammation of the salivary glands?
a. Chickenpox b. smallpox c. mumps d. Rubella |
c.
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75% of mumps occure in whom?
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teenage years
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when is mumps more prevealent?
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during the spring
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What are some physical findings of mumps?
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Incub 14-21
Parotid swelling, tenderness and facial edema are the most common unilateral 25% and edematous Drinking citrus or acidic foods exacerbates symptoms |
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What occurs 85% of all mump cases?
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Epididymtitis
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What is the treatment for pt over 35 yrs of age with mumps?
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Cetriaxone 250mg and Doxycycline 100mg
Over 35 Cipro 500mg |
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What is the overall treatment of mumps?
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Universal precautions
Supportive care Ensure proper nutrition |
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what complications occurs 30% of the time of pt with mumps?
1. pancreatitis 2. meningitis 3. hepatitis 4. endocarditis |
2.
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What is the prognosis of Mumps?
a. most pts recover never b. course for dz rarley last 2wks and pts recover fine c. All most dies after 14 days of disease d. Nothing happens after symptoms reside |
most pts recover without incidents and course of dz rarely last two weeks
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Pt 10-35y/o with fatigue, malaise, fever, pharyngitis, Post cervical adenopathy with prodrome phase lasting several days. Incubation peiord last 1-2months.
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Infectious mono
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What causes Mono?
a. hemorrhagic fever b. mumps c. Epstein Barr virus d. adnenovirus type II |
c. epstein barr virus
transmitted through close contact via salivia "kissing bug" |
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What is the treatment for Infectious Mono?
a. ASA 2tabs q4-6hrs prn b. Tylenol 325 2tabs q-4-6hrs PRN c. Prednisone 60mg PO QD x 3days d. Motrin 800mg 1tab q-6 hrs |
c. prednisone 60mg x 3days then taper over 1 wk
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How long should pts with Mono avoid contact sports and how long is their salvia infectious for?
a. 2 months and 12monts b. 1 month and 6 mnths c. 12 months and 6 months d. 1 month and 1 month |
1st month no contact
6 months of infeted saliva |
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This dz affects ages from 5-10y/o, peaks in springtime and is common and highly contagious viral illness charac. by vesicular rash and fever. The incubation is 10-20 days?
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Varicella (chickenpox)
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How do the lesions present on pts with varicella (chickenpox?
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prominetly on face, scalp and truck progressing to ext.
lesion 2-4 mm red papules with irregular border with a central clear vesicale "DEW DROPS ON A ROSE PETAL) |
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New lesion of varicella development generally ceases when and crusts when?
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cease on 4th day and crusting by the 6th day
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What lab should you do for varicella if diagnosis is in question?
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Tzanck smear
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What are some treatments for Varicella (chickenpox)?
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supportive
diphenhydramine 25mg PO Calamine lotion Acyclovir 800mg QID, give within the first 24hrs of prodromal symptoms |
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What are some complication of Varicella (AIRS)?
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ARDS
Ischemic strokes Reyes syndome Secondary bacterial infections |
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Pt comes in with 104temp, BAckache with centrigugal pattern rash starts as flat red lesions, evolving at same rate that are firm, domed or umbilicated. The rash is prominent fo face, arms and legs?
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Smallpox
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What is the definition of Varioloa (smallpox)?
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DNA virus due to the variola virus. It is human virus with no known nonhuman reseviors
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When is smallpox most contagious?
a. 3 wk of infection b. 1 wk of infection c. all times of infection d. 4 wk of infection |
during the 1st wk of infection
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what is the incubation period of smallpox?
a. 1-10 days b. 5-7 days c. 7-19 days d. 28 days |
c.
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What are some complications for Smallpox?
a. Blepharits, 2nd Bact infection, PNA, dehydration b. conjuncivitis, hydration, TensionPNA, virual infection c. Heart attack, corneal ulcers, PNA, stroke |
a.
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Who do you contact immediately with cases of Smallpox?
a. Prevemed and MO b. EPMU and infectious dz Physician c. ER and CDC d. Public health and CD |
b.
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What is the mortality rate of Variola major?
a. 10-20% b. 30-40% c. 20-50% d. 80-90% |
20-50%
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What is group of infectious disease caused by arthropod borne viruses?
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Viral hemorrhagic fever
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What are the five main genus of viruses?
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Arenavirdae
Bunyaviridiae Filoviridae Flaviviridae Paramyxoviridae |
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90% of this disease is part of the Filoviridae genus?
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ebola
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What genus does the Hanta virus falls under?
a. Flavivirdiae b. Paramyxoviridae c. Arenaviridae d. Bunyaviridae |
d.
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What would you find in lates stages of Viral hemorrhagic fever?
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Leukopenia
AMS Hemorrhagic diathesis |
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What are some treatments of pt's with Viral hemorrhagic fever?
a. supportive and tylenol b. supportive and Zantac c. supportive and Tums d. supporitve and antibiotics |
b. Zantac at 150mg bid for GI bleeding
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What is the mortality rate of VHF?
a. 5% b. 15-20% c. 20% d. 20-30% |
b.
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Is usually nonspecific, self limting, febrile illnesss with an incubation period of 7-10day?
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Dengue fever
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What is the cause of Dengue fever?
a. anopohles b. blow flow c. aedes aegypti mosquito d. sand fly |
c.
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What are some initial signs of Denque fever?
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Constitutional symptoms
Severe myalgia and arthralgias to back sore thorat Prostration Depression Conjunctival flushing Redness, flushing, blotching of skin |
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What is the definition of Dengue fever?
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Viral Flaviviurs transmitted by an arthropod bite
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What is it meant by biphasic fever curve?
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initial fever will last 3-7 days, then a remission period of a few hors to two days followed by another febrile period lasting 1 to 2 days.
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Rashes associated with dengue appears 80% of cases and how does the rashes appear?
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Scarlatiniform
Morbilliform Maculopapular Petechial Rash can last 2 hrs to several days Desquamates |
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What are some treatments for Dengue fever?
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Supoortive care
GI bleeding (zantac 150mg BID) ICe lavage/gavage Repeat CBC/HCT q 2hrs to tract potential complications. ***expect drop in HCT, with IV hydration |
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What are some complications of Dengue fever? (BODIP))
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Bone marrow failure
Orchitis or oophoritis Depression Iritis PNA |
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What disease occurs 70--90 % in Bolivia or Peru and has incubation period of 3-6days and affecting 20-40 yrs olds?
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Yellow fever
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What are the two tramsissable types of yellow fever?
a. sylavitic and blow fly b. anopheles and dropletic c. aedes aegyptis and sylvatic (jungle cycle) |
c.
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What is the toxic phase of Yellow fever?
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Jaundice
Oliguria Albuminuria Hemorrhage Encephalopathy shock acidosis |
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What could be some complications of Yellow fever?
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Lactic acid build up and shock
myocarditis Encephalopathy Decreased synthesis of clotting factors Disseminated intravascular coagulation |
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Pt comes in C/O of eye pain, rash fever, chills, myalgia, AMS is flaccid paraylsis, ataxia with Lymphadenopathy lasting 5days. Pt's become infected by the Culex mosquito?
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West Nile Virus
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What is the definition of West Nile Virus?
a. morbillioform infection b. encephalitides c. flavivirus encephalitides d. none of these |
c.
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What are some complications of West Nile Virus?
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Secondary infections
Urinary retention Tremors Seizures Death |
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A 25y/o male comes in with bite to the hand, c/o of sore thorat, constitutional symptoms, GI symptoms, pain, on exam you find Extreme hyperactivity, bizarre behaviour, thick tenacious saliva. what is his condition?
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rabies
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What is the incubation period of rabies?
a. 90 days b. 10-20days c. 10-90 days d. only 20 days |
c.
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What is the treatment for rabies?
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support
Thorough cleaning of wound. Human rabies immune globulin 20 IU/kg Anticonvulsant therapy |
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What are some complications of Rabies?
a. Paralysis and cellulitis b. Coma, death, paralysis c. cellulitis and death only d. no complications can occur |
b.
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What is the main cause of Poliomyelitis?
a. fecal-oral route by presents of adneovirus b. fecal-oral route by presents of enterovirus c. fecal-oral route by presents of staph aerus d. fecal -oral route by presents of gram postitive bacilli |
enterovirus present in throat washings and stool
Transmitted by the fecal oral route |
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What present of all cases usually results in asymptomacti infection of poliomyelitis?
a. 85% b. 75% c. 100% d. 95% |
95%
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Those who present with signs of poliomyelitis have one of what three presentations?
a. Paralytic, Nonparalytic, nonabortive b. abortive, anesthesia, paralytic c. abortive, nonparalytic, paralytic d. abortive, paralytic, nonabortive |
abortive, nonparalytic and paralytic
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What are some signs of Abortive poliomyeylitis?
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Constitutional symptoms
Sore throat diarrhea constipation |
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What are some complicatinos of Poliomyelitis?
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Urinary retention
UTI Atelectasis Myocarditis PNA Pul edema |
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What is the most common cause of hepatitis in the US?
a. Hep B virus b. Hep C virus c. Hep A virus d. Hep E virus |
c. HAV
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HAV effects whom more?
a. children 1-5y/o b. children 5-14y/o c. children 5-10y/o d. adolescence 10-15y/o |
children 5-14
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Which hepatitis virus in higher in Europe?
a. HBV b. HAV c. HCV d. HDV |
HBV
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What is the most common chronic blood borne infection in the US?
a. HDV b. HEV c. HBV d. HCV |
HCV accounts for 40% of nonalcoholic liver disease in US
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How long does hepatitis last, and when do you expect full recovery?
1. lasting 1-2wks, recover 5-10wks 2. lasing 2-3wks, recover 8-16wks 3. lasing 8-16wks, recover 2-3wks 4. lasting 1wk recovery in 2 wks |
disease lasting 2-3 wks and recovery in 8-16 wks
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Hepatitis being difficult distinguishing types, what are some prodromal type signs and symptoms of Hepatitis?
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Abrupt or insidious onset
constitutional symptoms (varaiable ferver) Aversion to smoking, distaste N/V/D or constipation Stool fatty, floating clay like ABD pain RUQ Hepatomegaly over 50-80% spleomegaly 15% |
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What would you find in the UA for pt with hepatitis?
a. blood b. casts c. bilirubin d. glycuose |
bilirubin
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For prognosis which Hep is self limiting, while the others have long term effects?
a. HAV vs HBV/HCV b. HBV vs. HAV/HDV c. HCV vs HAV/HBV d. HGV vs HEV/HBV |
Hep A is self limiting as HBV/HCV are chronic and have substantial long term effects
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22y/o male reported c/o constitutional symptoms, rigors, conjuntival suffusion, rigors, pharyngitis, lymphadenopathy, splenomeglay. He told you that it started few days ago and that prior he was swimming in a near by river in thailand. What is your diagnosis?
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Leptospirosis
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What is the definition of Leptospirosis?
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Zoonotic disease caused by bacterial spriochete leptospria interrogans
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What are some specific labs for Leptospirosis?
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CBC, HCT, RPR
UA Liver panel 24 hr urine chem10 CHest xray |
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What is the treatment for Leptospirosis?
a. PCN G and doxycycline b. Cipro and Doxy c. Steriods and PCN d. PCN only |
PCN G 6-12 mil units q day IV
Doxycycline 100mg or 200mg if in a endemic area |
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What is the prognosis of Leptospirosis?
a. excellent b. self limiting, with admin of Antibiotics less the symptoms c. even with therapy has morality rate of 10% d. death |
b. self limiting disease but administartion of antibiotics can decrease severity and duration of symptoms
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75y/o pt with S/S in last 48hrs with N/V/D, abd cramps, fever. Pt hx of ingesting bad poultry. what is the diagnosis?
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Salmonellosis
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If Salmonellosis becomes systemic, pts develop with _________ and present with _________?
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typhoid fever
presents with increasing malaise, HA, cough, sore thorat abd pain , constipation or diarrhea Fever 7-10 days.. |
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Pt is suspected to having typhiod fever secondary to Salmonellia, what is the treatment of choice in this case?
a. Doxy 100mg BID x 10days b. Cipro 500mg PO c. Ceftriazone 2g PO d. b & c only. |
d.
Treatment of carriers is largely unsuccessful, but recent studies suggest Cipro 500mg PO BID for 4 weeks is highly effective |
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Relapses occur in what Percent of the cases of salmonilla?
a.10% b. 20% c. 15% d. 30% |
15%
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Pt comes to the clinic c/o of gray, turbid, withoug fecal odor, blood or pus; describing stool as "rice water stool." No abd pain or fever with mild cramping. He also said he returned from South america a few days ago. what is his DX?
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Cholera
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What causes cholera?
a. consumption of chicken by chickpox virus b. consumption of bad water by the vibrio cholera. c. consumption of shellfish by mecury toxins d. nonpersistent toxin mediated disease |
caused by vibrio cholera, a persistent toxin mediated dz by comsumption of contaminated shellfish and water
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What is the first rule of thumb when it comes to treating cholera patients?
a. Antibiotics b. rest c. fluid replacment d. plasma replacement |
c.
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What is the mixture of contents in water that will help with mild cases of cholera.
a. 1Tsp of salt, 5Tbsp of glucose in 1L H2O b. 2Tbsp of salt, 5Tbsp of glucose in 1L water c. 1Tbsp salt, 4 Tbsp of glucsoe in 1L water |
c
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What antimicrobial therapy will shorten course of diseae of cholera, here are some choices, you figure out which. There are multiple answers
a. Tetracycline b. PCN c. Doxy d. Steriods e. Ampicillin f. Augmentin g. rocephine |
Tetracycline
Doxycycline Ampicillin |
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What are some complications of cholera.
a. Hypovolemia, Hypotension, Death b. Hypervolemia, HTN, Coma c. Hypercalcemia, Hypocalcemia, Coma d. Hypokalemia and hypertension |
a. Hypovolemia, hypotension, shock and death
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What disease has a great potential for use as a bioweapon due to its severe toxicity and durability?
a. E. Coli b. Yellow fever c. smallpox d. botulism |
botulism
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What is the definition of botulism?
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illness resulting from neurotoxin produced by clostridium botulinum.
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What is the main causative agent of Botulism?
a. Gram neg bacillus b. Anaerobic gram-postive Bacillus c. aerobic gram positive bacillus d. hemophilic Gram positive bacillus |
anaerobic gram-positive bacillus
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What are some finding of botulism?
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s/s begin 12-36hrs following ingestino
Severity is related to amount CN palsies (bilateral) Diploplia Blurred vision Ptosis Dysphagia Dysarthria Dry mouth**** N/V/D or constipation and cramps |
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What are some treatments for botulism?
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Antitoxin (trivalent equine botulinum)needs to be given as soon as possible, even prior to lab confirmation.
Give one vial IM, and 1 vial IV Antitoxin at CDC Wound botulism PCN 2mil/units IV or Amoxicillin 250mg PO |
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It is inflammatory disease of the bowel caused by one of several species of shigella?
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shigellosis (bacillary dysentery)
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What is the most common route of transmission of shigella?
a. indirect only b. direct only c. both a and b d. airborne |
c.
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Which is the most serious for of shigella?
a. S. sonnei b. s. aureus c. S dysenteriae d. e. coli |
c.
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What are some physical findings of shigellosis?
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incubation 1-3 days
Self limiting s/s occur abruptly: diarrhea (mixed with blood and mucus Abd cramping with tenderness tenesmus fever HA, chills, anorexia and malaise |
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What are some treatments for Shigellosis?
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suportive care
Septra DS PO or ciprofloxacin 500mg PO |
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What are some complications of shigellosis?
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Self limiting
dehydration and severe cases Seizures , intestinal perforatoin and death |
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This is disease is caused by yersinia pestis and transmitted by the bite of infected flea. Predominately found in China, Laos, Mongolia, India and Vietnam?
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Plague
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What are some physical findings for pt's with plague?
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Incub period is 1-7das
Initial sym. constitutional , sore throat, intense headache, Delirium, Tachycardia Lymphadentitis, 90% to inguinal nodes Development of bubo at infection site |
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If hematogenous spreads for plague, how will the pt present?
a. stupor, petechia spots and paralysis b. toxic, comatose, purpuric spots (black plague) on skin c. comatose, malasie, myalgia and spots on hands and feet d. malasie, myalgia and paralysis with koplike spots |
b.
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What are some unique lab test for plague?
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Gram stain of bubo discharge
Ovoid bipolar gram neg. rod (safety pin appearance (CBC, RPR, chest films, Serum titer) |
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How do we treat plauge?
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Support
wound cleaning, soap and water Gentamycin 2mg/kg loading dose, 1.7mg/kg Q8(best choice) alternative(doxy 100mg) chloramphenicol 500mg QID IV (ammal prep 1g vials) |
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What are some complications of Plaque?
a. toxic shock, DIC, Bact Sepsis, fulminant PNA b. Strep sepsis, Anemia, hypovolemic shock c. thalassemia, Bact sepsis, StrepPNA d. folic deficiency, gram neg sepsis, Bronchitis |
a
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What is the disposition of pt with plague?
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Bed rest and strit isolation of pt quarantine all personnel who had face to face contact
contact MO |
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75y/o male pt with diabetes who had heart surgery comes to ER with s/s of fever, hypotension, tachycardia, tachypnea, slightly AMS with elevated CBC (WBC count) and blood cultures are postive for bacteria. what is your likely Dx?
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Sepsis
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What are some caustive agents that lead to sepsis?
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E. coli
Klebsiella Pseudomonas Aeruginosa Staph Strep N. Meningitides Gram neg bact |
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What is our main treatment plan for pt who is septic?
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Id the source
supportive therapy Broad specturm IV (gentamycin and cipro) Bed rest, Strict iso Hospitalzation COntact MO |
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What is the definition of Typhus?
a. nonfebrile gram pos, obligate intracellular, bacteria b. febrile, gram-neg, nonobligate intracelluar, bacteria c. Febrile gram neg, obligate intracellular, bacteria d. Febrile gram bacilli, obligate extracellular, bacteria. |
Febrile gram negative, obligate intracellular bacteria
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How many types of Typhus are there?
a. 1 b. 2 c. 4 d. 3 |
c. 4
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What are the four types of typhus?
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Epidemic (louse borne) cause rickettsia prowazekii
California flea (rickettsia felis) Endemic (murine) cause rickettsia typhi Scrub (orientia tsutsugamushi) |
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What is the incubation period of typhus?
a. 2-3wks b. 1-2wks c. 2-10wks d. 1-3wks |
1-3 wks
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Signs and symptoms of epidemic, California and Endemic Typhu presents with what?
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HA, fever, chills
severe prostration Macular rash to truck, axial , then spreading to rest of the body sparing face palms and soles (epidemic) Maculopapular rash concentrated on the truck and fades rapidly (Murine) |
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How does Scrub typhus present?
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Malaise, chills, gradual onset of fever, Severe headache, Backache
Site of bite (turns Black Eschar with regional lymphadentitis) Macular rash appears primarily on truck |
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What are some late symptoms of typhus in the 2nd or 3rd week include?
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Obtunded
Pneumonitis Myocarditis Encephaltis Meningitis Acute Abd pain Cardiac failure Hep Renal failure |
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What is the treatment for typhus?
a. support and Doxy b. support and PCN c. Support and Steriods d Support and ASA |
a. doxycycline 100mg PO bid x 7 days or until two days after temp returns to normal
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What is the prognosis of pt with Typhus?
a. death is great b. good no matter what c. depends greatly on age and immunostatus d. depends on sex and gender |
c.
Mortality rate is 10-30% with proper tx fatality and relapses are virtually eliminated |
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What disease is acquired most often via inhalation of feces, placenta, and milk remnants in dust and is caused by rickettsial organism Coxiella burnett.
a. Typhus b. Qfever c. Pfever d. yellow fever |
b.
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What is the treatment for Q Fever?
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Supportive care
Doxycycline 100mg PO bid alternative therpay, Erythromycin 500mg |
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What are some complications that constitute 24% mortality?
a. pleural effusion b. hepatitis c. encephalitis d. endocarditis |
d. endocarditis
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10y/o boy comes to clinic with c/o of HA, Myalgia, Rash aroudnt he wirst and ankles, diffuse abd pain, nausea and vomitting. History was mother pulled a tick off of him 4 days ago? What is the Dx?
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rocky mountain spotted fever
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What is the definition of Rocky mountained spotted fever?
a. nonfebrile arthorpod borne illness b. febrile protoza borne illness c. nonfebrile protoza borne illness d. febrile arthropod borne illness |
febrile arthropod borne illness
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What is the infectious agent of RMSF?
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Rickettsia rickettsii, intracellular bacterium
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What is the treatment for RMSF?
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Doxy 100mg PO bid until two day after fever
Alternative choic Chloramphenicol 50mg supportive care |
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What is a flagellated parasitic intestinal and/or biliary tract infection?
a. e coli b. giardiasis c. cholera d. salmonlea |
b.
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What is the predominant age range for pts with Giardiasis?
a. 5-10 b. 1-5 c. 20-40 d. 19-25 |
c.
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What is the incubatin period of Giardiasis?
a. 1 wk b. 1-3 wks c. 2-4 wks d. 5-10wks |
1 to 3 weeks
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What might be the only compliant with pt who has Giardiasis?
a. crampy stomach b. nausea c. one bulky loose stool movement a day, after Breakfast d. constipation develops after breakfast |
c.
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What medication would you give to a patient with Giardiasis?
a. PCN b. nothing c. Tertracycline d. Metronidazole |
d. metronidazole 250mg PO TID for 7 days (CBC before and after)
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What disease has rates higher in tropical and subtropical areas of poor sanitation and institutions and is protozoal parastic infection of the colon?
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Amebiasis
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What causes Amebiasis?
a. Anerobic histolytica b. Aerobic entamoeba c. Entamoeba histolytica d. Antameoba histolytica |
c.
Mode of transmission is through consumption of infected water and food, and oral fecal route |
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What is the incubation period of Amebiasis?
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2-4wks , severe cases present in 8 days
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What would be some physical findings of severe intestinal (dysenteric) Amebiasis?
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Freq. BM 10-20 QD
1. Semi formed to liquid, with little fecal material 2. blood streaked, fresh or dark 3. Bits of necrotic tissue become evident |
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What medications do you want to avoid in pt with amebiasis, and what is the recommended treatment?
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Imodium (antiperistalic agents)
Metronidazole 750mg PO TID for 10days In sever cases admin IV |
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What is a febrile, flu like illness, caused by the genus Plasmodium?
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Malaria
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What are the four human malarias disease?
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P. Falciparum
P. vivax P. malariae P. ovale |
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What is the mode of transport for Malaria?
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bite of female Anopheles Mosquito
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What is the incubation period of P. falciparum?
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9-14days
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What is the incubation period of Pmalariae?
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18-40days
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What are some general findings of pt with malaria?
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Diaphoresis
Fatique and malaise N/V, Mild jaundice Mild hepatomegaly with tenderness Splenomegaly Rigors |
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What would be some signs of pt with P. Falciparum?
a. reguarl stool, HA , and tremors b. bloody stool, HA, seizures c. bloody stool, HA , profused vomitting d. Bloddy urine, HA, coma |
b.
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What are the two meds used for Malaria?
a. Doxycycline and PCN b. PCN and tetracycline c. Mefloquine and Primaquine d. Erythromycin and PCN |
c.
Mefloquine 750mg, then 500mg PO@6, 24 and 48hrs later Primaquine 26.3mg 2 tabs PO QD for 14 days |
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What are some characteristics of Renal failure and Black water fever?
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combo of fever and dark urine, indicating severe hemolysis following quinine treatment
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What is Schistosomiasis?
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Snail fever / Bilharziasis
Blood fluke infection with adult and female worms living within mesenteric or venules of veins of the host. |
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Humans are the main reservoirs for what type of Schistosomiasis?
a. |
S. mansoni
Haematobium |
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What are some initial signs of Schistomiasis?
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Cercarial dermatitis, then acute schistomiasis and chronic schistomiasis
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What is the incubation period of Schistomiasis?
a. 1-5wks b. 2-8wks c. 3-4wks d. 5-10wks |
b.
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What are some manifestations of Schistomiasis?
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Fever
malaise urticaria diarrhea may be bloody Myalgia dry cough |
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What is the time frame and signs of S. mansoni and Japonicum?
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begins 6 months to years after infection and presents
diarrhea, abd pain, irregular BM, blood in stool, Hard enlarged liver, Splenomegaly |
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What type of schistomiasis condtion is chronic and has early sym. of UTI, Freq, and dysuria followed by hematuria and proteinuria?
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S. haematobium
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What is the treatment plan for Schistomiasis?
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Treat only give if Live OVA present
Support Fluids Praziquantel 20mg/kg BID for 1 day |
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THis disease is zoonotic and transmitted by a bite from sand flies. This polymorphic protozan disease of the skin and mucous membranes caused by the genus leishmania?
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Leishmaniasis
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What are the four overlapping clincial syndromes of Leishmaniaisis?
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Visceral (most serious)
cutaneous (baghdad boil) Mucocutaneous (espundia) diffuse cutaneous |
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What are some important details of Visceral Leishmaniasis?
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Incubation period 10days to 24 months usually 4-6 months
Fever (peaks twice daily) chills, sweats, wt loss, cough, diarrhea, hepato-splenomegaly ( anemia Non ulcerating nodule at the site of bite. petechia bleeding from nose and gums Acute or insidious onset |
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What leishmaniasis appears two wks to several months after bite, lesion vary from small papules, to dry plaques, and encurted ulcers that are painless. Local lymphadenopathy?
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Cutaneous Leishmaniasis
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A parasitic infection caused by a nematode (round worm)?
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Ascariasis
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What is the most common intestinal helminthes?
a. E. Coli b. Cholera c. Ascarias Lumbricoides d. Ascarias Sacralricoides |
c.
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What are some physical findings of rAscarias?
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Low grade fever
Non productive cough blood tinged sputum Wheezing and localized rales Dyspnea Substernal pain Urticaria |
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What is the time frame of signs after ingestion of the eggs from the soil?
a. 1-10 days b. 9-12 days c. 10-20 days d. 5-10days |
b.
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What are some lab results of patient with Ascarias?
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CBC
Pul phase, Eosinophils may reach 30-50%, and remain high for 1months Intestinal phase , normal Eosinophils |
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What is the treatment for Ascarias?
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Supportive care
Mebendazole (vermox) 500mg PO single dose or 100mg PO BID for 3 days. Repeat treatment in 2wks. Recheck stools in 3 wks, retreat if ascariasis found |
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What are some complication of Ascarasis?
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Cholecystitis
Liver abcess Appendicitis Diverticulitis |
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A intestinal round worm disease, whose larvae migrate and become encapsulated in the muscle?
a. Ascariasis b. Pin worm c. Trichinosis d. round worm |
C.
Disease present world wide. Found in virtually all warm blooded animals |
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What is the incubation period of Trichinosis?
a. 10-20 days b. 5 hrs to 30 days, typcial 2-7days c. 12 hrs -28days, typical 2-7days d. 6hrs-20days, typical 1-10days |
c.
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What happens during the Muslce stage of Trichinosis?
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1. End of first stage, 6wks
2. Parasitized muscle show Inflammation 3. Fever, Low grade 4. Myalgia 5.Edema and spams 6. Periorbtial and facila edema 7. Sweating, Weakness 8. Dysphagia 9. Dyspnea 10. Subconjunctival, retinal and splinter nail hemrrohages |
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What are some definitive lab results that will key us in on Trichinoisis?
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CBC (Eosinophilia and leukocytosis, appearing in 2wks. In 3wks eosinophilia reaches 90%. Slow decline to NL over few months
Serum Muscle enzymes (cardiac enzymes) ESR, absence of elevated ESR, indicative |
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What is one of the main treatments for Trichinoisis?
a. Doxy 100mg PO BID 7days b. PCN 500mg PO TID 10days c. Mebendazole 200-300mg PO TID 3days, F/U 400-500mg PO TID 10days d. Tetracycline 200-400mg PO BID 2 days, f/u with Doxy 100mg PO BID 10days |
c. MEbendazole
also Supportive care |
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24y/o male comes to clinic c/o of of perianal itiching at night. Hx shows wt loss, insomina and irritability in past 2wks. No other major findings noted.What is the likely dx?
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Pinworm (Enterobiasis)
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What causes Pinworms?
a. Trichinosis b. Histomoto c. Enterobius Vermicularis d. Aerobic Vermicularis |
C.
Man is the only host |
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What is the incubation period of Pinworm?
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3-4wks, worm life span is 30 to 45 days.
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A parasitic infection of the intestine caused by a helminthes, its widespread prevalence, moist tropics, subtropics and southeastern US.
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Uncinariasis
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What are some causes of Uncinariasis?
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Helminthes, Ancylostoma, dueodenale, ceylanicum, caninum and Necatro americanus
Larvae penetrate skin and then gain acces to bloodstream Once in bloodstream larvae travel to pulm. capillaries, into alveoli |
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Some physical findings of pts with Uncinariasis?
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Ground itch, pruritic erythematous dermatitis
Pulm stage. Dry cough, Wheezing, Blood-tinged sputum, with low grade fever. |
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What will show if patient has heavy infection of UNCINARIASIS?
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anorexia
Diarrhea Vague abd pain Ulcer-like epigastric pain Pallor, and DEFORMED NAILS*** |
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Treatment for Uncinariasis?
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Mebendazole 100mg BID x3days
Repeat in 3wks MULIT_VIT 1 tab QDx 30days HIgh protein diet Ferrous sulfate 200mg tab TID x2mtns, f/u with 1 tab for 4mtns |
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What are some complications of Uncinariasis?
a. hyperalbuminemia and Anemia b. hypoalbuminemia and DIC c. hypoalbuminemia and anemia d. hyperproteinuria and thalessemia |
c.
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What is the definition of Tapeworm?
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Genus of parasitic flatworms belonging to the class cestode, known to cause dz in man
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What are the four primary causative agents known to cause disease in man (TAPEWORM)?
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Taenia Saginata (beeftape worm, 59ft)
Taenia Solium (pork 21 ft) Diphyllobothrium latium (fish 30ft) Hymenoplis nana (dwarf 25-40mm) |
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What are some physical findings of Large worm infections?
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may be asymptomatic
Vague GI problems (N/D, Abd pain) systemic symptoms (Fatigue, Hunger, Dizziness) |
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What are some treatments for Tapeworms?
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Supportive
Praziquantel 10mg/kg O single dose Laxative 2hrs post treatment, assists in passing of worm |
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THis disease is predomoninatly affects men (25-55), and is barrel shaped hyphae, and is a fungus that exists in the soil, windswept sproes easily fargment and the dispersed to infect other soil, animals and humans?
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Coccidiomycosis
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What is the incubation period of Coccidiomycosis?
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10-30 days
Asymptomatic infections is consistenet with nonspecific URI in 60% of cases |
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Usually asymptomatic, but what are some physical findings of Coccidiomycosis?
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cough, malaise, fever, chills and night sweats, anorexia, weakness, arthralgias
Scattered rales and areas dull to percussion with auscultation. |
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Treatment can be extensive, but circumstances exists, then what would be the drug of choice for Coccidiomycosis?
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Fluconizole 200-400mg PO QD (>6mtnhs)
Chemo for extensive problems |
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This disease is tranmitted thorugh inhalation of conidia, particles inhaled turn into small budding cells that are engulfed by phagocytic cells in the lung, where it then proliferates and is carried to other organs?
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Histoplasmosis
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What is H. Capsulatum?
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dimorphic fungus that has been isolated from soil contaminated by bird or bat droppings
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How is the clinical disease broken down for Histoplasmosis in different classes?
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Acute , Progressive disseminated
and Chronic Progressive Pulmonary |
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What are some Physical findings for Acute histoplasmosis?
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Fever, HA, Malaise, Pleuritic chest pain, Nonproductive cough, and wt loss
Illnes last 1week to 6mnths almost never fatal |
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What is the treatment for Histoplasmosis?
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No drug therapy is required if asymptomatic or mild forrms of pul. dz.
Acute dz may benefit with KETOCONAZOLE 400MG QD |
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A multisystem disorder caused by the transmission of a spirochete from a tick?
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Lyme's disease
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What is the causative agent of Lyme's disease?
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Borrelia burgodorferi
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Pt has flu like symptoms fever, chills, myalgia with flat raised red lesion , expands over several days with central clearing. It has three stages (early localized, early Disseminated and Late persistent infection?
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Lyme dz
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What is the causative agent of Lyme dz?
a. nematode b. flagellated parasite c. Borrelia burgodorferi d. polymorphic protozan |
c. Borrelia burgodorferi
transmitted by bite of tick |
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What is the definition of Lyme disease?
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multisystem disorder caused by transmission of Spirocehete from a tick
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Where is the B. Bissettti sp found?
a. Hawaii b. Oklahoma c. Flordia d. California |
d.
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What type of tick is found in North america?
a. Gariniii and afzelii b. bissettii c. serulato and serum stricto d. giarviasis and |
c.
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What are some physical findings of Lyme disease?
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Most pts experience cardiac or neurological manifestations
Myopericaditis, atrial or venticular arrhythmias and heart block neurological presentation most ofetn mimics asepticmeningitis with mild HA, Stiff neck Bell's Palsy Peripheral neuroapthy |
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This mycoplasmic infection accoutns for 5-10% of community acquired PNA and is 2nd most common lung infection in healthy people 5-35 yrs.?
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C. Pneumoniae
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What are some physical findings of Mycoplasmic Infections?
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Malasie
Cough-Productive in older children, and adults and dry in infants, young children Dyspnea-mild with exerction Chest pain- Pleuritic and is adacnet to the infected area |
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What is the treatment for Mycoplasmic infections?
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Macrolide (azithromycin, clarithromycin
Doxy 100mg BID Bed rest |
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Pt c/o of cough, drenching night sweats, slight dyspnea with yellowis or greenish sputum and "over all not feeling well." what could be the underlying cause?
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TB
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What is the definition of TB?
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small slow growing aerobic bacilli , with complex lipid rich cell envelope responsible for "acid fast".
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What is the treatment for lyme disease?
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Doxy 100mg PO BID for 21 days
alternative AMoxicillin 500mg TID x 21 days |
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What if there are neurological invovlment with Lyme disease, what is the recommended treatment?
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Ceftriaxone 2g QD 21 to 28days
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