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45 Cards in this Set

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category A diseases of bioterrorism?
antrax (bacillus anthracis)
smallpox (variola virus)
plague (yersinia pestis)
tularemia (francisella tularensis)
botulism (botulinum toxin)
viral hemorrhagic fever
3 disease forms of anthrax?
cutaneous
GI
inhalational
2 toxins of anthrax?
edema toxin (cause pleural effusion)
lethal toxin
prodromal phase of anthrax is influenza like.. however what is different?
almost no rhinorrhea
Dx of anthrax?
blood culture
Tx of anthrax?
ciprofloxaxin or doxycycline plus 1-2 others
cephalosporin not effective
maybe vaccine
supportive care
does person-person transmission occur in anthrax?
no
person-person transmission in smallpox?
yes. airborne possible
2 stages of small pox
prodromal stage (severe flu like, not contagious)
eruptive stage (rash. contagious)
characteristic of smallpox rash?
oral ulcer -> maculopapular -> vesiculopustular
centrifugal pattern
all same stage
characteristics of chickenpox rash?
asynchronous development
centripetal
spares palm/soles
Tx of smallpox?
supportive, airborne, droplet isolation
post exposure prophylaxis - vaccine
primary prophylaxis - vaccine
rat, prairie dog reservoir, cats
flea vector. which bioterrorism?
plague - yersinia pestis
person-person possible in plague?
pneumonic form only
3 manifestation types in plague?
bubonic
pneumonic
septicemic
tx of plague
aminoglycoside - streptomycin, gentamicin
doxycycline (higher relapse rate)
ciprofloxacin works pretty well
cephalosporins ineffective
"rabbit fever"
host small mammals
tularemia (francisella tularensis)
vector of tularemia?
ticks, deer flies
characteristics of tularemia?
**bradycardia with high fever
low back myalgia
pulse-temp dissociation
ulcer at inoculation
proximal lymphadenopathy
Dx of tularemia?
no good Dx
culture has poor sensitivity/dangerous
serology - 2 week delay
tx of tularemia?
aminoglycosides - streptomycin, gentamicin
doxycycline
ciprofloxacin
cephalosporin ineffective
person to person in tularemia?
no
generalized zoonosis Tx?
doxycycline
what do you do with animal bite wounds?
assess rabies risk
irrigate but not suture!
assess infection risk.
worse in terms of giving disease. cats of dogs?
cats
normal mouth flora of animal?
eikenella corrodens
staph aureus
pasteurella multocida
Tx of animal bite?
augmentin (amoxicillin + clavulanate)
animal reservoir is bats, skunks, raccoons, foxes
100% fatality
retrograde axonal spread
rabies
what histopathological feature does rabies have?
negri bodies
Dx of rabies
clinical is main..
PCR saliva, neck biopsy for IFA, serum/CSF for Ab
post exposure Tx for rabies
wound care
vaccine
immunoglobulin

experimental: ribavirin, IFN alpha, amantadine
cat scratch disease
bartonellosis (bartonella henselae)
features of bartonellosis?
relatively mild
vesicle/papule/pustule
painful lymphadenitis
fever
encephalopathy
Dx of bartonellosis?
PCR, serology
Tx of bartonellosis?
azithromycin (effect not well known)
direct/produc contact
agent is coxiella burnetti
flu like illness
atypical pneumonia
endocarditis, osteomyelitis
Q fever
Tx of Q fever?
acute - doxy
chronic - doxy + rifampin
Dx of Q fever?
serology
contract from delivery of cow..
ingestion of unpasteurized milk
wide variety of presentation -MSK, GI, GU, cardio, neuro, skin
brucellosis
Dx of brucellosis?
culture, serology
agent of brucellosis?
brucella melitensis, B. abortus
Tx of brucellosis?
doxy + aminoglycoside or rifampin
very common in birds
very infectious
transmission via bird contact/presence
pneumonia - lower lobe consolidation
psittacosis (chlamydia psittaci)
Dx of psittacosis
serology, culture
Tx of psittacosis
doxy