• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/118

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

118 Cards in this Set

  • Front
  • Back
Two types of Yellow Fever
Epidemic/urban AND Sylvatic/jungle
Aedes aegypti mosquito is the vector for what type of Yellow Fever?
epidemic/ urban
Where did Yellow Fever originate?
Africa
Is there a vaccine for Yellow Fever?
yes
Pathophysiology of Yellow Fever
female mosquito regurges the virus, the virus infects the vascular endothelial cell and is taken up by/replicates in the RES followed by secondary viremia and overwhelming of the immune system
Why is there jaundice in Yellow Fever?
replication occurs in the RES in the liver
"Why is the vomit in Yellow Fever called ""Black Water"" Vomit? "
because of mucosal and GI tract bleeding
Yellow Fever has a __________ pattern with ___ stages.
saddleback; 3
How many stages does Yellow Fever have?
3
What may be the only findings in Acute phase of Yellow Fever?
fewer/HA, nausea w/ bilious vomiting, and conjunctival injection
Other nonspecific symptoms that may be present in Yellow Fever
malaise, weakness, and myalgias
How long does the acute phase of Yellow Fever last?
usually 3 days
What percentage of patients stop at the acute phase of Yellow Fever?
85%
What follows the acute phase of Yellow Fever?
a 24 hour remission stage
When will specific IgM be seen in Yellow Fever?
7-10 days post infection
Tx for Yellow Fever
supportive therapy, may need central venous access, if actively bleeding--> FFP, isolation of patients, no effective antivirals, immunization and education, mosquito avoidance
What will serologic studies in Yellow Fever show?
4 fold increase in the acute and convalescent titers
What are some of the S/S of toxic phase yellow fever?
jaundice, oliguria, dark urine, tender hepatomegaly, petechiae, epistaxis, coffee ground emesis, hematemesis, melena, BRBPR, hematuria, relative bradycardia, myocardial depression, arrhythmias, and mental status changes
What will the CBC show in Yellow Fever?
leukopenia, thrombocytopenia, and HCT changes
Disease found in humans and nonhuman primates.
Ebola and Marburg
How many subtypes of Ebola?
4
How many types of Marburg?
1
What is a possible natural reservoir for Ebola/ Marburg?
maybe bats, but unknown
What is the mode of transmission of Ebola?
usually spread in healthcare/lab, but unknown
S/S early in Ebola
pharyngitis, severe constitutional changes, maculopapular rash, and bilateral conjunctival injection
What are the S/S late in Ebola?
expressionless hippocratic ghostlike facies, bleeding from mucous membranes, and tachypnea
What are the physical findings early in Ebola/Marburg?
severe HA, arthralgias/myalgias, fever with or without chills, anorexia, and asthenia
What are the type of GI symptoms that follow the early phase of Ebola?
abdominal pain, N/V, diarrhea, odynophagia, dysphagia
Sites that patients with Ebola will bleed from
GI tract, mucous membranes, puncture sites
What will be seen in a terminally ill patient with Ebola?
obtunded, anuric, tachypneic, normothermic, shock, hiccups, and tachypnea
When are hiccups noted in Ebola?
in fatal cases
What will the CBC show in Ebola?
thrombocytopenia, leukopenia, and pronounced lymphopenia
What will the chem panel and LFTs show in Ebola?
multiple organ failure, metabolic acidosis, and increase in BUN and Serum Creatinine
What are the diagnostic test for Ebola?
IgM and IgG ELISAs
What is the tx for Ebola>
no specific therapy- barrier isolation, fluid rehydration, nutrition; supportive care, Ribavirin, human convalescent plasma, Interferon alpha 2b
How long is recovery for Ebola victims?
requires months
Mortality rate in Ebola/Marburg
80% in Ebola, 25% in Marburg
Complications in Ebola/Marburg
ocular manifestations, tinnitus, unilateral orchitis, supportive parotitis, asymmetric and migratory arthralgia
Where is Lassa endemic?
West Africa
How is Lassa transmitted?
rodent to human transmission, secondary human to human transmission
What type of Lassa outbreaks have a high case-fatality?
nosocomial outbreaks
Lassa is particularly dangerous in what trimester of pregnancy?
third
Are most infections of Lassa severe or mild/subclinical?
mild or subclinical
S/S of Lassa
fever, weakness, joint/lumbar pain, cough, severe HA, prostration, abdominal pain, facial or neck edema, deafness
MC sequela of Lassa
deafness
Is the onset of Lassa insidious or abrupt?
insidious
Major cause of Lassa Fever in children and infants
pediatric hospitalizations
What are the symptoms of Swollen Baby Syndrome?
edema, anasarca, abdominal distention, bleeding
What is the prognosis with Swollen Baby Syndrome?
poor prognosis
What will the LFTs in Lassa show?
AST levels will be much higher than ALT levels
What will the CBC in Lassa show?
lymphopenia and thrombocytopenia
What are the diagnostic tests for Lassa?
ELISA for IgM and IgG and PCR (being researched)
Tx for Lassa
Ribavirin--best within first 6 days of illness, aggressive supportive therapy
What is Hantavirus better known as?
Hemorrhagic Fever with Renal Failure Syndrome or HFRS
What geographic area does HFRS occur in?
Far East
Triad in HFRS
fever, hemorrhage, and renal insufficiency
What is the reservoir for Hantavirus?
rodents
In what age group is HFRS mild?
in children under age 15
What are the four phase of HFRS?
febrile phase, hypotensive phase, oliguric phase, and diuretic stage
S/S of febrile phase
HA, chills, abdominal pain, malaise, flushing, petechiae, subconjunctival hemorrhage, absolute bradycardia
S/S of hypotensive stage of HFRS
tachycardia, acute abdomen in form of paralytic ileum, convulsions, purposeless movements
Tachycardia in the hypotensive stage of HFRS indicates what?
impending shock
What are the S/S of oliguric stage of HFRS?
oliguria, hypertension, bleeding tendency, edema, thrombocytopenia resolves
What causes bleeding tendency in HFRS?
caused by uremia
What are S/S in diuretic stage of HFRS?
other symptoms resolve rapid dehydration
How long is the convalesce stage in HFRS?
3-6 months
What is the pathogenesis of HFRS?
largely unknown
What will the UA in HFRS show?
hematuria, proteinuria that may last years
What will the CBC in HFRS show?
leukocytosis, elevated or normal hematocrit, thrombocytopenia
What will be the electrolyte abnormalities in HFRS?
hyponatremia and hyperkalemia
What is diagnostic for HFRS?
ELISA
Tx for Hantavirus
maintain fluid and electrolyte balance, supportive care, and Ribavirin may be efficacious
Rare complications of Hantavirus
pulmonary edema, metabolic dysfunctions like hypercalciuria, mortality up to 15%
What is the vector for CCHF?
ixodid ticks
Areas where CCHF is found?
Africa, Asia, Middle East, and Eastern Europe
Other names for CCHF
Central Asian Hemorrhagic Fever, Congo Fever
S/S of CCHF
flu like initially, hemorrhage after 3-5 days, massive ecchymosis, epistaxis, hepatomegaly, mucosal and GI bleeding, and erythema
Where is erythema in CCHF seen?
pharynx, conjunctiva, face, neck
What will the CBC show in CCHF?
leukopenia and thrombocytopenia
Diagnostic tests for CCHF?
ELISA and PCR
Tx for CCHF?
Ribavirin, supportive care
Complications of CCHF
rare encephalitis, mortality rate 13-50%
How many closely related serotypes in Dengue?
four- DEN 1,2, 3, and 4
Which DEN is more virulent?
DEN-2
What geographic area is Dengue found in?
tropics- between 35N ad 35S
What is the vector for Dengue?
domestic day biting Aedes aegypti mosquito that prefers to feed on humans
What are the three types of Dengue?
Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF), and Dengue Shock Syndrome (DSS)
Which type of Dengue is a symptom complex produced by the infection that may be asymptomatic or just a nonspecific febrile illness?
DF
S/S of Dengue Fever
very high fever, HA, retroorbital pain, N/V, truncal scarlitinaform rash, severe myalgias and malaise, abdominal pain, and hemorrhagic manifestations
What are the hemorrhagic manifestation in Dengue?
small amounts of bleeding from nose or gums, melena or hematemesis
What is a saddleback fever?
abates for a day and then returns
When is the risk for development of DHF and DSS highest?
at approximately the time of defervescence
Describe the rash in Dengue
scarlatiniform or maculopapular
Patients with DHF ill have what types of injections?
pharyngeal (97%) and conjunctival (1/3)
Physical findings in Dengue
rash, petechiae/purpura, injections, generalized lymphadenopathy, hepatomegaly
MC hemorrhagic finding in Dengue
petechiae and bleeding at venipuncture site
Describe Tourniquet test
inflate BP cuff to midway between D and S; hold for 5 minutes--a positive test is 20 petechiae per sq. inch
When will leukopenia be seen in Dengue?
at the end of the febrile phase
When will leukocytosis be seen in Dengue?
before defervescence or shock
What does a 20% rise in HCT precede in Dengue?
shock
How often should HCT be monitored in Dengue patient?
every 3-4 hours
What will the platelet count in Dengue show?
thrombocytopenia
What is the most common metabolic change in Dengue?
hyponatremia
What on the LFT is a sin of hemoconcentration in Dengue?
low albumin
What type of blood flow will there be when HCT is high by 20%?
oozing
What type of blood flow will there be when HCT is low by 10%?
actually bleeding, not oozing
How can diagnosis of Dengue be made>
isolation of the virus; paired serum samples with a 4 fold increase in IgM or IgG (also RT-PCR, IH, ELISA)
Describe Grade I Dengue
fever w/ nonspecific constitutional symptoms w/ positive tourniquet test or scattered petechiae as the only hemorrhagic involvement
Describe Grade II Dengue
Grade I, but with spontaneous hemorrhagic manifestations
Describe Grade III Dengue
circulatory failure manifested by rapid, weak pulse, narrow pulse pressure, or hypotension
Describe Grade IV Dengue
profound shock with undetectable pulse and BP
Tx for DF
self limited; acetaminophen
Tx for DHF/DSS
IV fluid, admit, blood transfusions if there is pulm edema, fresh whole blood is drop of HCT of 10%
What is the take on steroids with Dengue?
not beneficial
What does a drop of 10% in HCR indicate in DHF or DSS?
significant hemorrhage
Prevention of Dengue
insect repellant with 30% DEET
Who do you use caution with when using 30% DEET insect repellant?
kids- b/c of side effects; do not put on their hands
Complications of Dengue
neurologic manifestations- encephalitis, G-B Syndrome, and transverse myelitis; liver failure in DHF/DSS, overhydration during tx