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143 Cards in this Set
- Front
- Back
What is an acute febrile illness caused by infection, that is transmitted by small-particle aerosols and deposited on the respiratory epithelium has a Type A and B
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Influenza
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What are the 5 constitutional SX of all viral illnesses?
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Fever
Chills Myalgia Prostration Anorexia |
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What is a rare, but severe complication when ASA is used on a pt. suffering from an Influenza infection?
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Reyes syndrome
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What is an acute systemic infection caused by the RNA virus Morbillivirus?
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Rubeola (Measles)
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What acute systemic infection typically strikes children age 5 or less and is the leading cause of child death in developing countries?
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Rubeola (Measles)
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What is a mild systemic disease caused by the Togavirus?
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Rubella (German Measles)
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In pregnant women the highest risk of complications of Rubella occurs when?
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1st Trimester of gestation
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Rubella is a mild illness that rarely last longer than how many days?
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3-4 days
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What is an acute generalized paramyxoviral disease causing inflammation of the salivary glands?
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Mumps
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What acute generalized paramyxoviral disease is the leading cause of pancreatitis in children?
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Mumps
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What is the incubation period for Mumps?
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14-21 days with an average of 18 days
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What are the SX in the prodrome phase of Mumps
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The constitutional SX
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In Mumps consumption of what could make SX worse?
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Citrus or acidic foods
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In Mumps a high fever could be accompanied by what 2 things?
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Meningitis or Orchitis
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In Mumps, Epididymitis occurs in what % of all cases?
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85%
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A female pt. with lower abdominal pain and enlarged overies that has been DX with Mumps can also have what?
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Oophoritis
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DX of Oophoritis in the operational environment is difficult so the SX should be considered what?
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Surgical Abdomen
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What is a symptomatic infection caused by the Epstein-Barr Virus?
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Infectious Mononucleosis
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Infectious Mononucleosis is most common between what ages?
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15-24
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What is the classic triad of SX for Infectious Mononucleosis?
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Pharyngitis
Fever Adenopathy |
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A pt. with pharyngitis, fever, adenopathy, prominent fatigue, malaise, and splenomegaly can be dx' with what?
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Infectious Mono
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Why must you not palapte the spleen of a pt suffering from Infectious Mono?
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You risk creating a surgical abdomen
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What is the hallmark sign of a CBC of a pt. who is suffering from Infectious Mono?
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Atypical lymphocytes totaling 20%
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What is a tx for a pt. who is suffering from Infectious Mono when an impending airway obstruction is suspected?
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Prednisone 60 mg PO QD x 3 days, then taper over 1 wk
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What is a complication of a pt. who is suffering from Infectious Mono?
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Splenic rupture
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A common viral illness characterized by a vesicular rash and fever is defined as?
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Varicella (chicken pox)
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What is the predominant age of a pt who is suffering from chicken pox?
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5 to 10 yrs old
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Varicella peaks during which time of the year?
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Springtime
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What is the incubation period for Varicella?
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9 to 21 days
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Symptoms of varicella are generally worse in whom?
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Adults
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In a varicella infection, when does a fever usually peak?
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With the eruption of the vesicles
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In pt. w/ a varicella infection, how does the rash usually present (lesions)?
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Lesions at different states at the same time
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What med can be given within the first 72 hrs in the tx of varicella infection?
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Acyclovir 800 mg five times a day
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A DNA virus due to the variola virus, that is a human virus with no known nonhuman reservoirs of diseases is defined as?
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Variola (Smallpox)
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When was variola (smallpox) eliminated and how was it eliminated?
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In 1977 through vaccination (routine vaccination has since stopped per student guide)
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When is a pt. infected w/ smallpox most infectious?
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1st week of infection
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Group of infectious diseases caused by arthropod-borne viruses is defined as?
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Viral Hemmorhagic Fever
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What are the 5 genus of viruses that cause Viral Hemmorhagic Fever and what do they cause?
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-Arenaviridae (lassa fever)
-Bunyaviridae (hanta virus & rift valley) -Filoviridae (ebola & marburg) -Flaviviridae (tick-borne encephalitis) -Paramyxoviridae (hendra virus) |
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Spontaneous bleeding caused by a defect in clotting factor or blood vessel structure is a physical finding in Viral Hemmrhagic Fever that is defined as?
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Hemorrhagic diathesis
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In viral hemorrhagic fever, what is the tx in a pt. who has GI bleeding?
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Zantac 150mg BID
Ice water lavage/gavage |
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A viral flavivirus transmitted by an arthropod bite is defined as?
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Dengue fever
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What is the most prominent vector of Dengue Fever?
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Aedes mosquito
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What is the causative vector in Africa of dengue fever?
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Monkey mosquito
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What is the causative vector in Mexico and Texas of dengue fever?
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Asian Tiger Mosquito
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What are initial signs of dengue fever?
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Severe myalgia to back, head, and extremities (break-bone fever). Redness, flsuhing, and blotching of the skin.
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What is the febrile pattern of a pt. who suffers from dengue fever? It's also known as what?
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Initial fever will last 3-7 days, then a remission period followed by another febrile period lasting 1-2 days. (biaphasic fever curve)
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What laboratory finding will you see in the CBC of a pt. who suffers from dengue fever?
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Leukopenia and thrombocytopenia
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A viral disease infection of the liver, having systemic manifestations caused by the Yellow Fever Virus (YFV) is defined as?
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Yellow Fever
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What are the 2 transmission cycles of Yellow Fever?
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A sylvatic (jungle cycle)and urban cycle
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What is involved in the sylvatic (jungle cycle) of YF?
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Mosquito and nonhuman primates
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What is involved in the urban cycle of YF?
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Aedes aegypti mosquito and humans
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In YF, constitutional symptoms, myalgia, conjunctivitis, and bradycardia can be seen in which phase?
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Viremic (early phase)
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In YF, jaundice, oliguria, albuminuria, hemorrhage, encephalopathy, shock and acidosis can be seen in which phase?
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Toxic phase
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What are the 3 stages of YF?
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Viremic (early phase), Brief recovery period, and toxic phase
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What is the tx for GI bleeding in YF?
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Zantac 150 mg PO QD
Ice lavage/gavage |
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An arbovirus encephalitides that produces clinical manifestations in humans is defined as?
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West Nile Virus
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When was West Nile Virus identified in the U.S.?
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1999
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How is West Nile Virus transmitted?
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By the Culex Mosquito
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What is the incubation period for West Nile Virus?
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3 to 14 days, symptoms generally last 3-6 days
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True or false.
Most people infected by West Nile Virus are symptomatic? |
False.
Most people are asymptomatic |
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A zoonotic disease caused by the spirochete Leptospira interrogans is defined as?
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Leptospirosis
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What are the stages of Leptospirosis?
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Septicemic stage (stage last about 1 wk) and Immune stage
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What physical findings can be seen in the septicemic stage of Leptospirosis?
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Pharyngitis, Lymphadenopathy, Hepatomegaly, Splenomegaly
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What physical findings can be seen in the Immune stage of Leptospirosis?
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Same symptoms of initial phase, with the addition of "aseptic meningitis"
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What is the tx of Leptospirosis?
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Supportive Therapy
Tylenol 500 mg II PO Q6 Volume replacement PCN G 1 M.U. IM Q4 Doxycycline 100 mg PO BID x 7 Days |
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A viral (rhabdovirus) encephalitis is defined as?
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Rabies
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What is the incubation period of Rabies?
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10-90 days. (Incubation periods vary with location of biest and amount of contac made)
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What are the prodromal symptoms of Rabies?
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Constitutional sx's; px or anesthesia at exposure site; psychiatric sx's; sore throat, GI sx's
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What are the phases of Rabies?
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Prodrome and Acute Neurological period
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Larynx, pharynx spasm and severe px when drinking as well as hydrophobia and thick tenacious saliva can be seen in which phase of Rabies?
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Acute Neurological Period
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How is Poliomelitis transmitted?
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Fecal-oral route
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What is seen in the bulbar muscles innervated by cranial nerves during paralytic poliomyelitis?
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Flaccid paralysis w/o sensory defects
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What is the mortality rate in bulbar polio?
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50%
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What is the transmission route for HAV?
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Fecal Oral route
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What is the transmission route for HBV?
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Parenteral Route
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What is the transmission route for HCV?
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Parenteral route, iv drug accounts for most cases
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What is the transmission route for HDV?
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Possibly superinfection of HBV
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What is the transmission route for HEV?
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Water borne, ingestion
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What is the transmission route for HGV?
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Unknown
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In which stage of Hepatitis will you see aversion or distaste to smoking as well as fatty, floating, clay stools?
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Prodrome Stage
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What are the 3 stages of hepatitis?
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Prodrome, Icteric, and Convalescent
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What is the transmission method of Salmonellosis?
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Consumption of contaminated food/drink
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Which serotypes of Salmonellosis will cause infection?
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Typhi
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How is the diarrhea described in a pt. who suffers from Salmonellosis?
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"Pea-soup"
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What are the latent sx's of Salmonellosis?
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Splenomegaly, Abdominal distension, Bradycardia, and Dicrotic pulse
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What is an acute diarrheal infection?
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Cholera
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What is the causative agent of cholera? How is it transmitted?
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Vibrio cholera and it is transmitted by consumption of contaminated shellfish, h20, food
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In cholera, stool that is liquid gray, turbid and w/o fecal odor, blood or pus is described as?
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Rice water stool
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In cholera, what is the amount of diarrhea that can be produced in 1 day?
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15 liters
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What is the first rule in the operational tx of cholera?
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Fluid replacement
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What antimicrobials can be used in shortening the course of Cholera?
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Tetracycline
Cloramphenicol Ampicillin |
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What is a complication that can occur from Cholera?
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Shock and Death
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What disease due to its severe toxicity and durability has a great potential to be used as a bioweapon?
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Botulism
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What is the most powerful neurotoxin known to man that prevents acetylcholine at the neuromuscular junction and autonomic synapses?
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Botulism
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Cranial nerve palsies (bilateral nerve involvement) such as Diplopia, Opthoalmoplegia, dysphagia, dysarthria, and dry mouth are physical findings of what disease?
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Botulism
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What type of GI symptoms can be seen in botulism?
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N/V/D or constipation and cramps
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What medication needs to be given asap (even prior to lab confirmation) in the tx of botulism in the operational setting?
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Antitoxin (trivalent equine botulinum)- antitoxin available at CDC
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In an outbreak of botulism, describe the the prognosis?
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High mortality rate in 1st case of an outbreak, subsequent cases tend to recover completely
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An inflammatory disease of the bowel caused by one of the several species of shigella is described as?
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Shigellosis (bacillary dysentery)
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Outbreaks that occur in crowded conditions, where personal hygien is poor such as jails, mental hospitals, child care centers, and refugee camps; with male homosexuals being at increased risk can be seen in what disease?
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Shigellosis (bacillary dysentery)
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Shigellas are composed of how many species?
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4
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What is the most common isolated species in the U.S. of Shigellosis?
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S. Sonnei
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What is the most serious form of Shigellosis?
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S. Dysenteriae
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In obtaining the medical history of a pt. w/ shigellosis, what are 2 important ?'s to ask?
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Environmental/Social hx
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A specific zoonosis disease involving rodents and their fleas is defined as?
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Plague
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What continues to be a threat worldwide due to persistent rodent infection?
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Plague
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What is the infectious agent of Plague? What is the most common vector?
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Yersinia pestis
Oriental rat flea |
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What is the incubation period of Plague?
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1-7 days, plus or minus 2-3 days
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What are 3 initial symptoms that can be of sudden onset in Plague?
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Intense headache, delirium, and tachycardia
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What % of lymph fluid will drain to the inguinial lymph nodes when affected with the Plague
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90%
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In Plague what has a high risk of fatality without TX being started within a few hours of onset?
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Fulminant Pneumonitis
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A systemic illness caused by a generalized bacterial infection can be defined as what?
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Bacterial Sepsis (Septicemia)
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What is the approximate number of Gram-negative bacteremia among hospitalized pt.
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300,000
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What are predisposing factors for a Bacterial Sepsis infection?
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General medical status
Age Immunosuppressive therapy Recent surgery Diabetes Hyposplenism |
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E. Coli, Klebsiella, Pseudomonas aeruginosa, Staphyloccus, Streptococcus, Neisseria meningitides, and Gram-Negative bacteria can cause which disseminated infection?
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Bacterial Sepsis (septicemia)
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What are the less common sources of infection in Bacterial Sepsis?
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Fungal
Viral Rickettsial Parasitic |
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What is the tx of Bacterial Sepsis that is based on the possible disease process?
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Broad spectrum IV antibiotics (used judiciously by the IDC)
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What are the four species of Typhus?
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Epidemic (louse bourne)
California Flea Endemic (murine) Scrub |
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What is the causative pathogen in Epidemic (louse bourne) typhus?
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Rickettsia prowazekii
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What is the geographic prevalence for epidemic (louse bourne) typhus?
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North and South America, Africa, and Asia
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What is the causitive pathogen of California flea typhus?
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Rickettsia felis
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What is the geographic prevalence for California flea typhus?
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Southern California and Texas
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What is the causitive pathogen in endemic (murine) typhus?
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Rickettsia typhi
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What is the only typhus with a worldwide geographic distribution?
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Endemic (murine) typhus
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What is the causitave pathogen of scrub typhus?
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Orietia tsutsugamushi
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The prevalence for this type of typhus is Southeast Asia, Japan, and Austalia?
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Scrub typhus
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A macular rash to trunk, axial, then spreading the the rest of the body sparing face, palms, and soles is seen in what type of typhus?
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Epidemic (louse bourne) typhus
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A macularpapular rash concentrated on the trunk and fades rapidly in which type of typhus?
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Endemic (murine) typus
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The development of a flat black eschar with regional lymphadenitis at the site of a bite and a macular rash the appeats primarily to the trunk after a week long fever is present in which typhus?
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Scrub typhus
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What are the late S/S that develop in the second or third week of a typhus infection?
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Obtunded
Pneumonitis Myocarditis Encephalitis Meningitis Acute Abd pain Cardiac failure Hepatitis Renal failure |
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What is the primary antimicrobial treatment in typhus?
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Doxyclycline 100mg PO BID for 7 days or until 2 days after temp returns to normal
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This is an acute or chronic systemic febrile illness aquired most often via inhalation of feces, placenta, and milk remnants contained in dust.
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Q fever
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What is the incubation period for Q fever?
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1 to 3 weeks
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In Q fever where might abdominal pain be generalized to?
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RUQ
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In an operational setting what are lab test that should be ordered for Q fever?
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CBC
UA PPD |
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What is the operational treatment for Q fever infection?
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Supportive care
Tylenol 500mg 2 PO q6hrs O2 and fluids PRN Doxyclycline 100mg PO BID x 14 - 21 days. Alternate: E-mycin 500mg PO QID x 14 days Contact M.O. |
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What are the complications of Q fever?
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Pleural effusions
Hepatitis Endocarditis Encephalitis |
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What is a febrile arthropod bourne illness?
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Rocky Mountain Spotted Fever
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In the U.S. what two ticks are responsible for the transmission of Rocky Mountain Spotted Fever in the west and east?
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Western = Wood tick
Eastern = Dog tick |
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What is the incubation period for Rocky Mountain Spotted Fever?
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3 to 12 days, mean is 7 days.
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In which disease rash appears first to wrist and ankles progressing centrally to the trunk and to include the palms and soles?
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Rocky Mountain Spotted fever with Hx of tick bite.
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In operational setting what labs should be ordered in suspected case of Rocky Mountain Spotted Fever?
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CBC
UA RPR, & STD work up Serum glucose |
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What is treatment for Rocky Mountain Spotted fever?
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Doxycylcine 100mg PO BID until 2 days after fever.
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