Reading...
Play button
Play button
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;
30 Cards in this Set
- Front
- Back
|
What is cholera?
|
Vibrio cholera
Gram negative vibrio |
|
|
Where does cholera live in intestines?
|
Crypts of microvilli of intestines
|
|
|
How many cholera pandemics known?
|
7
|
|
|
Most recent cholera pandemic?
|
1961-1991 SE asia to africa to S america (including louisiana)
|
|
|
How did cholera pandemic reach s. america?
|
In ballast of a boat from asia
|
|
|
What time of year is cholera commonly seen?
|
Warm summer months
|
|
|
Of all the choleras, which ones cause epidemics?
|
Those that are toxigenic and in group 01 (profuse, watery diarrhea)
|
|
|
How does cholera impact the gut?
|
Produces secretory diarrhea from toxin
A/B toxin goes intracellular, increases Na/K pump, secreting sodium, water follows |
|
|
Describe the spectrum of illness of V. cholera 01, biotype el tor
|
Only 2%% with severe illness. 75% asymptomatic
|
|
|
Sx of "typical" = severe cholera?
|
Stool losses 0.5-1liter / hour
Vomiting, absence of nausea/blood/bile in emesis Rice water stools 4-6 day duration |
|
|
Complications of cholera diarrhea?
|
Metabolic acidosis from loss of stool bicarb
Lactic acidosis from poor tissue perfusion/shock Acidosis masks hypokalemia Renal failure and renal tubular acidosis (improves with rehydration) Hypoglycemia Cardiak arrhythmia from acidosis/hypokalemia Paralytic ileus from hypokalemia Sezures in kids (hypoglycemia) In pregnancy, 50% fetal death in 3rd trimester Pulmonary edema |
|
|
Risk factors for severe cholera?
|
Blood group O
No breast feeding Malnutrition Decreased gastric acidity Family contact |
|
|
How dx cholera?
|
Liquid stool or rectal swab
Cary Blair transport media (great for many microbes) Alkaline peptone water (specific for cholera) Fecal sample dipped in filter paper Rapid: Dark field micro Fluorescent antibody Coagglutination Gold standard: stool culture |
|
|
How to culture cholera?
|
Gold standard
TCBS Agar Serology: Antitoxin antibodies, vibriocidal antibodies |
|
|
How to treat cholera?
|
Oral rehydration
Alimentation Abx: Tetra/doxy/FQ/furazolidone |
|
|
How do antibiotics help cholera
|
Shorten course by several days
|
|
|
Is ORS ok for cholera?
|
Yes! 90% can be treated with ORS
|
|
|
Best IV fluid for cholera?
|
LR
Can also use NS/ 1/2NS DO NOT USE D5W |
|
|
Who are the victims of endemic vs. epidemic cholera?
|
Endemic: young children (2-15)
Epidemic: all ages |
|
|
Which type of cholera transmission requires multiple reservoirs of infection?
|
Endemic
|
|
|
How long does cholera live outside host?
|
On surfaces: few hours
Moist soil: 4-10 days Sea water: dormant for months Mollusks: even longer than sea water |
|
|
How to get a water sample to check for cholera?
|
Moore swab -- gauze on a wire
|
|
|
How cholera transmitted?
|
Fecal oral in food or water
Normally not person to person Environmental reservoir Undercooked fish Contaminated food without refrigeration (rice, milk, potato, eggs) Green vegies washed with contaminated water Contaminated drinking water Ice from contaminated drinking water |
|
|
What's the broad street pump?
|
The pump id'd as a cholera spread source in london in 1855
|
|
|
How much chlorine needed to prevent cholera spread?
|
0.5mg/liter in potable water
|
|
|
How to disinfect water with chlorine?
|
Make a basic solution (10tsp powdered bleach in 1 liter water)
Add 3 drops per liter water Add 1 tsp per 30 liters |
|
|
How to detect cholera epidemic?
|
INcrease cases rice water stools
Liquid diarrhea/severe dehydration in persons > 10 y/o |
|
|
Are there cholera vaccines?
|
Old vaccine...only 50% effective, only lasted 3 mos, no longer available)
New vaccine (not in US): Oral, inactivated whole cell/b subunit vaccine, 60-70% effective, lasts 3 years Live attenuated: only effective against classical cholera (65% vs el tor) NOT AVAIL IN US YET |
|
|
Can you get cholera from bathing in infected water?
|
Yes
|
|
|
INSCRUTABLE
|
mysterious
People have always longed to understand the inscrutable universe. |
