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67 Cards in this Set
- Front
- Back
What is the causative organism for anthrax?
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bacillus anthracis
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What is the causative organism for tularemia?
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franciella tularensis
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What is the causative organism for plague?
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Yersina pestis
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What is the causative organism of small pox?
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-Variola major (30 % fatality causes most severe illness)
-variola minor |
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What is the causative organism for ebola?
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-RNA virus from family filovirdae
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What are the subtypes of ebola?
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-Ebola-Zaire
-Ebola-Reston -Ebola-Sudan -Ebola-Ivory Coast |
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What form of ebola causes illness only in monkeys?
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Ebola-Reston
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What are the signs and symptoms of cutaneous anthrax?
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-papule to fluid filled vesicle to dry coal black scab
-malaise, fever, and HA |
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What are the signsand symptoms of inhalation anthrax?
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-starts as cold or flu like symptoms
-then non-productive cough, chest discomfort, SOB, tiredness, and muscle aches -short improvement period (2 days) -abrupt onset of severe respiratory distress with dyspnea, diaphoresis, stridor, and cyanosis -septicemia, shock and death usually follow w/i 24-36 hours of severe respiratory distress |
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What is the incubation period for cutaneous anthrax?
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1-6 days
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What is the incubation period for inhalation anthrax?
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1-6 days
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What are the signs and symptoms of bubonic plague?
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- enlarged tender lymph nodes in the inguinal area
- extreme malaise, HA, high fever -small pustule at site of flea bite |
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What are the signs and symptoms of the pneumonic plague?
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-high fever, chills, HA, extreme malaise and myalgia
-bloody sputum, nausea, vomiting, and abdominal pain -progress to dyspnea, stridor, and cyanosis, respiratory failure, and circulatory collapse |
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What are the signs and symptoms of septicemic plague?
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-septicimic shock and circulatory collapse
-always is preceded by bubonic or pneumonic plague |
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What is the incubation period of bubonic plague?
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2-10 days
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What is the incubation period of pneumonic plague?
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1-6 days
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What are the signs and symptoms of typhoidal tularemia?
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-high fever
-chills -cough -prostration -HA -substernal chest pain |
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What are the signs and symptoms of ulceroglandular tularemia?
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-fever
-chills -HA -malaise -ulcerative skin lesion at site of contact -painful lymphadenopathy |
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What are the signs and symptoms of glandular tularemia?
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-fever
-tender lymphadenopathy -no skin lesion |
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What are the signs and symptoms of oculoglandular tularemia?
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-purulent conjunctivitis
-cervical lymphadenopathy -periorbital edema -small lesions or ilcerations of conjunctiva |
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What are the signs and symptoms of oropharyngeal tularemia?
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-pharyngotonsilitis with cervical lymphadenopathy
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What are the signs and symptoms of pneumonic tularemia?
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-severe atypical fulminant pneumonia
-symptoms consistent with typhoidal tularemia -progress to dyspnea and bloody sputum -rarely leads to lung abscess -respiratory failure may occur |
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What is the incubation period of tularemia?
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1-21 days (average of 3-5 days)
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What are the signs and symptoms of smallpox?
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-deep lesions that start of face
-lesions develop at the same time -lesions can occur on soles of feet and palms -malaise, high fever, and prostration, backache and vomiting -maculopapular rash around mouth mucosa and pharynx -rash spreads to face then forearms then trunk and legs -crusting of pustules around day 8 or 9 -scabs fall off around day 21 and are contagious |
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What is the incubation period of smallpox?
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10-14 days
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What are th signs and symptoms of ebola?
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-sudden onset of flu like symptoms (fever, prostration, chills, HA, myalgia, generalized weakness, cough, sore throat, and conjunctivitis for 4-7 days)
-progress to nausea, vomiting, diarrhea, abdominal pain, photophobia, maculopapular rash, red eyes, hiccups, internal and external hemorrhage -multi organ failure -renal insufficiency -death |
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What is the incubation period for ebola?
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2-21 days
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How is cutaneous anthrax diagnosed?
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by signs and symtpoms
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How is inhalation anthrax diagnosed?
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-signs and symptoms
-mediastinal widening on vhest x-ray with pleural effusion and infiltrates -blood smears will support diagnosis with presidence of gram (+) rod |
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How is plague diagnosed?
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-by signs and symptoms
-plague should be considered |
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How is a definitive diagnosis of tularemia made?
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-clinical suspicion
-hx of possible exposure -differential diagnosis of other typhoidal syndromes, pneumonic condition such as plague or mycoplasm -definitive diagnosis through lab tests |
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How is small pox diagnosed?
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-clinical presentation
-must make differential diagnosis form other types of pox |
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How is ebola diagnosed?
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-clinical suspicion and hx of exposure
-differential diagnosis between typhoid fever, fulminant hepatitis, and other viralhemorrhagic fevers |
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What is the treatment regimen for naturally occurin anthrax?
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- Penicillin 2million units IV every 2 hours
- if allergy can use erythromycin or tetracycline |
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What is the treatment for cutaneous anthrax?
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-Ciprofloxacin 500 mg PO Q12
OR -doxycycline 100 mg PO Q12 *for 60 days |
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What is the treatment regimen for inhalation/GI anthrax?
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-Ciprofloxacin 400 mg IV Q 12
OR -levofloxacin 500 mg IV Q24 OR -doxycycline 100 mg IV Q12 PLUS -rifampin 600 mg PO daily OR clindamycin 900 mg IV Q8 OR imipenem 500 mg IM or IV Q6 OR ampicillin 500 mg IV Q6 OR clarithromycin 500 mg Q12 *tx. for 60 days, switch to PO once pt. is stable |
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What type of resistance can be a problem with anthrax?
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-penicillin resistance; must test for susceptibility before treating with ampicillin
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What antibiotic regimen is used for anthrax prophylaxis?
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Ciprofloxacin 500 mg PO Q12
OR Doxycycline 100 mg PO Q12 OR Amoxicillin 500 mg PO Q8 OR Acellular vaccine 0.5 ml SQ at exposure then at 2 and 4 weeks, 6, 12, 18 months (generally only for military, 1st responders, lab workers) |
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How long is the tx of anthrax prophylaxis?
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60 days
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What are the preferred treatment regimens for plague?
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-Streptomycin 50 mg/kg IM Q12
OR -Gentamycin 5 mg/kg IM or IV QD |
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What alternative regimesn are available for plague if preferred regimens are unavailable?
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-Doxycycline 100 mg IV BID or 200 mg IV QD
OR -Ciprofloxacin 400 mg IV BID OR -Chloramphenicol 25 mg/kg QID |
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What is the length of treatment for plague?
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10-14 days
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What antibiotic regimen is used for anthrax prophylaxis?
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Ciprofloxacin 500 mg PO Q12
OR Doxycycline 100 mg PO Q12 OR Amoxicillin 500 mg PO Q8 OR Acellular vaccine 0.5 ml SQ at exposure then at 2 and 4 weeks, 6, 12, 18 months (generally only for military, 1st responders, lab workers) |
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How long is the tx of anthrax prophylaxis?
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60 days
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What are the preferred treatment regimens for plague?
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-Streptomycin 50 mg/kg IM Q12
OR -Gentamycin 5 mg/kg IM or IV QD |
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What alternative regimesn are available for plague if preferred regimens are unavailable?
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-Doxycycline 100 mg IV BID or 200 mg IV QD
OR -Ciprofloxacin 400 mg IV BID OR -Chloramphenicol 25 mg/kg QID |
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What is the length of treatment for plague?
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10-14 days
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What antibiotic regimen is used for anthrax prophylaxis?
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Ciprofloxacin 500 mg PO Q12
OR Doxycycline 100 mg PO Q12 OR Amoxicillin 500 mg PO Q8 OR Acellular vaccine 0.5 ml SQ at exposure then at 2 and 4 weeks, 6, 12, 18 months (generally only for military, 1st responders, lab workers) |
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How long is the tx of anthrax prophylaxis?
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60 days
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What are the preferred treatment regimens for plague?
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-Streptomycin 50 mg/kg IM Q12
OR -Gentamycin 5 mg/kg IM or IV QD |
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What alternative regimesn are available for plague if preferred regimens are unavailable?
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-Doxycycline 100 mg IV BID or 200 mg IV QD
OR -Ciprofloxacin 400 mg IV BID OR -Chloramphenicol 25 mg/kg QID |
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What is the length of treatment for plague?
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10-14 days
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What is the treatment of plague meningitis?
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Chloramphenicol 1 g IV Q6 X 10-14 days
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What is post-exposure prophylaxis for plague?
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Doxy 100 mg PO BID X7
OR Cipro 500 mg PO BID X7 |
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What is 1st line treatment for tularemia?
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-Streptomycin 7.5-10 mg/kg Q12 X7
OR -Gentamycin 1-1.7 mg/kg Q* or 4-7 mg/kg/day X 10-14 days |
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What are the second line treatment options for tularemia?
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-Cipro 400 mg IV or 750 mg PO Q12 X 10-14
-Doxy 100 mg Q12 X 3-4 weeks -Tetracycline 500 mg PO QID X 3-4 weeks |
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What post-exposure prophylaxis is available for tularemia?
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-Cipro 500 mg Q12 X 2 weeks
-Doxycycline 100 mg PO Q12 for 2 weeks -Tetracycline 500 mg PO Q6 X 2 weeks |
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What should be avoided in ebola patients?
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IM injections and ASA
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List some AEs of ciprofloxacin.
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-phototoxity
-tendon dmg etc. |
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What are some counseling points for ciprofloxacin?
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-no excercise
-phototoxicity -not taken with dairy or antacids -stay hydrated finish entire course -may cause dizziness -avoid caffeine b/c clearance is decreased |
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What are some counseling points for doxycycline?
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-finish entire course
-phototoxic -remain upright -best on empty stomach |
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What are the AE of strptomycin?
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-HA
-neurotoxicity -skin rash -N/V -anemia -ototoxicity -nephrotoxicity -dizziness |
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What are some AE of gentamycin?
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-vertigo
-gait instability -ototoxicity -nephrotoxicity -neuromuscular blockade -respiratory |
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What are some AE of chloramphenicol?
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-aplastic anemia
-bone marrow suppression -gray syndrome -confusion -HA -rash -N/V -diarrhea -sore throat -unusual bleeding/bruising |
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List some counseling points for aminoglycosides?
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-finish entire course
-avoid concominant muscle relaxants -avoid dehydration because it may increase risk of toxicity |
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List the AE of tetracyclines
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-GI intolerance
-tooth discoloration in children -photosensitivity |
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List the AE of fluoroquinololnes.
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-QT prolongation
-photosensitivity -arthropathy -GI intolerance -CNS toxicity |