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67 Cards in this Set

  • Front
  • Back
What is the causative organism for anthrax?
bacillus anthracis
What is the causative organism for tularemia?
franciella tularensis
What is the causative organism for plague?
Yersina pestis
What is the causative organism of small pox?
-Variola major (30 % fatality causes most severe illness)
-variola minor
What is the causative organism for ebola?
-RNA virus from family filovirdae
What are the subtypes of ebola?
-Ebola-Zaire
-Ebola-Reston
-Ebola-Sudan
-Ebola-Ivory Coast
What form of ebola causes illness only in monkeys?
Ebola-Reston
What are the signs and symptoms of cutaneous anthrax?
-papule to fluid filled vesicle to dry coal black scab
-malaise, fever, and HA
What are the signsand symptoms of inhalation anthrax?
-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
What is the incubation period for cutaneous anthrax?
1-6 days
What is the incubation period for inhalation anthrax?
1-6 days
What are the signs and symptoms of bubonic plague?
- enlarged tender lymph nodes in the inguinal area
- extreme malaise, HA, high fever
-small pustule at site of flea bite
What are the signs and symptoms of the pneumonic plague?
-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
What are the signs and symptoms of septicemic plague?
-septicimic shock and circulatory collapse
-always is preceded by bubonic or pneumonic plague
What is the incubation period of bubonic plague?
2-10 days
What is the incubation period of pneumonic plague?
1-6 days
What are the signs and symptoms of typhoidal tularemia?
-high fever
-chills
-cough
-prostration
-HA
-substernal chest pain
What are the signs and symptoms of ulceroglandular tularemia?
-fever
-chills
-HA
-malaise
-ulcerative skin lesion at site of contact
-painful lymphadenopathy
What are the signs and symptoms of glandular tularemia?
-fever
-tender lymphadenopathy
-no skin lesion
What are the signs and symptoms of oculoglandular tularemia?
-purulent conjunctivitis
-cervical lymphadenopathy
-periorbital edema
-small lesions or ilcerations of conjunctiva
What are the signs and symptoms of oropharyngeal tularemia?
-pharyngotonsilitis with cervical lymphadenopathy
What are the signs and symptoms of pneumonic tularemia?
-severe atypical fulminant pneumonia
-symptoms consistent with typhoidal tularemia
-progress to dyspnea and bloody sputum
-rarely leads to lung abscess
-respiratory failure may occur
What is the incubation period of tularemia?
1-21 days (average of 3-5 days)
What are the signs and symptoms of smallpox?
-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
What is the incubation period of smallpox?
10-14 days
What are th signs and symptoms of ebola?
-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
What is the incubation period for ebola?
2-21 days
How is cutaneous anthrax diagnosed?
by signs and symtpoms
How is inhalation anthrax diagnosed?
-signs and symptoms
-mediastinal widening on vhest x-ray with pleural effusion and infiltrates
-blood smears will support diagnosis with presidence of gram (+) rod
How is plague diagnosed?
-by signs and symptoms
-plague should be considered
How is a definitive diagnosis of tularemia made?
-clinical suspicion
-hx of possible exposure
-differential diagnosis of other typhoidal syndromes, pneumonic condition such as plague or mycoplasm
-definitive diagnosis through lab tests
How is small pox diagnosed?
-clinical presentation
-must make differential diagnosis form other types of pox
How is ebola diagnosed?
-clinical suspicion and hx of exposure
-differential diagnosis between typhoid fever, fulminant hepatitis, and other viralhemorrhagic fevers
What is the treatment regimen for naturally occurin anthrax?
- Penicillin 2million units IV every 2 hours
- if allergy can use erythromycin or tetracycline
What is the treatment for cutaneous anthrax?
-Ciprofloxacin 500 mg PO Q12
OR
-doxycycline 100 mg PO Q12
*for 60 days
What is the treatment regimen for inhalation/GI anthrax?
-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
What type of resistance can be a problem with anthrax?
-penicillin resistance; must test for susceptibility before treating with ampicillin
What antibiotic regimen is used for anthrax prophylaxis?
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)
How long is the tx of anthrax prophylaxis?
60 days
What are the preferred treatment regimens for plague?
-Streptomycin 50 mg/kg IM Q12
OR
-Gentamycin 5 mg/kg IM or IV QD
What alternative regimesn are available for plague if preferred regimens are unavailable?
-Doxycycline 100 mg IV BID or 200 mg IV QD
OR
-Ciprofloxacin 400 mg IV BID
OR
-Chloramphenicol 25 mg/kg QID
What is the length of treatment for plague?
10-14 days
What antibiotic regimen is used for anthrax prophylaxis?
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)
How long is the tx of anthrax prophylaxis?
60 days
What are the preferred treatment regimens for plague?
-Streptomycin 50 mg/kg IM Q12
OR
-Gentamycin 5 mg/kg IM or IV QD
What alternative regimesn are available for plague if preferred regimens are unavailable?
-Doxycycline 100 mg IV BID or 200 mg IV QD
OR
-Ciprofloxacin 400 mg IV BID
OR
-Chloramphenicol 25 mg/kg QID
What is the length of treatment for plague?
10-14 days
What antibiotic regimen is used for anthrax prophylaxis?
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)
How long is the tx of anthrax prophylaxis?
60 days
What are the preferred treatment regimens for plague?
-Streptomycin 50 mg/kg IM Q12
OR
-Gentamycin 5 mg/kg IM or IV QD
What alternative regimesn are available for plague if preferred regimens are unavailable?
-Doxycycline 100 mg IV BID or 200 mg IV QD
OR
-Ciprofloxacin 400 mg IV BID
OR
-Chloramphenicol 25 mg/kg QID
What is the length of treatment for plague?
10-14 days
What is the treatment of plague meningitis?
Chloramphenicol 1 g IV Q6 X 10-14 days
What is post-exposure prophylaxis for plague?
Doxy 100 mg PO BID X7
OR
Cipro 500 mg PO BID X7
What is 1st line treatment for tularemia?
-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
What are the second line treatment options for tularemia?
-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
What post-exposure prophylaxis is available for tularemia?
-Cipro 500 mg Q12 X 2 weeks
-Doxycycline 100 mg PO Q12 for 2 weeks
-Tetracycline 500 mg PO Q6 X 2 weeks
What should be avoided in ebola patients?
IM injections and ASA
List some AEs of ciprofloxacin.
-phototoxity
-tendon dmg
etc.
What are some counseling points for ciprofloxacin?
-no excercise
-phototoxicity
-not taken with dairy or antacids
-stay hydrated
finish entire course
-may cause dizziness
-avoid caffeine b/c clearance is decreased
What are some counseling points for doxycycline?
-finish entire course
-phototoxic
-remain upright
-best on empty stomach
What are the AE of strptomycin?
-HA
-neurotoxicity
-skin rash
-N/V
-anemia
-ototoxicity
-nephrotoxicity
-dizziness
What are some AE of gentamycin?
-vertigo
-gait instability
-ototoxicity
-nephrotoxicity
-neuromuscular blockade
-respiratory
What are some AE of chloramphenicol?
-aplastic anemia
-bone marrow suppression
-gray syndrome
-confusion
-HA
-rash
-N/V
-diarrhea
-sore throat
-unusual bleeding/bruising
List some counseling points for aminoglycosides?
-finish entire course
-avoid concominant muscle relaxants
-avoid dehydration because it may increase risk of toxicity
List the AE of tetracyclines
-GI intolerance
-tooth discoloration in children
-photosensitivity
List the AE of fluoroquinololnes.
-QT prolongation
-photosensitivity
-arthropathy
-GI intolerance
-CNS toxicity