1.02 MTB Step 3 - Animal-Borne Diseases (Part II)

Question 1

PLAGUE

How is the Plague transmitted?

Answer 1

Rodent Exposure

in the American Southwest region

Question 2

PLAGUE

What are (4) common symptoms of the Plague?

Answer 2

1. High Fever (sudden-onset)
2. Intense Headache
3. Severe Myalgia
4. Massively Enlarged Lymph Nodes (buboes)

Question 3

PLAGUE

1. What is the Best INITIAL Diagnostic Test for the Plague?
2. What is the Most ACCURATE Diagnostic Test for the Plague?

Answer 3

Best INITIAL Test: Gram Stain (Gram-Negative rods on Smear of Node Aspirate)

Most ACCURATE Test: Culture

Question 4

PLAGUE

What is the Treatment for the Plague?

Answer 4

Streptomycin

or

Gentamicin

or

Doxycycline

Question 5

PLAGUE

Which form of the Plague can be Fatal within 24 hours?

Answer 5

Pneumonic Plague

(Lung)

Question 6

STRONGYLOIDES

What is the Causative Agent of Strongyloides?

Answer 6

Nematode

(Roundworm)

Question 7

STRONGYLOIDES

What are (6) common symptoms of Strongyloides?

Answer 7

1. Skin involvement
2. Respiratory symptoms
3. GI symptoms
4. Itchy lesions, particularly on the feet (where the organism entered — wear shoes! )
5. Eosinophilic Pneumonia (coughing up the organism from the lymphatics)
6. Nausea, Diarrhea (from swallowing what was coughed up)

Question 8

STRONGYLOIDES

What are (2) Diagnostic Tests used for Strongyloides?

Answer 8

Stool Sample & Bronchoscopy

show Worms/Larvae (not eggs)

Question 9

STRONGYLOIDES

What is the Treatment for Strongyloides?

Answer 9

Ivermectin

or

Albendazole

Question 10

STRONGYLOIDES

What form of Strongyloides infection do you see in Immunocompromised patients?

Answer 10

Hyperinfection Syndrome

(Everywhere)

Question 11

BRUCELLOSIS

How is Brucellosis transmitted?

Answer 11

Exposure to Unpasteurized Milk or Uninspected Meat from outside the United States; “returning war veteran.”

Brucella needs long periods to grow

Question 12

BRUCELLOSIS

What are (6) common Clinical Findings for Brucellosis?

Answer 12

1. Fever for weeks/months
2. Hepatosplenomegaly
3. Endocarditis
4. Osteomyelitis
5. Meningitis
6. Chronic joint pain

Question 13

BRUCELLOSIS

What are (2) Diagnostic Tests used for Brucellosis?

Answer 13

Culture

(Blood, CSF, Urine, Marrow)

and

Serology

Question 14

BRUCELLOSIS

What is the Treatment for Brucellosis?

Answer 14

Doxycycline

and

Gentamicin

Add Rifampin for Bone and Heart infection