All Diseases

Question 1

What agent causes Rheumatic Fever

Answer 1

Streptococcus pyogenes

Question 2

What type of agent causes Rheumatic Fever?

Answer 2

Gram positive bacteria in chains.

Question 3

How is Rheumatic Fever transmitted?

Answer 3

Sequela from strep infection.

Question 4

What are symptoms of Rheumatic Fever?

Answer 4

Carditis (inflammaitonof the heart)
Polyarthritis
subcutaneous skin nodules
chorea--jerk muscle movements
erythema marginatum (redness)

Question 5

What is Staphylococcal Toxic Shock Syndrome (STSS)?

Answer 5

l

Question 6

How is this STSS transmitted?

Answer 6

Super absorbent tampons in too long
or
Dental extraction cotton packed after extraction. Keeping the cotton in too long.

Question 7

What are the symptoms of STSS?

Answer 7

High fever
vomitting
chills
profuse watery diarhea
sore throoat
Myalgias--
rash may appear
desquammation of skin
progress to sever shock, respiratory distress syndrome
......
.......
.....

Question 8

What bacteria causes Anthrax?

Answer 8

Bacillus………..

Question 9

What type of agent causes Anthrax?

Answer 9

gram positive spore-forming rods … box shaped….

Question 10

What are the methods of transmisssion of Anthrax

Answer 10

infected animal (20% lethal
Cutaneous (95% lethal)
Pulmonary (??% lethal)
intestinal (??% lethal)

Person to person transmission is rare

Question 11

What are the signs and sympotoms of Anthrax?

Answer 11

Cutaneous
Raised, itchy papule, resembling insect bite within 2-5 d
1-2 days later, vesicle, then painless ulcer (1-3cm) with black eschar/scab, necrotic center
Adjacent lymphadenopathytoxemia, bacteremia
Hemorrhagic mediastinitis, hemorrhagic thoracic lymphadenitis, hemorrhagic meningitis

Pulmonary
Resembles common cold
Hemorrhagic mediastinitis, hemorrhagic thoracic lymphadenitis, hemorrhagic meningitis
After several days, severe breathing problems, shock, death

Intestinal
Acute inflammation of intestinal tract
Nausea, loss of appetite, vomiting, fever
Abdominal pain, vomiting of blood, severe diarrhea

Question 12

How do you treat anthrax?

Answer 12

Ciprofloxacin, doxycycline, penicillin

Natural B. anthracis strains are resistant to broad-spectrum cephalosporins.

Question 13

How can you prevent anthrax infections?

Answer 13

Vaccination
Inactivated, cell-free product made from nonencapsulated attenuated strain.
Live attenuated strain in former USSR.
Protective antigen (PA) is the antigenic molecule
6-dose series
Active and reserve US military
Will take years to make enough for civilian use.
Standard barrier isolations
HEPA masks
Appropriate biosafety level 2 conditions
Hypochlorite
Proper burial of humans and animals
Prefer cremation

Question 14

What is the causative agent of Gangrene? and what type of agent is this?

Answer 14

Clostridium sp. (particularly C. perfringens)

Gram positive, anaerobic, spore-forming rods

Question 15

How is Gangrene transmitted?

Answer 15

For gas gangrene, loss of blood supply and infection of wound with C. perfringens bacteria.

Question 16

What are the signs and symptoms of Gas Gangrene?

Answer 16

Pain, swelling
Fermentation causes gas production (crepitation) and lower pH
Increased vascular permeability, shock

Question 17

Why is gangrene from frost-bite so common?

Answer 17

spores in soil in contact with injured wounds on feet.

Question 18

What are the signs and symptoms of anaerobic cellulitis (Clostridia infection)? (ie gangrene).

Answer 18

Rapid progression of subcutaneous infection
No myonecrosis
Production of gas (more than gas gangrene)
Suppuration-leaking of fluids
Pain, swelling absent
Not as serious as gas gangrene and easier to treat

Question 19

How do you treat gas gangrene?

Answer 19

Initiate immediately
Debulking (prevents further anaerobiosis)
Resection of muscle groups, amputation
Abx; protein synthesis inhibitors
clindamycin, cephalosporins, penicillins
Hyperbaric O2
Polyvalent antitoxin—used historically, but ineffective

Question 20

How can you prevent gangrene?

Answer 20

Prompt cleaning of serious wounds

Prophylactic use of antibiotics (penicillin).

Question 21

What is the causative agent of Plauge?

Answer 21

Yersinia pestis
(look like saftey pins)
Gram negative rods

Question 22

How is the plauge transmitted?

Answer 22

Bubonic plague (Black Death): flea bite
Pneumonic plague: aerosolized droplets
Ceptacemic plauge….

Question 23

What is the pathogenesis of the plague.

Answer 23

Rats are resivour
fleas are vector, bite infected rat
Bacteria multiply in foregut until the block the proventriculus.
Host rat dies and fleas seek new host
Infectd flea regurgitates bacteria into new bite wound
New host (rat or human) develops bubonic plague.

If bubonic plague develops into secondary pneumonia (by bacteremic spread to lungs) coughing can lead to droplet spread and pneumonic plague.

Question 24

What are the symptoms of bubonic plague?

Answer 24

Incubation 2-7 days
Onset
–Fever,
–buboes (swollen lymph nodes)

Without treatment

• -50-75% patients
• -Bacteremia to G- septic shock to death
• -Takes hours to days
• -5% develop pneumonic plague with mucoidy, bloody sputum

Question 25

What are the symptoms of pneumonic plague?

Answer 25

Shorter duration (2-3 days)
Fever, malaise, tightness in chest
Cough with mucoidy, bloody sputum, dyspnea, cyanosis and death on 2nd or 3rd day
No survivors without specific therapy

Question 26

What is the treatment of the Plauge?

Answer 26

Streptomycin
Tetracycline, chloramphenicol, sulfonamides
Requires timely treatment

Question 27

What are common preventative measure for the Plauge?

Answer 27

Urban cycle control

• Rat control
• Insecticides
• Chemoprophylaxis
• Vaccination
  
  • -Formalin-killed bacteria

Sylvatic cycle control

• Too difficult to control vectors
• Avoid dead or sick rodents and rabbits

Question 28

What is spirochete and what is an example?

Answer 28

Spiral bacteria structure. Borrelia burgdorferi.

Question 29

What are erythema migrans?

Answer 29

Concentric circles, bullseye rash/lesion. found in 50% of cases of lyme disease.

Question 30

What is the antibiotic of choice to treat lyme disease?

Answer 30

doxycycline.