AOB2 Flashcards
Mainly bacteria
Anthrax causative organism
Bacillus anthrax
Gram +ve rod
Treatment antrhrax
Cirpo or penicillin or doxy
Prevention methods of Antrhax
Safe dipsosal of ill animals
spores can last for 50 years
Clinical manifestations of anthrax
Cutaneous 95%
GI
Resp
Flaviruses list
Yellow Fever
Dengue virus
Zika virus
West Nile virus
Japanese Encephalitis virus
Tick-Borne Encephalitis virus
Important Filoviruses
There are 5 but 2 we need to know
Ebolavirus
Marburgvirus
(Cuevavirus, Striavirus, and Thamnovirus)
Brucella bacterial cause
Gram negative cocobaccili - intracellular
Brucella melitensis
Treatment brucellosis
Doxy 6/12 + aminoglycoside for 1/52
Clinical course brucellosis
Slow insidious onset
Incubation can be 1-4 weeks
Can be subacute presentation
Osteoarticular syndrome and urogenital syndrome possible
Can have low grad meningoencephalitis
Diagnosis brucella
Difficult to blood culture (need to warn lab staff)
Tissue see non case sating granulomas
Standard and microscopic agglutination test
What type of bacteria is plague?
Yerssinia PErstis is a gram negative coccus bacillus
Where has there been recent plague outbreaks?
madagascar
Clinical course of the plague
Short incubation period 1-3 days
Aggressive disease
Bubo - swollen, tender, erythematous swollen regional lymph nodes
Antrax CXR
Widened mediastinum and pleural effusions
Pneumonic plague CXR
Looks like atypical pneumonia
Medicines for plague
Fuloroquinolones often first line
Cephalosporins not particularly effective
Can give prophylactic doxy
Explain pneumonic plague outbreak
Bubonic plague - ?haemotagenous spread to loung
Y pestis in resp droplets
Inhaled and infects someone who inhlaes droplets
Differentials for a massive spleen (5 important ones, 3 bonus)
- Malaria or hyperreactive malaria splenomegaly
- Portal hypertension, e.g. caused by schistosomia-
sis, cirrhosis, etc. - Lymphoma, leukaemia, myelodysplasia
- Haemoglobinopathies and hereditary haemolytic
anaemias - Splenic hydatid cyst
Bonus 3
* Still’s disease
* Glycogen storage and other metabolic diseases
* Amyloidosis
Intermittent preventive treatment in pregnancy
Sulfadoxine Pyremethamine
Malarone
Ataquavone proguanil
Good but expensive
What neuro condition can zika precipitate?
Guillian Barre syndrome
Mycemetoma
Chronic foot infection
Red grains - bacterial
Black grains - fungal
White grains - no clue
Abe or antifungal tx
Drugs which can cause pellagra (b3 deficiency)
Isoniazid,
Chloramphenicol
Fluorouracil
Mercaptopurine.
Systemic treatment options CL
Lip Amp B
Meglumine Antimonate
Milfetisone
Snail genus schistosomiasis
varies depending on type - not going to learn
Shistosoma intercalatum epi
DRC
Asplenism organisms
polysaccharide-encapsulated bacteria, such as Streptococcus pneumoniae and other Streptococcal species, Haemophilus influenzae type b, Neisseria meningitidis, Escherichia coli, Salmonella, Klebsiella.
TORCH conditions
Toxoplasmosis
Other - syphilis, Hep B
Rubella
Cytomegalovirus
Herpes symplex
Rubella
Contagious viral infection transmitted by airborne droplets
Leading preventable cause of birth defects
Infection during pregnancy - miscarriage, fatal death or CRS
CRS - hearing, eye, heart and other lifelong disability
What is the VHF with a vaccine?
Junin virus
Severe features for dengue?
One or more of
1) plasma leakage that may lead to shock (dengue shock) and/or fluid accumulation, with or without respiratory distress
2) severe bleeding
3) severe organ impairment.
Highest number of people with TB?
Highest burden is South Asia and SSA
Highest number - India because India is big
TB in HIV
TB is commonly seen in conjunction with advanced HIV
This is due to mechanisms controlling latent TB fail due to low CD4 counts
Pulmonary TB is often more widespread and more prominent lymphadenopathy.
Cavities are less common as is the preference for UL disaease
Organophosphate poisioning
Organophosphates block the action of acetylcholinesterase within the synapse, leading to accumulation of acetylcholine.
This causes miosis, confusion, diarrhoea and vomiting, profuse sweating, and salivation.
Organophosphates are effective insecticides, which are widely used by farmers in tropical areas. Poisoning is common, with up to 3,000,000 cases and 200,000 deaths each year. Sadly, organophosphate poisoning often heralds a suicide attempt. Opioids can also cause miosis, but they are difficult to source in most tropical settings.
Cocaine and belladona both cause mydriasis. Botulism usually manifests with rapid onset global paralysis, and mydriasis.
Marasmus features
characterised by marked irritability; thin, flaccid, but intact skin; and a wasted, emaciated, wizened ‘old man’ appearance
Kwashiorkor features
Lethargic and apathetic, with desquamating skin rashes and pitting oedema and abdominal distension (reflecting third spacing of fluid due to low oncotic pressure from hypoalbuminaemia).
COCP and cancer
Increases risk of cervical and breast
Decreases endometrial and colorectal
Congenital rubella syndrome
cataracts or congenital glaucoma,
congenital heart disease (most commonly patent ductus arteriosus or peripheral pulmonary artery stenosis),
hearing impairment, OR
pigmentary retinopathy;
Congenital syphilis
Saber shin
Interstitial keratitis
Saddle nose
Hutchingsons teeth
What do all VHF viruses have in commmon?
VHF viruses are RNA viruses, enveloped by a fatty lipid coating.
H.influenzae
This is a Gram negative rod which often colonises the upper respiratory tract.
There are six encapsulated serotypes of H. influenzae, of which serotype B is the most clinically significant. Hib is associated with (usually childhood onset) pneumonia, epiglottitis, meningitis and bacteraemia.
Asplenism is an important risk factor for the development of infections with encapsulated bacteria, which underscores the need for vaccination and lifelong penicillin prophylaxis for such patients.
The treatment of choice for upper and lower respiratory tract infections is usually co-amoxiclav; patients with meningitis respond well to ceftriaxone.
A highly effective conjugate vaccine has led to a significant reduction in clinically significant Hib infections in high-income settings.
Disability definitions
Handicap - a disadvantage for a given individual that limits or prevents the fulfillment of a role that is normal.
Disability - Impairment in a person’s body structure or function, or mental functioning
Impairment: Any loss or abnormality of psychological, physiological, or anatomical structure or function
Calculating maternal mortality rate
(Number of maternal deaths / Number of live births) X 100,000
Zika virus epi
Central and south america - aedes is vector
Can lead to GBS
Can lead to microcephaly in neonates
MADM (malnutrition associated diabetes mellitus)
MADMis poorly understood
Acute presentations can be differetitated from DKA with a lack of ketosis
Leptospirosis when and where
In the acute phase of illness, leptospires are present in the blood (septicemia) for approximately the first 4–6 days of illness.
Leptospires may be shed intermittently in the urine after approximately the first week of illness onset.
How does PF cause severe disease
PF expresses receptors on RBC surface which cyoadhere to other RBCs and endothelial lining causing sequestration of large number of mature parasite into deep tissues.
JE testing
CSF JE-specific IgM.
This highly sensitive and specific test typically becomes positive 10d into illness, so repeated convalescent samples are often needed. This expensive test is out of reach for most people living in hyperendemic settings – diagnosis is often made on typical clinical syndrome in at-risk areas, following exclusion of other CNS pathogens on CSF analysis
Gram staining
Fix
Crystal violet
Iodine
Decolorisation
Counter stain - Safrinin
