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Tropical Medicine > Bacteria (and STIs) > Flashcards

Bacteria (and STIs) Flashcards

1
Q

Treatment for Gonorrhea

A

Ceftriaxone/azithromycin

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2
Q

Treatment for BV

A

Flagyl

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3
Q

Treatment for chlamydia

A

doxycycline or azithro

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4
Q

Treatment for chlamydia in pregnancy

A

azithromycin

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5
Q

Treatment for epididymitis

A

Ceftriaxone + Doxycycline

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6
Q

What causes cervicitis

A

Chlamydia Trachomatis, N gonorrhoeae, Mycoplasma Genitalium

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7
Q

RUQ Pain sexually active women with fever, dyspareunia, vaginal discharge, dysuria, nausea/vomiting ; what are common pathogens

A

PID: Chlamydia Trachomatis, Neisseria Gonorrhea, Fusobacterium species, Mycobacterium Genitalia, Streptococcus Agalactiae)

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8
Q

Treatment for PID

A

CTX + Doxy + Metronidazole

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9
Q

typical etiologies of urethritis

A

Chlamydia trachomatis, neisseria gonorrhea, trichomoniasis, mycoplasma genitalium

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10
Q

what is the most sensitive tool for detecting gonorrhea urethritis

A

gram stain of urethral secretion (however a lot of people dont do the gram stain anymore)

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11
Q

Uncomplicated gonoccocal infection of cervix, urethra, rectum WITHOUT chlamydia

A

Ceftriaxone IM (if chlamydia not excluded, give doxy)

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12
Q

Treatment of Mycoplasma genitalium

A

Check resistance; doxycycline and azithromycin
or Doxy and then moxifloxacin (can use this combo if there is no resistance testing avail)

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13
Q

typical causes of proctitis

A

Gonorrhea, Chlamydia trachomatis (LGV and non-LGV strain-L1 L2 L3 ), HSV, CMV, Ameobiasis

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14
Q

What is LGV

A

lymphogranuloma vernereum
Caused by chlmaydia trachomatis
Serovars L1, L2, L3
Endemic in areas of E. W Africa, India, SE Asia, Caribbean
Presentation: proctitis, LN swelling, genital ulcer
Treatment: Doxy

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15
Q

Patient with migratory polyarthralgia and tenosynovitis and monoarticular purulent arthritis found to have tender encrotic acral pustules

A

Disseminated gonoccocal infection -

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16
Q

What kind of bacteria is Cholera

A

Vibrio cholerae
Gram Negative Bacilli
Anaerobic
Motile and curved

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17
Q

What is v. cholerae classified based on

A

Serogroup O1 and O139 (and other non O1s)

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18
Q

Rice Water, fishy odor

A

Vibrio Cholerae

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19
Q

How to treat cholera

A

Rehydration phase: lasts 2-4 hours
Maintenance phase: Lasts until diarrhea abates

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20
Q

When can you discharge a cholera patient

A

If Oral Tolerance >1000mL/hr
If Urine Output >40mL/hR
If Stool Vlume <400cc/hr

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21
Q

What are the preferred cholera abx

A

Tetracycline or Bactrim or Cipro or Azithro

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22
Q

Does vaccinating against cholera protect you

A

Not against the O139 strain

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23
Q

What are the vaccines for cholera

A

Give to mission workers (i.e. peace corps)
Give to endemic areas, esp school age children

Dukoral: Killed cell 2-3 doses Oral
Live Attenuated vax is also an option (Travelers, single dose)

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24
Q

Typhoid fever in Asia mostly caused by

A

Salmonella Paratyphi A

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25
Q

Phase I of typhoid fever
Phase II of typhoid fever

A

Bacteremia: S typhy penetrates the TERMINAL ILEUM (Peyer patches)
Phase II: localization or complications-bowel perforation, GI bleeding, typhoid status, hepatitis

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26
Q

Patient had a fever at night more commonly, Diarrhea and constipation alternating, sleeping disorders, insomnia in adults, hypersomnia in children

A

Typhoid Fever

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27
Q

Rose spots, abdominal pain, dissociation pulse rate

A

Typhoid fever

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28
Q

How to diagnose typhoid fever

A

Widal Test, blood cultures

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29
Q

What are the side effects of previously used treatment for typhoid fever

A

chloramphenicol-side effects included are hematological side effects: Anemia, leukopenia, rarely bone marrow aplasia

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30
Q

First line current drug against typhoid fever

A

ceftriaxone-unless iraq or pakistan, then consider azithromycin, or meropenem

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31
Q

what is a serious complication of typhoid

A

perforation, usually after the 3 weeks of first symptoms-distal ileum usually

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32
Q

What does it mean to have a chronic carriage of S typhi or S paratyphi

A

Person who excretes S typhi in the bile and/or hte stools for more than 12 months

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33
Q

what is a risk of being a chronic carrier of s typhi

A

you shed in bile and stool x 12 months; you also develop hepatobiliary cancer

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34
Q

treatment of typhoid in a chronic carrier state

A

amoxicillin but has a high relapse rate if GB disease
Fluoroquinolone

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35
Q

What vaccines prevent typhoid fever

A

Ty 21a vaccine -3 doses (oral)
V poysaccharides vaccine

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36
Q

Patient with constant fever, HA, diarrhea followed by constipation and insomnia. Just back from India. Bradycardia and high temp.

A

S. Typhi
Tx: Ciprofloxacin if not resistant; or ceftriaxone, amoxicillin; or meropenem

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37
Q

10 year old boy from Lagunas in the Peruvian Amazon basin develops a large asymptomatic ulceration on hte right leg. Ulcer has undermined borders

A

Buruli Ulcer
Mycobacterium Ulcerans Infection

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38
Q

What are the endemic regions of buruli ulcer

A

West Africa, nigeria, Australia

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39
Q

Who is most likely to get buruli ulcer

A

people in poverty, 15 and under years old, stagnant waters

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40
Q

What is the pathogenesis of buruli ulcer

A

Polyketide toxin called mycolactone, cytotoxicity and immunosuppression can explain the extent of the ulcer

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41
Q

Describe category I, II, and III of Buruli Ulcer

A

I. Small, single lesion
II. Ulcerated and non-ulcerated plaque ; edematous form
III. Disseminated and mixed forms -osteitis, osteomyelitis, arthritis

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42
Q

how to diagnose buruli ulcer

A

direct exampintion, culture, skin biopsy, PCR (gold standard)

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43
Q

What would you find under microscope of buruli ulcer

A

Extensive fat necrosis-bluish dusty material in clumps in the areas of necrosis, minimal inflammatory infiltrate, abundant clumps of acid-fast bacilli

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44
Q

Treatment of buruli ulcer

A

Rifampin and streptomycin
Or rifampicin and clarithromycinPO

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45
Q

List common causes of bloody diarrhea

A

Shigella, Salmonella, Campylobacter, Yersinia, STEC or EHEC or VTEC, EIEC, C Diff, V Parahaemolyticus, E histolytica, Balantidium Coli

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46
Q

Incubation period of shigella

A

1-4 days

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47
Q

Watery diarrhea and tenesums that turns into bloody diarrhea in 1-2 days

A

shigella dysenteriae

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48
Q

What are common species and distributions of Shigella

A

S. Flexneri, S Boydii, S Dysenteriae Type 1

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49
Q

Describe shigella dysenteriae type 1
-Toxin?
-Epi?
-Transmission?
-Risk factors?

A

Produces cytotoxin (Shiga Toxin), causes an illness that is more severe, frequently fatal, resistance to antimicobials occur more frequently
-Outbreaks in Africa, South ASia, Central America
-Contaminated food/water, flies
-humans are the only reservoir
-Risk factors: Infants, adults>50yo, no breastfeeding, recovering from measles, malnourishments
-
-

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50
Q

Complications of Shigellosis

A

Abdominal: protein losing enteropathy, perforation, abscesses
Neuro: Seizures, headache, Toxin encephalopathy (ekiri)
Renal: HUS (s dysenteriae serotype1)

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51
Q

how do you diagnose shigella

A

isolate the organism from stool, serotype the isolate

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52
Q

Treatments for Mild shigella, Moderate/severe shella?

A

Mild: Furazolidone
mod-severe; Cipro, cefixime, ceftriaxone

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53
Q

What are the shigella vaccines

A

You can give a vaccine against 17 serotypes including S dysenteriae type 1, S flexneri, S sonnei

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54
Q

Most common species of shigella in developing countries

A

S flexneri, s sonnei

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55
Q

Guillan barre is associated with which gram negative bacteria

A

campylobacter jejuni/coli

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56
Q

Campy:
Human illness associated with what species?
Reservoir?
Most common time of life for infection?

A

Campylobacter Jejuni, Campylobacter Coli
Reservoir: Poultry, Pig
Infection common in the first year of life

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57
Q

How to dx cmapy

A

diagnosis; stool culture at 42 deg C

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58
Q

Tx of Campy

A

Erythromycin and azithromycin

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59
Q

Biggest risk factor of campy

A

Poultry

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60
Q
A

What is

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61
Q

If the child presents with blood diarrhea WITHOUT fever, antibiotics?

A

NO Because of hte risk of HUS due to EHEC or STEC

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62
Q

watery or bloody diarrhea without fever,

A

STEC

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63
Q

Pathogen neonate PNA

A

Listeria
GBS
CMV
HSV

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64
Q

PNA children 0-3mo

A

Chlamydia
RSV
S pneumonia
S Aureas

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65
Q

3mo-5 years PNA

A

Adenovirus
S pneumo
H flu
Mycoplasma
RSV

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66
Q

5-15 years PNA complciation

A

chlamydia pneumo
S pneumo
Mycoplasma
TB

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67
Q

AFebrile, respiratory distress, neonate, CXR with e/o PNA. What is highest on ddx

A

chlamydia trachomatis

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68
Q

itchy vaginal discharge, yellow/green, strawberry cervix, pH >4.5, +whiff test, flagellated protozoa

A

trichomoniasis

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69
Q

Itchy, thick clumpy cottage cheese vaginal discharge, pH<4.5, pseudohyphae on KOH

A

candida

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70
Q

+whiff test vaginal discharge, clue cells

A

Bacterial vaginosis
Treatment: Metronidazole

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71
Q

Neutrophilic infiltrate with multiple acid fast bacilli

A

tuberculous chancre

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72
Q

Definition of Chancre

A

Superrficial ulceration and superficial granuloma with neutrophils or caseous necrosis

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73
Q

Definition of Scrofuloderma

A

Fistulous draining from underlying structure such as a lymph node, bone, or epididymis

74
Q

fistula draining

A

scrofuloderma

75
Q

what is the definition of a gumma

A

cold abscess as a result of hematogeneous spreading

76
Q
A

Gumma: Bacilli likely seen

77
Q

hematogeneous spread, apple jelly

A

lupus vulgaris, facial, Cutaneous TB

78
Q

How do you treat a cutaneous TB

A

As a pulmonary TB

79
Q

38 year old male from Cajamarca (northern highlands of Peru) complains of nasal obstruction, difficulty breathing

A

Russell bodies-rhinoscleroma on biopsy
Klebsiella Pneumonia sp Rhinoscleromatis

80
Q

Patient with crusting, paleness, malodor, atrophy, Bluish discoloration, polypoid lesions, ulcerations. what is histology? what is treatment?

A

klebsiella pneumnoia rhinoscleromatis (rhinoscleroma)
Histology: large histiocytes with rods, mikulicz cells, russell bodies
Tx: prolonged administration of antibiotics such as tetracycline, quinolones, ceftriaxone from 6 weeks to 6 months

81
Q

26yo HIV + not on HAART with 1 year history of ulcerated fungating masses on the glands and body of penis

A

Klebsiella Granulomatis, granuloma inguinal

82
Q

What can cause autoamputation of penis in HIV2 ? What is the treatment

A

donovanosis, Tx: Azithromycin 1gm, then 500mg daily

83
Q

The spontaneous appearance of abscesses primarily in the large muscles of hte limbs and trunk accompanied by systemic symptoms such as fever and localized pain

A

tropical pyomyositis (likely 2/2 staph, not MRSA)
Treatment with oxacillin

84
Q

What are the 3 brucella species that cause most human disease

A

Brucella Melitensis -Goat, sheep
Brucella ABortus-cattle, water buffalo
Brucella Suis-Pig

85
Q

What is the route of transmission for brucella melitensis?

A

Ingestion of unpasteurized dairy products, direct contact with animals and secretions, vets, lab personell

86
Q

Night time fever, malaise, sweating, back pain, arthralgias, myalgias with hepatomegaly

A

Brucellosis

87
Q

50 year old female with pain in the lumbar region involving 2 + vertebrae with lytic and blastic lesions

A

brucellar spondylitis

88
Q

What is the pons sign?

A

Anterior upper angle erosion in the back-caused by brucella spondylitis

89
Q

What are the most frequent brucellar arthritis locations

A

unilateral sacroilitis and peripheric mono-arthritis

90
Q

Why do women have more severe brucella melitensis than men?

A

Iron deficiency: brucella rapidly grows under this condition and causes severe thrombocytopenia, arthritis

91
Q

What is theh most common ocular manifestations with brucella

A

posterior uveitis

92
Q

How do you diagnose brucella

A

Rose bengal test (agglutination), ELISA (less specific than TAT), PCR (expensive)

93
Q

How do you treat brucella?

A

Doxycyline + Gentamycin
or Doxy + Rifampicin

94
Q

How to treat children <7 years old for brucella?

A

Cefriaxone + Rifampin
DO NOT use tetracycline

95
Q

31yo Man of tuscon, arizona returned from Colorado and started to have fever, deydration, nausea, vomiting. Went into septic shock with pneumonia, gram stain sputum showed gram neg rods

A

Yersinia Pestis (plague)

96
Q

Country with the highest plague currently

A

Madagascar. Between 2000-2009, Congo, Madagascar, and Zambia

97
Q

What does plague look like on staining

A

Gram negative bacillus with bipolar staining (closed safety pin)

98
Q

What are the virulence factors of plague

A
  1. YOPS (yersinia outer membrane-inhibits phagocytosis, downregulates pro-inflammatory cytoquines, induces cell death
  2. F1 Antigen (Capsule): ANtiphagocytic
  3. V Antigen: Survive and multiply in the macrophages
  4. LPS endotoxin (Cell wall )
99
Q

What are the reservoirs of plague

A

urban: Rat, sylvatic: squirrels, prairie dogs

100
Q

How do you get the plague

A

Flea regurgitates infectious remnants from previous blood meal into bite wound

101
Q

clinical manifestations of the bubonic plague

A

incubation period is 2-8 days, regional lymph nodes; sudden onset of fever and chills (high fever)
-Hepatosplenomegaly , thrombocytopenia, DIC

102
Q

Septiemic plague clinical manifestations

A

bacteremia without a bubo, nausea, vomiting, diarrhea, delirium, coma, hemorrhage, shock

103
Q

Pneumonic plague clinical manifestations

A

secondary (hematogenous), primary (inhalation-frothy blood tinged sputum)
Chest discomfort, cough, tachypnea, dyspneae, hemoptysis, respiratory distress

104
Q

31yo M 3rd year resident with high fever, tachypnea, decreased breath soudns, in shock within 3 days; labs show DIC, elevated WBC . What is the orgnaism? diagnosis/ Tx

A

Yersinia Pestis (Plaque)
Can do F1 Ag (rapid Yersinia pestis test)
Tx: Streptomycin + chloramphenicol

105
Q

What is the treatment for the plague

A

streptomycin, gentamicin, doxycycline, ciprofloxacin (treat at least 10-14 days or until 2 days after fever subsides)

106
Q

How to prevent plague (chemoprevention) in someone exposed

A

7 days of Tetracycline (doxy)

107
Q

What is the recommendation for healthcare workers taking care of those with the plague

A

droplet precautions for 8 hours while patient is on abx, wear surgical mask

108
Q

Painless, superficial or deep, sharply demarcated, indurated, nonpurulent base genital ulcer

A

Treponema Pallidum (syphilis)

109
Q

Superficial, painful genital vesicule, small, no induration

A

HSV

110
Q

Deep, irregular, UNDERMINED edges, purulent, genital LAD

A

Chancroid: H. Ducreyi

111
Q

List the Ulcerative STIs

A
112
Q

What is the pathogenesis of HSV

A

Primary infection happens through inoculation/epithelial replication –>retrograde transport to sensory ganglia–>latency in the sensory neurons–>reactivation

113
Q

incubation period of HSV?
Vesicular pustule time frame?
Wet ulcer time frame?
Dry Crusts time frame?

A

IP: 4 days
Vesicular: 0-6 days
Wet ulcer 6-12 days
Dry Crusts 12-20 days

114
Q

What test do you NEED to use to accurately test for HSV

A

Glycoprotein gG test-NOT IgM !

115
Q

When is testing for HSV actually useful

A

Recurrent or atypical genital sx or lesions with a negative HSV PCR previously, clinical diagnosis, 12 weeks after acquisition, partners are possible positive

NOT helpful for screening general population

116
Q

Tx for HSV

A

Acyclovir, Famciclovir, Valacyclovir

117
Q

How is HSV shed

A

genital mucosa-usually transmitted during asx genital shedding

118
Q

What is monkey pox

A

orothopoxovirus

119
Q

Classic presentation of monkey pox

A

Fevers/chills (prodrome), Rash including firm deep seated well circumscribed umbilicated lesions that srtart ont he face and spread. can be painful.

120
Q
A

Monkey pox

121
Q

How do you diagnose monkey pox

A

PCR-use CDC and state labs

122
Q

What are the treatments for Mpox

A

Supportive care, Tecovirimat, Vaccination

123
Q

Small fastidious gram negative rod with erythematous papule evolves into ulcer-typically 1-2cm

A

Chancroid: Hemophilus ducreyi

124
Q

Tx for chancroid

A

Azithromycin or ceftriaxone

125
Q

Lymphogranuloma Venereum: Organism, Clinical sx, Diagnosis, tx?

A

Chlamydia trachomatis, Proctitis among MSM, genital ulcer, inguinal lymph node/bubo; Diagnose with PCR; Treatment -doxy or azithro

126
Q

What s granuloma inguinale

A

Klebsiella granulomatis (Gram negative Rod); Starts as firm papule that ulcerates, beefy red, non-tender ulcers; Dx with donovan bodies on biopsy; azithromycin is the tx of choice

127
Q

LGV Proctitis treatmetn

A

doxycycline x 3 weeks

128
Q

67yoM in HIV clinic for rash given dx of contact dermatitis. HIV well controlled CD4 633.

A

Syphilis (treponema pallidum)
Tx: Penicillin

129
Q

What are the stages of syphilis

A

Exposure–>chancre (primary)–>rash/fever/neuro (secondary)–>.latent (no symptoms) (usually in the first year )
Then 30% can have latent for 5-50 years and then develop tertiary (gumma, cardiac, tabes dorsalis etc)

130
Q
A

Treponema Pallidum
Classic chancre: Primary stage
RPR/VDRL (even if neg, and concerned about syphilis, treat)

131
Q
A

Secondary stage of syphilis:
generalized rash: macular, papular, codyloma lata; 2-6 weeks

132
Q

A 25 year old male presenting to outpatient clinic with disseminated crusted lesions, MSM +. RPR negative.

A

malignant syphilis. The patients’ serum was diluted and RPR was positive. PROZONE -false negative response resulting from overwhelming Ab titers .
Tx: Benzathine penicillin prob for 3-4 weeks

133
Q

DDx of disseminated rusted lesions in the tropics

A

Disseminated leish
Histo
Crypto
Lobomycosis
Chromoblastomycosis
Yaws (t. pallidum)
Pinta (no longer)
Disseminated varicella/zoster
Cutaneous TB
Leprosy

134
Q

56yoF with HIV, anterior uveitis, tinnitus b/l, painless genital lesions, rash over palms and soles

A

treponema pallidum : syphillis

135
Q

How do you define syphilis latent stage:

A

Positive treponemal serology , no sx
<1 year: early latent
>1 year: Late latent
2/3 persons with untreated syphilis remain in latent stage or life

136
Q

Neurosyphilis clinical manifestations

A

meningovascular, meningitis, posterior column (tabes dorsalis)-ataxia, charcots joints, optic nerve defeneration

137
Q

What are the tests for syphilis

A

Nontreponemal: VDRL and RPR (Ab to cardiolipin-lecithin-cholesterol antigen) Quantitative -use for treatment response

Treponemal tests: TP-PA, FTA-ABS (Qualitative)

EIA: Screening (high false positive)

138
Q

Treatment of syphilis

A

Early syphilis tx: IM x1 BZN penicillin
Late latent IM x3 BZN penicillin
Neuro syph tx: Aqueous PCN x 2 weeks

139
Q

10 month old female with vesicular skin lesions involving hands and palms. Nasal discharge +
Fever+. +saddle nose deficit.

A

Congenital syphilis: IM penicillin tx

140
Q

Risk factors for neonatal sepsis

A

prematurity, low birth weight

141
Q

What determines newborn immunity

A

immunoglobulins IgG for placenta; nuetrophils reserve is less than the adulr

142
Q

common gram positives in neonatal sepsis

A

coag negative staph, GBS, enterococcus, s aurus

143
Q

acute onset fever, chills pallor, jaundice. from ecuador. has hepatomegaly. increased reticulocytes

A

bartonella bacilloformis: Rx: Cipro/Azithro

144
Q

macular star on fundoscopy

A

bartonella

145
Q

abrupt onset fever, chills, myalgias, headache, meningeal symptoms after swimming in stagnant wate, conjunctival suffusion, very high bili

A

leptospirosis: Ceftriazone, penicillin

146
Q

jaundice with ARDS after swimming with rodent contaminated water

A

leptospirosis: CTX, PCN

147
Q

27 year old male with erythematous lesion developed aft over hte left thigh 3 weeks after closed trauma , multiple fistulas dark brown purulent material without granules. 11% eos. sulfur granules

A

Actinomycosis: sulfur granules (gram positive filamentous anaerobic bacteria) Tx: Penicillin

148
Q

35yr old female with 10 year history of slow growing swelling on left foot, draining fistula with secretions containing white grains, ffrom ayachucho, rainforest

A

Actinomycetoma: Nocardia or Streptomyces or Actinomadura
Tx: Penicillin

149
Q

gram positive bacilli on culture, skin lesions painless colorless blister

A

cutaneous anthrax: bacillus anthracis , penicillin therapy

150
Q

fistula, white purulent exudate, osteomyelitis; what disease/ what is it associated with?

A

Botryomycosis caused by staph: HTLV association
Tx: Clindamycin and cipro

151
Q

T2DM with BKA 7 days before, feeling unwell, difficulty swallowing. Couldn’t open his mouth, drooling MUscles rigid, sweating profusely . What organism? What kind of org?

A

Clostridium Tetani (anaerobic gram-positive bacllus)

152
Q

C tetani pathophys

A

Injury via spores–>Tetanospasmin travels to the spinal cord–>trismus, muscle spasm–>release of inhibitory neurotransmitters to te renshaw cell–>unopposed muscular contraction–>opisthotonos, risus sardonicus

153
Q

DDx tetanus

A

strychnine poisoning, narcotic withdrawal, meningitis, rabies, hypocal tetany, NMS, stiff person

154
Q

WHO definition of adult tetanus

A

Trismus (inability to open mouth) OR risus sardonicus (sustained spasm of the facial muscles) OR painful musclar contractions

155
Q

How do you diagnose tetanus

A

CLINICAL! Spatula test-bite down and no gag

156
Q

Incubation period of tetatnus? Period of onset of tetanus?

A

Incubation period: <7 days
Symptoms day 7 trismus, dysphagia, back pain
Day 10: generalized spasms
Day >10 CVS HR >130, GI/Renal, Pyrexia >40deg C

157
Q

What is modified Ablett Score

A
158
Q

What are the two types of generalized tetanus

A

localized tetanus: rigidity, pain, weakness, increased deep tendon reflexes
Cephalic tetanus: Lower cranial nerve muscles, facial palsy, stiffness, trismus, pharyngeal spasms, largyngeal spasm, neck stiffness, paresis of IX, X, III

159
Q

Treatment of Tetanus

A

minimize light and sound
benzos (use IV)
Chlorpromazine
Neuromuscular blockade with vec
Magnesium
VEntilation and early tracheostomy

160
Q

Treatment of Tetanus

A

minimize light and sound
benzos (use IV)
Chlorpromazine
Neuromuscular blockade with vec
Magnesium
VEntilation and early tracheostomy
Antitoxin (TIG 500 IM/IV, Equine Antitoxin)
Abx: Metronidazole
B blocker, morphine, clonidine

161
Q

7 day old child with fever, difficulty opening mouth, not opening mouth, sensitive to light, sound, touch. Orgnaism? Treatment? Prevention?

A

Clostridium Tetani
Tx: Abx-flagyl. anti toxin-TIG. Sedativie-phenobarb, chlorpromazine, anti-spastic-benzo; muscle relaxant-magnesium, quite dark stimulation

Prevention: mom vaccination-1st dose in 1st tri pregnancy, 2nd dose at least one moth later (3rd tri)

162
Q

What is the global progress with maternal and neonatal elimination **TEST

A

Elimination is defined as <1 NNT case per 1000 live births every district per year

163
Q

Definition of tetatnus

A

muscle stiffness spasms with or without cardiovascular instability + preserved consciousness

164
Q

Patient with facial lesion, UMN lesion, after MVC

A

Cephalic tetanus

165
Q

Definition of neonatal tetanus

A

normal ability to suck and cry during 2 days of life. Then could NOT suck normally between day 3 and 28 . Muscle stiffness and spasms (jerking)

166
Q

Spread of Coxiella

A

aerosolization (>10km downwind), lambing, raw milk, tick bite

167
Q

Incubation of Q fever

A

2-6; mostly asymptomatic, fever, pneumonia, hepatitis, HEADACHE *** ; mortality is very low IF treated

168
Q

Pregnant woman with coxiella

A

TMP/SMX through pregnancy, be careful with staff who are coming into contact with placenta

169
Q

20 year old malawian man-arrived in Italy from Malawi, 2 days of high fever, scratch marks on skin, CRP elevated

A

Borrelia Recurrentis infection

170
Q

Louse Borne diseases (list 3)

A

Rickettsia Prowazekii
Bartonella Quintana
Borrelia

171
Q

What is the vector for borrelia

A

pediculus humanus humanus

172
Q

Louse borne relapsing fever incubation period (borrelia) and clinical picture

A

incubation period (4-17 days)
Sudden high fever, chills , HA, confusion, nightmares; jaundice, chest signs; can have relapses

173
Q

severe complications of louse relapsing fevers

A

uterine bleeding, abortion, myocarditis, acute LVF, pulmonary edema, severe bleeding, splenic infarction and rupture , secondary bacterial infections

174
Q

What is the jarisch-Herxheimer reaction , how do you prevent it

A

abx precipitation: CHILL (rigors) FLUSH (Vasodilation) AND RECOVERY in borrelia; treat with low dose procaine penicillin IM , then tetracycline

175
Q

tx of louse borne relapsing fever

A

Tetracycline–>but high risk of JHR; or procaine penicillin but may have relapses

176
Q

What is a tick borne relapsing fever caused by

A

borrelia duttonii//reservoir is ticks, humans, mammals

177
Q

What are the differences between LBRF, TBRF?

A
178
Q

single primary painless lesion , enlarges to exudatve papilloma or painless ulcer with local LAD

A

Yaws: T pallidum Pertenue (TPE)

179
Q

What are features of treponematoses

A

Gram negative spirochetes, fragile (prefer body temp); infection via small skin abrasions/lacerations , cause chronic gramulomatous disease

180
Q
A

secondary yaws

181
Q

Yaws diagnosis

A

dark ground examination-like in syphilis

182
Q
A

Endemic syphilis (bejel) -skin to skin, small painless papule/ulcer; angular stomatitis, gumma

Tropical Medicine (19 decks)

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