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Tropical Medicine > Bacterial > Flashcards

Bacterial Flashcards

1
Q

2 countries with highest Leprosy

A

Brazil, India

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2
Q

2 rickettsia with higher mortality (40% UnTx)

A

RMSF

epidemic typhus

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3
Q

3 spirochetes

A

lepstospirosis, treponema, Borrelia

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4
Q

3 typhus types: disease, agent, vector

A

Epidemic- R. prowazekii- Louse

Scrub- O. tsutsu- Mites/chiggers

Murine- R. typhi- flea

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5
Q

acute watery diarrhea causes CCERN

A

rotovirus, norovirus, cholera, cryptosporidium, ETEC

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6
Q

African Tick Borne Fever- agent, vector, skin

A

R. africae

tick

eschar, often vesicular rash

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7
Q

Anthrax- agent, micro, bioterror, transmission, incubation max, Sx, Tx, special

A

Bacilius anthracis

gram pos rod

1

arerosol, contect, ingest

typical 1-7 d but pulmonary up to 43 day

95% cutaneous- painless eschar with edema and satellite vesicles, Do NOT debride

Inhalation- mortality up to 90%; Hemorrhagic mediastinal lymphadenitis (wide mediastinum)

GI- dysentery, ascites, sepsis (mortality > 50%)

Cipro (doxy, amp)- use 2 agents

Resistant to EtOH

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8
Q

Bacillary angiomatosis- agent, pt, Sx, Tx

A

B. henselae and B. Quintana

immunocompromised

vascular lesions, may ulcerate

doxy/macrolide

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9
Q

Bacillus anthracis- micro, portal (3), 2 findings, Dx (3), Tx, proph, mortality

A

gram pos rod

cutaneous (most), GI, inhalation

painless ulcer with lots edema and vesicles; widened mediastinum

culture, biopsy, serology

quinolone (multidrug)

doxy exposure prophylaxis for 60 days; PEP

20% UnTx cutaneous, 90% pulmonary

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10
Q

Bacterial diarrhea needing ABx

A

ETEC, EAEC, Shigella

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11
Q

Bartonella vectors

A

bacilliformis- sandfly

hensaleae- flea

quintana- louse

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12
Q

Bartonella- micro, 3 types, vectors and Sx

A

gram neg rod flagella intracellular

B. bacilloformis – bartonellosis (Oroyo, Verruga peruana- Carrion dz) in Andes, sand-fly; Tx chloramp + PCN

B. henselae- flea, cat scratch (zithro), bacillary angiomatosis (HIV), endocarditis (culture negative)

B. quintana- trench fever due louse (doxy), endocarditis, bacillary angiomatosis

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13
Q

Bartonellosis- agent, vector, 2 forms dz, Tx

A

B. Bacilliformis

sand fly

Oromo and Verruga peruana

Chloramphenicol and PCN

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14
Q

BCG partial protection against 3

A

TB, Bureli ulcer, leprosy

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15
Q

bejel- cause, Sx

A

endemic syphilis

ulcers of lips and oropharynx

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16
Q

Best culture source for S. typhi

A

bone marrow

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17
Q

Bioterror categories

A

A- airborne, sturdy, easily grown; e.g. anthrax, small pox, plague, tularemia, ebola, botulism (P. BATES)

B- moderately easy to produce, moderate Sx; e.g. Q-fever, brucellosis, ricin, glanders, meliodosis, typhus, staph, salmonella, shigella, E. coli O157:H7, cholera

C- more difficult to produce and distribute

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18
Q

Botulism- agent, micro, transmission, incubation max, Sx, Tx

A

Clostridium botulinum toxin

gram pos rod

aerosol, ingest

10 days max

Neuro- CN, descending paralysis, pupils fixed/dilated, autonomic dysfxn

Supportive, equine antitoxin

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19
Q

Brucellosis- micro, source, Dx, Tx

A

gram neg intracellular coccobacilli

dairy, meat, hunting/skin, inhalation

Cx- esp marrow or tissue

doxy, rifampin, bactrim

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20
Q

Brucellosis- source, Sx, Tx

A

animal milk, urine, afterbirth; labs (many farm animals)

Arthritic, Miscarriage. Orchitis. Heptatis, Peritonitis,

Meningitis, Endocarditis (most mortality)

PO doxy + rifampicin AND 2 wks streptomycin or gent

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21
Q

Bubonic plague- agent, frequency, Sx, Tx, prophylaxis

A

Yersinia pestis

90%

Bubos, LAD, fever, sepsis UnTx

streptomycin

doxy and cipro

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22
Q

bubos can be caused by (3)

A

Bubonic plague

Lymphgramuloma venereum

Chancroid

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23
Q

Campylobacter- kids in developing vs developed

A

developing may have multiple

developed more inflammatory

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24
Q

Campylobacter- 2 main strains, micro, source, season, classic Sx, complication, Tx

A

C. jejuni (more industrialized) and C. coli

spiral neg rod with flagella

food (chicken), animal (no P2P)

more dry season

bloody stool, mimic appy

Guillian-Barre

ABx only IF high risk

highest identified travel diarrhea

fewer outbreaks in developing due to some immunity

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25
Q

can present as either watery or bloody diarrhea

A

shigella and campylobacter

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26
Q

Cat scratch disease- agent, Sx, Tx

A

B. henselae

papule, LAD may suppurate

zithro (doxy and gent if neuro or retino)

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27
Q

Cat scratch- agent, vector, Tx

A

B. henselae

flea

zithro

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28
Q

Cats assoc with- saliva (4), fecal (8), aerosol (1), direct (2)

A

saliva- bartonella, pasturella, rabies, tularemia

fecal- salmonella, campy, giardia, toxocara, echinococcus, toxoplasma, ancylostoma, dipylidium

aerosol- coxiella (Q)

direct- sporothrix, microsporum canis

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29
Q

Most common cause of necrotizing fasciitis

A

Group A BHS

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30
Q

Chancroid- agent, micro, Sx, Tx

A

H. ducreyi

gram neg rod

painful ulcer and bubos

zithro, roceph, cipro, erythro

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31
Q

Chancroid- agent, Sx, Tx (3)

A

Haemophilus ducreyi, gram neg rod

genital ulcer, bubos

zithro, EES, Cipro

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32
Q

Chlamydia- micro, tx, serovars

A

gram neg intracellular zithro, doxy

A-C -> blindness

D-K -> STD

L -> lymphogranuloma venereum

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33
Q

Cholera- agent, host, gram, source, Sx, Tx, Cx, prevention

A

Vibrio cholera, El Tor strain

man

gram neg bacilli with flagella

water, fish, shellfish, produce

Sx rice water diarrhea; rare fever or pain

Tx: hydration, optional ABx (doxy, TTC)

Cary-Blair, tellurite or bile salts

2 oral vaccines outside US

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34
Q

clofazine for leprosy- effect, SE

A

bacteriostatic

SE: transient blue skin, itch, constipation

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35
Q

Clostridia perfringens spores- diagnostic amt in stool, killed by

A

feces >106 spores per gram of stool

cooking

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36
Q

Clostridum tetani micro

A

Gram positive rod, drumstick appearance

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37
Q

Coxiella burnetii- micro, bio terror category, source, complications (3), Tx

A

Intracellular rod

Cat B

Animals- inhale, contact

Endocarditis, OB complications, persistent localized

Doxy, bactrim for preg, kids

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38
Q

Cryptosporidium- person

A

infants, immunocompromised

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39
Q

Cryptospridium- size, pt type, source, resistant, incubation, Sx, Dx, Tx

A

5 microns

Infants, immunocompromised

Fecal-oral: soil, food, water; autoinfective

RESISTANT chlorine

Both sexual and asexual reporduction

Incubation 1 wk

Sx: watery diarrhea, weight loss, abdominal pain, fever, N+V

Stool AFB/modified ZN stain, DFA, Ag test

Most Sx resolve in 10-14 d

Nitrazoxanide - reduces oocyst shedding

No swimming for 2 weeks after Sx resolved

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40
Q

Culture media for Francisella tularensis

A

Buffered Charcoal Yeast Extract (BCYE)

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41
Q

dapsone for leprosy- effect, SE (3)

A

bacteriostatic

check G6PD

SE: methemoglobinemia, neutropenia, neuropathy

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42
Q

dapsone special

A

check G6PD

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43
Q

diarrheal infections causing HUS

A

shigella (give ABx), EHEC (avoid ABx)

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44
Q

diarrheal infections NOT requiring ABx

A

salmonella, EHEC, yersinia

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45
Q

diphtheria transmission

A

P2P, droplet, rare fomite

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46
Q

Dogs assoc with saliva (3), fecal (7), aerosol (2)

A

saliva- rabies, pasturella, brucella

fecal- salmonella, campy, giardia, toxocara, ancylostoma, echinococcus, dipylidium caninum

Aerosol- bordetella, Coxiella (Q)

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47
Q

Donovanosis (granuloma inguinale)/ agent, micro, Tx

A

calymmatobacterium (Klebsiella) granulomatis

gram neg rod, intracellular, bipolar stain

beefy destructive ulcers (no LAD)

doxy

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48
Q

E. coli micro

A

gram neg rod fermenting lactose

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49
Q

EAEC Sx, Tx, more from..

A

persistent diarrhea in kids and HIV

ABx

Latin America

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50
Q

EHEC- agent, reservoir, pathogenesis, sx, tx

A

enterohemorrhagic E. coli (e.g. O157:H7)

reservoir is primarily cattle

(Shiga-producing E. coli)

1-2 days of watery, then cramping and bloody diarrhea

Treatment: antimicrobials are NOT recommended, (increased risk of HUS)

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51
Q

EHEC- pathology, Sx, complication, Tx

A

shiga toxin

50% bloody, significant abd pain

HUS

supportive; NO ABx (increased risk HUS)

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52
Q

Ehrlichia- agents, vectors, target cells, Sx, Tx

A

E. chaffeensis and E. ewingii- deer and dog ticks

Anaplasma phagocytophilum- Ixodes

leukocytes

Flu, Rash, vomit, meningitis

doxy

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53
Q

EIEC- sx

A

bloody dysentery similar shigellosis

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54
Q

Entamoeba histolytica- agent, complication

A

protozoa

hepatic abscess

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55
Q

enteric fever is due to

A

salmonella typhi and paratyphi

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56
Q

Enteritis necroticans- agent, pt profile

A

Clostridium perfringens

malnutrition, diabetic, neutropenia

also known as pigbel

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57
Q

EPEC Sx

A

infant diarrhea

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58
Q

Epidemic typhus- agent, vector, skin, special

A

R. prowazekii

louse

No eschar

Brill-Zinsser recrudescence

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59
Q

Erythema nodosum leprosum (ENL)(type 2)- type, cause, Sx, timing, Tx

A

BL, LL (lepromatous types)

Immune complex with vasculitis (type III hypersensitvity),

Elevated TNF-alpha New papules/plaques/pustules and tender subq nodules neuritis, orchitis, iriditis, GN, HSM, LAD fever, flu-like before

diagnosis or even years after Tx

Tx: severe need thalidomide (or clofazimine per WHO) and prednisone

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60
Q

eschars can be caused by (5)

A

Anthrax

Staph

Tularemia

Scrub typhus

Rikettsial spotted

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61
Q

ETEC Sx, person, Tx

A

acute watery diarrhea

leading cause diarrhea in older kids and adults

ABx

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62
Q

ethambutol- effect, SE

A

disrupts cell wall vision

vision, hepatotoxic

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63
Q

feacal lactoferrin

A

more sensitive than leokocyte smear for inflammatory diarrhea

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64
Q

Flagellated bacteria (5) BCCCS

A

Bartonella, Clostridium, Campylobacter, Cholera, Salmonella

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65
Q

Flea borne rickettsia (3), other bacteria (2), parasite (2)

A

R. felis

R. typhi (murine)

Wolbachia piientis

B. henslae

Y. pestis

Parasite: Dipylidium caninum, tungiasis

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66
Q

Flea Rickettsiosis- agent, vector

A

R. felis

flea

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67
Q

Flinders Island fever- agent, vector

A

R. honei

tick

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68
Q

Gram beg coccobacilli

A

Yersina, Brucella

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69
Q

Gram neg cocci (1)

A

Neisseria

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70
Q

Gram negative coco bacilli resembling safety pin

A

Yersinia

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71
Q

Gram pos rod (CALC)

A

Clostridia, Anthrax, Listeria, Corynebacteria

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72
Q

helminth borne rickettsia (2)

A

Wolbachia

Neorickettsia

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73
Q

How long is anthrax proph needed?

A

60 d

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74
Q

HUS- Sx (3), causes (3)

A

triad- thromobytopenia, micro hemolytic anemia, ARF

assoc shigella, EHEC, campy

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75
Q

HUS related to which infections

A

Shigella, EHEC, streptococcus in US

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76
Q

Incubation on bioterror A- highest, lowest

A

Anthrax 43 days

Tularemia 5 d

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77
Q

Infections mimicking appendicitis- 3 bacteria, 4 worms

A

Yersinia, TB, campylobacter

Pinworm, Ascaris, Angiostrongylus, Oesophagostomum

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78
Q

infections presenting as eschar

A

aspergillosis, anthrax, ecthyma gangrenosum, rickettsial, plague, Staph, Tularemia, Scrub typhus

79
Q

intracellular bacteria (BBCCEFMORS)

A

Brucella, Burkholderia, Coxiella, Chlamydia, Ehrlichia, Francissella, MAC, Orientia, Rickettsia, Salmonella

80
Q

invasive diarrhea causes (7) CEEESSTY

A

non-typhoidal salmonella, shigella, yersinia, campylobacter, EIEC, EHEC, entamoeba

81
Q

Ioxides tick transmits (3) BELA

A

Anaplasma/ehrlichiosis, babesiosis and Lyme

82
Q

Isoniazid- effect, SE

A

inhibit cell wall synthesis

hepatitis, neuropathy (take B6)

83
Q

Japanese Spotted Fever- agent, vector

A

R. japonica

tick

84
Q

Leprosy BB type- number, appearance, AFB, special

A

BB- Borderline

Multiple

mac, pap, plaque, dome, punched out Satellite lesions Less distinct borders asymmetric

AFB readily seen

common periph nerves

85
Q

Leprosy BL type- number, appearance, AFB, special

A

BL- Borderline-lepromatous

Multiple

macules, papules, nodules Often symmetrical Smooth, shiny Borders may be ill defined

Sensation diminished or lost

Smear with many bacilli

Enlarged periph nerves

86
Q

Leprosy BT type- number, appearance, anesthesia, AFB, special

A

BT- Borderline tuberculoid

Few to multiple

patches Vary size

Mod-marked anesthesia

Some AFB

Early neuropathy- may not resolve with Tx

Reversal reactions

87
Q

Leprosy indeterminate type- number, appearance, anesthesia, AFB

A

one or few

hypopigmented, undefined edges

+/- anesthesia

rare AFB

88
Q

Leprosy lesion number

A

Paucibacillary 1-5 (TT, BT)

Multibacillary > 5 (BB, BL, LL)

89
Q

Leprosy LL type- number, appearance, AFB, special

A

LL- Lepromatous leprosy

Many lesions

macule, papule, nodule, infiltration, erythema, hyperpigment Symmetric

Anesthesia appears late Neuropathy late

erythema nodosum 50%, rare Lucio phenomena Ocular, nasal, testicular

Smears very positive

90
Q

leprosy reaction 1 +2- name, hypersensitivity type, leprosy type, fever ?

A

1 vs 2

reversal vs erythema nodosum

type 4 vs type 3

borderline vs lepromatous

fever rare vs common

91
Q

Leprosy TT type- number, appearance, anesthesia, AFB, special

A

tuberculoid- few lesions

large, flat, irreg, scaly, hypopig

asymmetric anesthesia (5% diag early before rash)

AFB rare

corneal denervation/lagopthalmos in 10% (unable close eyes)

92
Q

Leprosy type having corneal denervation/lagopthalmos

A

tuberculoid

93
Q

Leprosy type having erythema nodosum

A

lepromatous

94
Q

Leprosy types- source, incubation, susceptibility, Sx, Dx

A

Human reservoir, 9 banded armadillo

Incubation up to 20 yrs

Only 3-5% of population susceptible

Rash with anesthesia 75% sensitive. Also congestion, leonine, Madurosis, ocular, erythema nodosum, nerve hypertrophy

skin fluid smear, nasal, skin Bx, nerve Bx -> AFB bunching into globi

95
Q

leprosy: tuberculoid vs lepromatous

A

few vs many lesions

few vs many AFB

early vs late anesthesia

asymmetric vs symmetric

96
Q

Leptospirosis- reservoir, entrance, micro, Sx, Tx

A

rodent reservior, affects mammals (human dead end )

urine, water/soil enter thru skin cute conjunctiva (rare ingest)

gram neg spirochete

? fever, HA, conjuntivitis, GI to Weil’s disease- liver and renal failure

Tx: doxy, zithro, PCN, ceftriaxone

97
Q

Louse borne relapsing fever- agent, geo, Sx, special

A

Borrellia recurentis- sprochete

NE Africa

Fever, Bleed, Miscarriage, Myocarditis. Liver failure, Spleen rupture

Jarisch-Herxheimer (Acute worsening with Tx)

98
Q

Louse borne rickettsia (1)

A

R. prowazekii (epidemic)

99
Q

Lucio Phenomenon- type, cause, Sx, Tx

A

LL

Necrotizing vasculitis due to massive load bacteria

Diffuse shiny skin infiltration with Madurosis, Looks like burns, loss body hair, anemia, myxedema, bacterial sepsis -> toxic -> death

Tx- supportive, steroids, treat AFB

100
Q

Lymphogranuloma venereum- agent, micro, Sx, Tx

A

C. trachomatis

gram neg intracellular

painless ulcer, bubos

doxy, zithro, TTC

101
Q

MAC in HIV, Sx, CXR, Dx

A

fever, wt loss, LAD, HSM, cytopenias, LFTabnormalities.

lack of pulmonary symptoms and normal chest

isolation of the organism, most often from blood or bone marrow (granulomas)

102
Q

main dource of leprosy

A

UnTx multibacillary

103
Q

main source for new leprosy infections

A

untreated multibacillary in human

104
Q

Mediterranean spotted fever- agent, vector, skin

A

R. coronii

tick

eschar

105
Q

Melioidosis- agent, micro, bioterror, source, Sx, Tx, special

A

Burkholderia pseudomallei

gram neg intracellular, bipolar safety pin

3

saprophytic soil, water

abcess esp parotid, sepsis, pneumonia

IV ceftaz -> bactrim PO; may be 10 days before defervesce

may relapse up to 10 yrs

106
Q

Mite borne rickettsia (2)

A

R. akari (rickettsial pox)

O. tsutsugamushi (scrub)

107
Q

most common bacterial diarrhea in US

A

Campylobacter

108
Q

most common causes of dysentery- 6 bacteria, 3 parasites

A

Shigella, Campy, EHEC, salmonella, C. dif, Yersinia

E. histolytica, Balantidium coli, schisto

109
Q

most common infectious diarrhea in US? world?

A

norovirus, rotovirus

110
Q

Murine typhus- agent, vector, skin, special

A

R. typhi

flea

NO ESCHAR

25% renal

111
Q

Mycobacterium Avian Complex prophylaxis indication for HIV

A

CD4 count <50

112
Q

Mycoplasma genitalium- micro, Tx

A

gram neg

zithro

113
Q

Mycoplasma genitalium- micro, Tx

A

gram neg

zithro

114
Q

Neisseria gonorrhea- agent, Tx

A

gram neg diplococcus

rocephin

115
Q

neonatal tetanus Tx

A

diazepam

IG

TT if > 6 wks

Flagyl (alt pen, erythro)

quiet, dark

116
Q

non-typhoidal salmonella enterica- source, micro, Sx, Tx

A

food- FO, P2P

gram neg rod with flagella- O somatic and H flagella antigens

GI, disseminated in kids, old, immunocompromised

NO Abx -> prolongs shedding

117
Q

O. tsutsugamushi causes

A

scrub typhus

118
Q

Oroya fever- agent, Sx, Tx

A

B. bacilliformis

fever, anemia, HSM, LAD, possible secondary infection

Cipro

119
Q

Painless skin ulcer with surrounding edema

120
Q

Pinta- cause, Sx

A

treponema

papules, plaques, depigmentation

121
Q

Plague- micro, source/transmission, incubation max, Sx, Tx, prevention, high risk

A

Yersinia pestis, gram neg coccobacilli, bipolar stain

aerosol, contact, P2P

19 d max

pulmonary- V, D (30% bloody), abd pain, SOB, hemoptysis, shock, 100% fatal UnTx

Bubonic- more common, 50% fatal UnTx

streptomycin 1st, gent, Cipro, chloramphenicol

vaccine available, Cipro proph

high iron levels, e.g chronic hemolysis, sickle cell disease, or Beta thalassemia

122
Q

Pneumonia with cavitary lesions- 4 bacteria, 1 worm

A

TB, S. aureus, Klebsiella, meliodosis, paragonimiasis

123
Q

pyrazinamide- effect, SE

A

acidify -> disrupt cell mem; bacteriostatic for TB

hepatitis (esp with RIF), avoid in pregnant

124
Q

Q fever- agent, sx, Tx

A

Coxiella burnetti (intracellular)

Flu, hepatitis, Pneumonia, Meningitis, Miscarriage, Chronic fatigue

doxy (add hydroxychloroquine for endocarditis)

125
Q

Queensland TBF- agent, vector, skin

A

R. australis

tick

eschar, vesicular

126
Q

R. africa causes… eschar?, complication

A

AfricanTBF

eshar may be tiny and hard to find

reactive arthritis

127
Q

R. akari causes

A

Richettsial pox

128
Q

R. australis

A

QuuenslandTBF

129
Q

R. coronii causes

A

Mediteranean SF

130
Q

R. felis causes

A

Flea rickettsiosis

131
Q

R. honei causes

A

Flinders Island

132
Q

R. japonica causes

A

Japanese Spotted Fever

133
Q

R. prowazekii causes

A

epidemic typhus

134
Q

R. rickettsia causes

135
Q

R. siberica causes

A

Siberian Tick Typhus

136
Q

R. slovaca causes

A

Tick borne LAD

137
Q

R. typhus causes

A

murine typhus

138
Q

relationship between salmonella and schistosomiasis

A

salmonella can hide in schisto

139
Q

Reversal reaction (type I)- types, Sx, Tx

A

BT, BB, BL (borderlines)

type IV hypersensitity, CMI acute neuritis Inflammation in old lesions- red, pain, swelling new lesions

Tx: prednisone 3-6 mos

140
Q

Ricin- transmission, category, source, Sx

A

inhaled

Category B Toxin

castor bean seed

fever, cough, pulm edema, resp failure

141
Q

Ricketsial infections with high mortality (2)

A

RMSF, epidemic typhus

142
Q

Rickettsial diseases without eschar (4)

A

RMSF, murine typhus, epidemic typhus, tick borne LAD

143
Q

Rickettsial pox- agent, vector, geo

A

R.akari

mite

S. Africa, Ukraine

144
Q

rifampin for leprosy- effect, prednisone interaction, SE

A

bactericidal

reduce if prednisone needed (induces hypermetabolism)

SE: bone marrow suppression, red fluids, elevated LFT, interstitial nephritis

145
Q

rifampin- effect, SE

A

block RNA pol

rash, multiple drug interactions

146
Q

Rifaximin- treats _____ but not _____ because _______

A

watery diarrhea but not invasive because not absorbed

147
Q

RMSF- agent, vector, skin

A

R. rickettsia

tick

no eschar, rash often purpuric (centripital- ext 1st) and after viral syndrome

148
Q

Rose spot

A

shigella; invasive salmonella

blanching 2-4 mm papules on torso

149
Q

rose spots

150
Q

Rotovirus claim to fame

A

leading cause diarrhea

151
Q

Salmonella in HIV

A

high risk of invasive disease, 50% mortality rate, 40% rate of recurrent infection.

152
Q

Salmonella typhi/paratyphi vs non-typhoidal salmonella

A

Salmonella typhi- prodrome weeks before GI

non-typhoidal- acute GI

153
Q

Scrofula

A

TB in node, seen in 43%

154
Q

Scrub typhus- agent, geo, vector, special Sx, Tx

A

O. tsutsugamushi

Asia, AUS

Chigger (immature mite)

50% eschar, ocular ingection, deafness

doxy, chloramphenicaol, macrolide

155
Q

Shigella complications- 4 systems

A

GI: toxic megacolon, perforation

renal: HUS

Neuro: Sz

Rheum: Reiter’s syndrome (urethritis, conjunctivitis, arthritis)

156
Q

Shigella 4 strains and their geo/situation

A

S. dysenteriae- developing, epidemics

S. flexneri- more in developing

S. boydii- Indian subcontinent

S. sonnei- more in developed, milder Sx

157
Q

Shigella- fame, micro, pathology, source, Sx (GI, neuro), Tx

A

leading cause invasive diarrhea

anaerobic neg rod

serotype 1 has shiga toxin -> epidemics human (FO, P2P)

toxic megacolon, rectal prolapse, perforation, Sz, sepsis, encephalopathy, HUS (due to toxin)

Tx: antibiotics if severe only

158
Q

Siberian typhus- agent, vector

A

R. siberica

tick

159
Q

Smallpox- agent, transmission, incubation max, Sx, Tx, prevention

A

variola virus

aerosol, contact, P2P

19 days max

mucosal lesion followed next day by papular face rash- spreads centrifugal

Mortality due to response to infection

supportive

vaccine available

160
Q

Streptomycin SE

A

Ototoxic, nephrotoxic, drug interactions, no pregnant

161
Q

Syphilis- agent, micro, Tx

A

Treponema pallidum

gram neg spirochete

PCN

162
Q

TB % pulmonary

163
Q

TB meds that are most bactericidal (2)

A

rifampin and INH

164
Q

tetanus presentations (3)

A

Classic rigidity: jaw -> generalized

Local tetanus- muscle contraction around wound

Cephalic tetanus is rare, related to OM, involves paralysis of cranial nerves, especially facial area

165
Q

third leading cause of infectious death

166
Q

Typhoid- agent, host, HIV, incubation, Sx by week, Dx, Tx (2), vaccine effectiveness

A

Salmonella typhi

human carriers

HIV protective

incubation 10-20 d

Sx by week:

1: fever, abd pain, constipation, HA, cough
2: high fever with bradycardia, rose spots
3: weak, diarrhea
4: improve

Dx- blood Cx

Tx Cipro, azithro in Asia

75% vaccine effective

167
Q

Tick borne LAD- agent, vector, skin, geo

A

R. slovaca

tick

NO rash, just LAD

Gulf Coast, Brazil, Uraguay

168
Q

Tick borne relapsing fever- agent, geo, Sx

A

Borrelia

widespread, esp Africa

Epistaxis, Abdpain, Diarrhea, Cough, Splenomegaly, Neuro, Rash including petechiae

169
Q

top 2 causes of infectious blindness in world

A

Oncho, chlamydia (toxocaria)

170
Q

Treatment and proph for Yersinia pestis

A

Streptomycin, Doxy, cipro

171
Q

Treatment for active pulmonary TB

A

INH + RIF x 6 mo WITH

ETH and PZA for 1st 2 mo

172
Q

treatment for chronic Bartonella quintana (trench fever)

A

Doxycycline for 4 weeks plus gentamicin for the first 2 weeks

173
Q

Treatment of Brucella

A

Rifampin and doxycycline for 6 weeks

174
Q

treatment of Q fever

175
Q

Treatment severe erythema nodosum leprosum

A

Prednisone + thalidomide or clofazine

176
Q

Trench fever- agent, vector, Tx

A

B. quintana

louse

doxy

177
Q

trench fever agent, Sx, Tx

A

B. quintana

fever, myalgia, HA, conjunctivitis (95%), splenomegaly, shin bone pain

may be single or recurent episodes over 6 week

gent 2 weeks, doxy 4 wks overlap

178
Q

Tropical Pyomyositis- cause, Sx, Tx

A

usually Staph aureus

muscle abscess

drainage and ABx

179
Q

Tularemia bioterror- agent, micro, transmission, incubation max, Sx, mortality, Tx, Cx

A

Francisella tularensis (Gram neg intracellular)

aerosolized

5 days max

pneumonia

mortality 60% untreated

gent, cipro, doxy, chloramphenicol

yeast charcoal

180
Q

Tx bloody diarrhea

A

Cipro

if no improve 48 h change to zithro

if Giardia change to tindazole

181
Q

Tx MAC in HIV (3)

A

Clarithromycin, ethambutol, rifabutin

182
Q

Tx multibacillary leprosy- daily/monthly, duration

A

daily dapsone + clofazine (self)

OR monthly rifampin + clofazine (supervised)

x 12 months or more

183
Q

Tx paucibacillary leprosy, duration

A

daily dapsone + monthly rifampin (supervised) 6 months

184
Q

typhoid vs non-typhoid salmonella- Sx, timing

A

non-typhoidal- acute enterocolitis, N+V, in days

Salmonella typhi- rare diarrhea (fever, Ha, pain), 2-3 weeks after infection

185
Q

Verruga peruana- agent, Sx, Tx

A

B. bacilliformis

angioma-like nodules and ulcers -> resolve no scarring

rifampin or streptomycin can clear faster

186
Q

Vibrio cholera- micro, pathology, source, Sx, Tx

A

curved neg rod with flagella

phage toxin affecting chloride secretion

water, fish, P2P

vomit, rice water stool (no fever) rehydration

Abx may reduce duration and shedding

187
Q

Weils disease

A

Renal and liver failure seen with leptospirosis

188
Q

Where MDR TB most prevalent

189
Q

Where TB most prevalent

A

Africa (esp horn)> Asia

190
Q

Which form of plague has P2P

191
Q

Yaws- agent, sx, tx

A

treponema (not T. pallidum)

papule, ulcers, scabs, hyerkeratosis, late gummas

“mother yaw” painless and heals in months without scarring -> more wks to yrs later

Untreated can cause destructive lesions of the skin and bone (gummas)

Tx: penG x 1

192
Q

Yersinosis- micro, source, Tx, complications

A

neg coccobacilli, safety pin bipolar stain, fermenting glucose

pork, surface water

supportive, ABx if septic (rocephin)

erythema nodosum, reactive arthritis

193
Q

Yersinosis- agent, Sx (3)

A

Y. enterolittica

GI (DDx appy)

few rash and joint pain

Tropical Medicine (7 decks)

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