BIOTERRORISM

Question 1

Fever, Rash starting in the ORAL mucosa and moving distally including palms and soles. Rash is in the SAME stage at any given time is most likely

What is the treatment?

Answer 1

SMALLPOX
Differs from Chicken pox as chicken pox starts in the trunk and moves to face/ extremities, rash is in DIFFERENT stages

Supportive, tecovirimat recently approved for treatment
Can give post exposure vaccine within 7 days of exposure targeting close contacts of patients with small pox.

Question 2

Painless ulcer with black eschar and surrounding edema

What is the treatment?

Answer 2

Anthrax

Oral Cipro

Question 3

Government clerk with 3 days of fever, cough and headache, Chest XRAY shows scattered pulmonary infiltrates and a widened mediastinum.

Answer 3

Inhalation Anthrax
IV Cipro + two other abx ( big guns)

Raxibacumab is a monoclonal ab that neurtralizes Anthrax toxin can also be used as treatement

Question 4

How can you prevent inhalational anthrax

Answer 4

Post exposure vaccine + cipro x60days

Raxibacumab is a monoclonal ab that neurtralizes Anthrax toxin

Question 5

How does bubonic plague differ from septicemic plague and pneumonic plague

What is the treatment

Answer 5

bubonic plague- primary cutaneous exposure followed by buboes ( infected swollen lymph nodes)
septicemic plague- DIC multiorgan failure
pneumonic plague- hematogenous spread from a bubo or direct inhalation presents with : Pleuritic chest pain, hemoptysis, sputum cx will grow classic BiPolar Gram Negative staining or safety pin shape

Streptomycin or Gentamicin

Question 6

How will Tularemia present

What is the treatment

Answer 6

cough, dyspnea, chest pain respiratory failure
gram stain will grow Gram NEG COCCObacili
Test for IgM or IgG to francisella tularensis

Treat mild/mod disease with Cipro/doxy, treat severe with streptomycin/ gentamicin

Question 7

What are the 5 D of Botulism

What is the treatment

Answer 7

Diplopia, Dysphonia, Dysarthria, Dysphagia, Descending paralysis
monitor in the ICU, debride wounds,
TRIvalent ( A/B/C) equine serum antitoxin

Question 8

High fever, mylagia, prostration, conjunctival hemorrhage , petechial hemorrhage, bruising, shock, generalized bleeding from mucous membranes, GI tract with multiorgan failure

Answer 8

Viral Hemorrhagic Fever ( Ebola)

Supportive treatment