CD - HPV, Lyme, West Nile, Zika, Campy Flashcards
what is the agent for HPV infection and how many types are there (1)
1- over 200 distinct types of human papillomaviruses have been identified
what is the reservoir for HPV (1)
1- humans
what are risk factors for acquiring HPV -
‘sexual behaviours’ - 5
‘substance use’ - 1
‘immunosuppression’ - 2
(8)
1- lifetime number of sexual partners
2- history of previous STIs
3- history of sexual abuse
4- MSM (for men)
5- inconsistent condom use
6- tobacco or marijuana use
7- immunosuppression
8- HIV infection
what is the mode of transmission for HPV (2)
1- vertical
2- contact (direct epithelial to epithelial contact)
what is the incubation period for HPV - range (1)
1- range = 1-20 months
what is the communicable period for HPV - general (1)
1- Presumably communicable during the acute infection and during persistent infection
what percentage of Canadians, if unimmunized against HPV, will have an HPV infection at some point? (1)
1- 75% of Canadians unimmunized against HPV will have an HPV infection at some point
what is the typical clinical presentation of HPV (1)
1- most HPV infections are asymptomatic
do you need to treat HPV infections (1)
1- no - most HPV infections are self-limiting
how long does it generally take for HPV infections to resolve without treatment (1)
1- HPV infections generally resolve within 24 months without treatment
what are the high-risk HPV types (7)
16, 18, 31, 33, 45, 52, 58
what disease can the high-risk HPV types lead to (1)
1- cancer
what kinds of cancer can the high-risk HPV types lead to -
go from bottom to the top of body
(8)
1- vulva
2- vagina
3- cervical
4- penis
5- anogenital
6- anus
7- oropharynx
8- mouth
what are the low-risk HPV types (2)
6, 11
what kind of disease do the low-risk HPV types cause (1)
1- genital warts
which HPV vaccines are authorized for use in Canada (2)
1- gardasil-9 (HPV9)
2- cervarix (HPV2)
which HPV types does gardasil-9 protect against (1)
1- gardasil-9 protects against the 9 types of HPV mentioned - 6, 11, 16, 18, 31, 33, 45, 52, 58 - i.e. both low and high-risk
which HPV types does cervarix protect against (1)
1- HPV 16 and 18
how effective are current HPV vaccines at preventing cervical cancer and its precursors? (1)
1- VERY - efficacy of HPV9 vaccine against types 16- and 18-related cervical disease is nearly 100%
how effective are current HPV vaccines at preventing genital warts (1)
1- VERY - efficacy against external genital lesions related to HPV types 6, 11, 16, or 18, including genital warts, is 95% to 99%
how effective are current HPV vaccines at preventing high-grade disease
1- VERY - efficacy against high grade disease related to HPV types 31, 33, 45, 52, and 58 contained in HPV9 vaccine is over 96%
what is the recommended dosing of HPV9 for immunocompetent individuals age 9-20 (1)
1- one-dose schedule
what is the recommended dosing of HPV9 for immunocompetent individuals age 21-26, and 27+ (1)
1- two-dose schedule
what is the recommended dosing of HPV9 for Individuals who are immunocompromised and/or living with HIV, regardless of age (1)
1- three-dose schedule
what are the indications for getting HPV vaccine in girls and women (7)
Prevention of :
1- vulvar ca
2- vaginal ca
3- anal ca
4- oropharyngeal and other head and neck cancers
5- genital warts
6- precancerous lesions
7- cervical cancer
what are the indications for getting HPV vaccine in boys and men (4)
1- anal ca
2- oropharyngeal and other head and neck cancers
3- genital warts
4- precancerous lesion (anal intraepithelial neoplasia)
In July 2020, the Federal Drug Administration in
the USA approved indication of HPV vaccine for
prevention of head and neck cancer - why is this a hot topic? (1)
1- because prior to this, HPV vaccine was only approved for use in the prevention of anogenital-related cancers
what are some reasons for seeing increasing trends in STIs - host factors (4)
1- increased number of sexual partners
2- unprotected intercourse
3- substance use
4- increased awareness of (and getting) testing
what are some reasons for seeing increasing trends in STIs - agent factors (2)
1- antimicrobial resistance
2- synergistic interactions between microbes
what are some reasons for seeing increasing trends in STIs - environment factors (4)
1- changes in case definitions and/or clinical guidelines
2- new medical treatments (e.g. PrEP)
3- social media and dating apps
4- changes to tests (e.g. increased sensitivity)
what is the Pan Canadian STBBI Framework for Action (1abcd)
The framework sets out a
1a- vision,
1b- desired outcome,
1c- strategic goals, and
1d- guiding principles for reducing the health impact of STBBIs in Canada
what are the 4 pillars and 1 underlying foundation of the Pan Canadian STBBI Framework for Action (5)
1- prevention
2- testing
3- initiation of care and treatment
4- ongoing care and support
5- supportive environments
what are some reasons for emerging infectious diseases related to host (5)
1- vulnerable (made to be) populations
2- lifestyle behaviours
3- occupational factors
4- travel/tourism
5- migration
what are some reasons for emerging infectious diseases related to agent (2)
1- food/water quality
2- animal health
what are some reasons for emerging infectious diseases related to environment (8)
1- inequities (in SDoH)
2- prevention measures
3- terrorism
4- global trade
5- climate changes
6- natural environment
7- surveillance/reporting
8- healthcare system
what is the agent for lyme disease (1)
1- Borrelia burgdorferi
what is the reservoir for lyme disease (2) - MD
1- mice
2- deer
what is the mode of transmission for lyme (1)
1- vector-borne (Ixodes
scapularis [black legged/deer tick], pacificus, and angustus)
what is the incubation period for lyme disease - range (1)
AROUND 1 MONTH
1- 3-32 days
is there a communicable period for lyme (1)
1- NO, there is no person-to-person transmission/spread
what are the 4 stages of clinical presentation for lyme (4) - EELP
1- early local
2- early disseminated
3- late
4- post-lyme disease syndrome
what is the clinical presentation of early local lyme - FEM FHAM (7)
1- fever
2- erythema migrans (bulls eye rash)
3- myalgias
4- fatigue
5- headache
6- arthralgias
7- malaise
what is the clinical presentation of early disseminated lyme - MC MAC (5)
1- multiple erythema migrans rashes
2- carditis
3- meningitis
4- arthralgias
5- cranial nerve palsies
what is the clinical presentation of late lyme - EROC (4)
1- encephalopathy
2- recurrent arthritis
3- optic neuritis
4- carditis
what is the clinical presentation of post-lyme disease syndrome - CSF (3)
1- cognitive impairment
2- subjective MSK pains
3- fatigue
what is Post-exposure prophylaxis (PEP) for lyme (1) and for what weight category
What is the criteria for starting PEP (3) - BTS
PEP is single dose doxycycline 200 mg PO x 1 if >45 kg; weight-based if < 45kg
Treat (PEP) with doxycycline only if ALL OF THE FOLLOWING:
1- tick was blacklegged
2- tick was attached for >24h (twenty-four)
3- doxy is given within 72 hours of tick being removed (seventy-two)
is there contact management for lyme (1)
1- NO, not applicable
what are things you can do to mitigate risk of acquiring lyme - LIAA (4)
1- long pants/shirts (wear)
2- insect repellant that has DEET or icaridin
3- avoid tick-infested areas
4- active surveillance is done in Canada via Canadian Lyme Sentinel Network (CaLSeN)
what is the reservoir for west nile virus (WNV) (1)
1- birds
what is the mode of transmission for WNV (2)
1- vector-borne (culex mosquitoes)
2- blood-borne (transfusion, organ transplantation)
what is the incubation period for WNV - range (1)
1- 2-21 days
what is the communicable period for WNV (1a) and why (1b)
1a- <7 days in immunocompetent persons
1b- live virus stays in infected person’s blood for 4-7 days
what is the most common clinical presentation for WNV (1)
1- majority of cases are asymptomatic
if there are symptoms, what is the clinical presentation for WNV - I-HMF (1)
1- mild influenza-like illness (ILI) - headache, myalgia, fever
what are rare (<1% of cases) symptoms of WNV - N-MEA (1)
1- neurological symptoms (meningitis, encephalitis, acute flaccid paralysis)
what is case management for WNV (2)
1- supportive management
2- educate that case should not donate blood or organs until 8 weeks have past since date of infection
what is contact management for WNV (1)
1- none - not applicable
what can you do to mitigate risk of acquiring WNV - 4Ds (3)
1- DEET insect repellant when outdoors
2- Dress with long sleeve tops/pants
3- Drain standing water
4- Dusk to Dawn (limit time spent outdoors in these hours)
what is the reservoir for zika virus (1)
1- likely humans
what is the mode of transmission for zika - VBVS (4)
1- vector-borne (aedes aegypti - mosquito)
2- blood-borne
3- vertical
4- sexual
what is the incubation period for zika - average (1)
1- 3-14 days
what is the communicable period for zika (1)
1- unclear
what is the most common clinical presentation of zika (1)
1- 75% of cases are asymptomatic
if there are symptoms, what is the clinical presentation of zika - MR GCFH (6)
1- myalgias
2- rash
3- GBS
4- conjunctivitis (purulent)
5- fever
6- headache
what are features of congenital zika syndrome - H-COMA (5)
1- hypertonicity/seizures
2- club foot
3- ocular anomalies
4- microcephaly
5- abnormal brain development
what is case management for zika (1)
1- supportive management, no treatment
2- serology recommended only for pregnant women who are symptomatic, have travel hx, or sexual partner with travel hx to zika-endemic region
what is contact management for zika (1)
1- none, not applicable
what can you do to mitigate risk of acquiring zika - personally, and as per CATMAT (2)
1- measures to prevent mosquito bites
2- CATMAT no longer recommends that pregnant travellers avoid zika-endemic regions or take special precautions to prevent sexual transmission while abroad or upon return
what is the ddx for for GI symptoms that usually resolve within 24 hours - ABC-SENS (7)
1- Staph Aureus enterotoxin
2- Bacillus Cereus enterotoxin
3- Clostridium perfringens
4- Salmonella
5- E. Coli
6- Norovirus
7- Shigella
**what is the ddx for GI illnesses that cause bloody diarrhea - “Your Shit Smells Extra Crappy” (5)
1- yersinia
2- shigella
3- salmonella
4- e. coli
5- campylobacter
what is the agent for campylobacter enteritis (campy) (1)
1- campylobacter jejuni
what is the reservoir for campy (3)
1- poultry
2- cattle
3- pets
what is the mode of transmission for campy (2)
1- direct contact - fecal-oral
2- ingestion (undercooked meat)
what is the incubation period for campy - range (1)
1-
1-10 days
what is the communicable period for campy (1)
1- it is shed in feces for days to weeks
what is the clinical presentation of campy - NDA-FM (5)
1- nausea/vomiting
2- diarrhea, bloody or non
3- abdominal pain
4- fever
5- malaise
what is case management for campy (1)
1- exclude food handlers, HCW, daycare staff/attendees until symptoms have resolved for 24h
what is contact management for campy (2)
1- exclude symptomatic contacts
2- test asymptomatic contacts if outbreak
