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8th > Chapter 156 - Miscellaneous Bacterial Infections With Cutaneous Manifestations > Flashcards

Chapter 156 - Miscellaneous Bacterial Infections With Cutaneous Manifestations Flashcards

1
Q

Most common form of anthrax associated with lowest morbidity

A

Cutaneous anthrax

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2
Q

Natural pathogens of anthrax (3)

A

Sheep
Goats
Cattle

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3
Q

Anthrax is CDC Category __

A

A

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4
Q

There is no potential for human to human transmission of inhalational anthrax.
True or False

A

True

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5
Q

MC route of transmission of anthrax

A

Percutaneous inoculation of spores

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6
Q

Injectional anthrax is more __ than cutaneous anthrax with ___ mortality rate.

A

Insidious without eschar

Higher

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7
Q

Major virulence factors of anthrax (2)

A
  1. Poly-D-glutamic acid capsule
  2. Tripartite anthrax toxin
    (Protective antigen, lethal factor, edema factor)
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8
Q

Best target for vaccines or immunotherapy of anthrax

A

Protective antigen

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9
Q

True pustules are pathognomonic for anthrax.

True or False

A

False, rare

‘Malignant pustule’

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10
Q

Important feature for differentiating anthrax from brown recluse spider bite

A

Painless necrotic ulcer

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11
Q

Naturally occurring anthrax is treated with

A

Penicillin

Doxycycline

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12
Q

Weaponized anthrax or bioterrorism associated anthrax is treated with

A

Fluroquinolones, even in pregnant or on children

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13
Q

FDA -license humanized monoclonal antibody approved for cases of inhalational anthrax

A

Raxibacumab

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14
Q

Smears and cultures from vesicles or from the necrotic tissue beneath the eschar became negative within __ hours of initiation of penicillin therapy for anthrax

A

6

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15
Q

Mortality rate of untreated cutaneous anthrax is roughly

A

5-20%

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16
Q

Most common form of tularemia in the United States

A

Ulceroglandular disease

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17
Q

Most common tick vectors of tularemia (3)

A

Dermacentor variabilis
Amblyomma americanun
Ixodes

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18
Q

Mosquitoes may serve as mechanical vectors of waterborne variant of tularemia (F. Tularensis holarctica)
True or False

A

True

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19
Q

Type of Francisella that infect patients with inherited defects in phagocytosis such as chronic granulomatous disease

A

Francisella philomiragia

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20
Q

Painful red ulcer evolving into a necrotic chancriform ulcer covered by a black eschar with regional lymphadenopathy

A

Tularemia

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21
Q

Culture of F. Tularensis

A

Cysteine-supplemented blood agar

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22
Q

Treatment for tularemia (3)

A

Aminoglycoside (Gentamicin) 10 days
Fluroquinolone 10 days
Doxycycline 15 days

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23
Q

Prophylaxis for tularemia

A

Ciprofloxacin

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24
Q

Types of tularemia (5)

A 
Ulceroglandular: 5% mortality rate
Oculoglandular 
Oropharyngeal
Typhoidal: 30% mortality rate
Pulmonary: 30% moratlity rate
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25
Q

Most common form of plague; Form of plague with highest mortality

A

Bubonic plague

Pneumonic plague

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26
Q

Flea vector associated with epidemic plague in the Old World

A

Xenopsylla cheopis

27
Q

Plague is considered a CDC category __ biologic weapon

A

A

28
Q

Hallmark of bubonic plague

A

Tender regional LN with extensive subcutaneous edema

29
Q

In anthrax, most common site of buboes in adults; in children

A

Inguinal buboes

Cervical and axillary buboes

30
Q

Diagnosis of plague is suggested with a convalescent passive hemagglutinin titer greater than ___

A

1:16

31
Q

Preferred treatment but not FDA approved for plague

A

Gentamicin x 10 days

32
Q

Use as postexposure prophylaxis for plague

A

Doxycyline x 10 days

Cotrimoxazole

33
Q

All forms of plague are nearly always fatal.

True or False

A

False, pneumonic and septicemic

34
Q

Most important way to prevent plague

A

Rodent control prevention

35
Q

Brucellosis involve 4 organ systems

A

Joints
Reproductive organs
Liver
CNS

36
Q

Reservoirs for Brucella

A

Domesticated animals

37
Q

2 species that commonly infect human

A

Brucella melitensis

Brucella abortus

38
Q

Most common source for human infection

A

Contaminated unpasteurized milk or cheese

39
Q

Cause of mortality of most brucellosis patients

A

Endocarditis

40
Q

Culture of Brucella sp

Specimen for culture

A

8 to 10% CO2

BM biopsy

41
Q

Cross reactions with ___ are known and recent ___ baccination may stimulate false positive Brucella agglutination

A

F. Tularensis

Cholera

42
Q

Treatment for brucellosis

A

Doxycyline and Rifampin for 6 weeks

43
Q

Brucella is categorized as Category ___ bioweapon

A

B

44
Q

Brucella is an intracellular pathogen hence AIDS patients have a more frequent or more severe disease.
True or False

A

False, do not

45
Q

Matching type

  1. Fatal endocarditis
  2. Abortion in cattle
  3. Caseation necrosis

A. Abortus
B. Melitensis
C. Canis
D. Suis

A

B
A
D

46
Q

Skin lesions occur in <5% of patients as violaceous papulonodular eruption on trunk and lower extremities.
True or False

A

True

47
Q

For cultures, ___ have the highest yield

A

Bone marrow specimens

48
Q

Causative agent of glanders

A

Burkholderia mallei

49
Q

Characteristic eruption of glanders is crops of pustules, papules, bulla with prominent involvement of ____

A

Nasal mucosa

50
Q

Common manifestation of glanders

A

Mucopurulent bloody nasal discharge

51
Q

Counterpart of glanders in animals

A

Farcy

52
Q

Agglutination titer of ___ for brucellosis is sufficient to begin treatment

A

1:160

53
Q

Treatment for glanders

A

Sulfadiazine
+
Ceftazidime, Gentamicin, Doxycycline, Imipenem, Ciprofloxacin

54
Q

Subcutaneous and viscera abscesses of glanders should be treated for ___

A

1 year

55
Q

Treatment for pasteurella multicida

A

Co-amoxiclav

56
Q

Cat teeth are longer and sharper and may cause (2)

A

Septic arthritis

Osteomyelitis

57
Q

Characteristic for pasteurella multocida

A

Necrotizing cellulitis

58
Q

2 etiologic agent of rat bite fever

A

Streptobacillus moniliformis

Spirillum minus

59
Q

Classic triad of rat bite fever

A

Fever
Polyarthralgia
Acral rash

60
Q

Confirmatory diagnosis of rat bite fever

A

Blood cultures

61
Q

Matching type

  1. Less than 10 days incubation period
  2. Bite occurs concurrently with systemic symptoms
  3. 60% arthritis
  4. Rash most prominent on palms, soles, and around joints

A. Streptobacillus moniliformis
B. Spirillum minus

A

A
B
A
A

62
Q

MOT of rat bite fever

A

Rat bite
Or
Contact with rat contaminated food or drink

63
Q

Culture of rat bite fever sp

A

Trypticase soy broth

Supplemented thioglycolate

8th (28 decks)

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