Clinical Medicine 3 Flashcards
Cause of anthrax
Bacillus anthracis. Endospore forming gram + rod. Comes from undercooked meats or from infected animals. Can be either skin, inhalation, or ingested
Clinical presentation of cutaneous anthrax
Most common form. Small sore that becomes a blister and eventually ulcerates with a black center. Death rare
Clinical presentation of inhalation anthrax (aka wool sorters disease)
Most severe and lethal form (bioterrorism)
1. SX occur 7days-6wks
2. common cold/flu like sx
3. Will be followed by wheezing, cyanosis, shock, severe edema
DEATH MAY OCCUR RAPIDLY IF NOT TX’D
4. CXR shows mediastinal widening with pleural effusions/infiltrates
Management of anthrax
- ABX
- Vaccination available for high risk occupations
- Post exposure prophylaxis with cipro or doxy, especially in airborne verson
Clinical presentation of GI anthrax
Very uncommon. NVD, abdominal px
GI ulcerations lead to hematemesis or melena
(coffee ground stools)
Leading cause of death in the tropics and subtropics due to mosquito bites
Dengue (self-limited biphasic febrile illness)
Clinical presentation of dengue
- Sudden fever - “breakbone fever”
- Severe px of muscle and joint
- Measles-like skin rash
- Mosquito bite s/sx begin 4-7 days after. Typically last 3-10 days
Management of dengue
Supportive over the course of illness. Pain management
Complications of dengue
Hemorrhagic fever and shock syndrome. This is when there is an increased capillary permeability and disordered blood clot which causes significant internal bleeding
Cause of cat scratch fever “subacute regional lymphadenitis”
Bartonella henselae a gram - rod. Transmitted by scratch or bite from a cat
Clinical presentation of cat scratch fever
- Initial - papule at the site of inoculation
- Then a solitary lymphadenopathy appears
- Fever, headache, malaise
Management of cat scratch
It is a self limited bug, so no tx is required unless it moves. DO NOT CONFUSE with pasteurella multicoida
Cause of tularemia
Francisella tularensis. Acquired by humans with contact of animal tissues ( or insect bit or drinking contaminated water
Clinical presentation of tularemia
- Papule at site of inoculation which is most often in skin or eye
- GI issues if ingested
- Potential pneumonia like sx if inhaled
1-14 day incubation
Management of tularemia
ABX - streptomycin or tetracycline family
Causes of plague
Yersinia pestis, gram - rod. Comes from wild rodent (mice, rats) who were bitten by a flea
2 types of plague
- Bubonic
2. Pneumonic - spread person to person
Clinical presentation of bubonic plague
Buboes - lymphadenitis (massive swollen lymph nodes)
Clinical presentation of pneumonic plague
Headache
Hemoptysis
Hematemesis
Weakness
Complications of plague
- Septicemic plague - bacteria enters bloodstream via lymphatics
- Meningeal plague - bacteria crosses the BBB resulting in meningitits
Cause of toxoplasmosis
Toxoplasma gondii. Transmitted via cat feces (and sometimes birds), or ingestion of raw or undercooked meats, or contaminated water. Crosses placenta!
Clinical presentation of primary toxoplasmosis
- May be completely asymptomatic (mild mono-like symptoms)
- Fever
- Nontender cervical adenopathy
- May have hepatosplenomegaly
Clinical presentation of latent toxoplasmosis
After primary infection, latency occurs in mostly immunocompromised patients.
- Ring enhancing lesion in the brain
- Altered mental status
- Focal brain lesion seen on MRI (seen in AIDS pts)
Causes of malaria
4 different species of mosquitos. Most severe is caused by Plasmodium - P falciforum. Transmitted by mosquito bites!!
Clinical presentation of malaria
- Incubation of 7-30 days - no symptoms
- Cold stage - RIGORS!
- Hot stage - fevers, headaches, sweating
- Episodic 6-10 between hot and cold
Complications of malaria
- Hemolytic anemia
- Organ failure
- Acute respiratory distress
- Altered coagulation
Malaria starts to attack the RBC in the body
Management of malaria
Antimalarial drugs to fight the erythrocyte stage. Multi drug regimen
DX of malaria
Thick and thin blood smear - looking for evidence of parasites
