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1
Q

What is Naegleria?
Where is it found?

A

Naegleria is a free-living ameba.
It is commonly found in warm fresh water (such as lakes, rivers, and hot springs) and soil.

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2
Q

How does Naegleria fowleri infect people?

A

Naegleria fowleri infects people when water containing the ameba enters the body through the nose.

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3
Q

Where is Naegleria fowleri found?

A

Naegleria fowleri lives in warm fresh water and soil around the world. The amebae may be present in any freshwater body in the United States, regardless of the state, especially during the warmer months of July, August, and September.

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4
Q

What organism causes Amebiasis

A

Protozoa

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5
Q

Amebiasis transmission route

A

Fecal Oral - Male-male sex

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6
Q

Amebiasis symptoms

A

Cramps
Diarrhea (bloody)
Weight loss

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7
Q

Four kinds of Atnhrax

A

Cutaneous, Ingestion, Injection, & Inhalation

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8
Q

Medication used to treat GI Worms (Helminth)

A

Mebendazole

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9
Q

Types of Malaria

A

Plasmodium falciparum: most lethal, most drug-resistant (sub-Saharan Africa)
P. vivax: relapsing species, widest geographic distribution
P. ovale: relapsing species (western areas of sub-Saharan Africa)
P. malariae: AKA ‘benign’ malaria (mild course)
P. knowlesi: found throughout Southeast Asia, and is the most common cause of human malaria in Malaysia

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10
Q

Malaria Fevers

A

P knowlesi is daily
P vivax and P ovale malaria, every 48 hr, tertian
P malariae every 72 hours, quartan malaria

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11
Q

What does a mosquito inject to cause Malaria?

A

Sporozoites

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12
Q

Malaria type and name of reproduction in Hepatocytes?

A

Asexual
Schixogony

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13
Q

Malaria post-reproduction in Hepatocytes

A

Merozoites

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14
Q

Term and phase for Merozoites feeding

A

Endocytosis in Erythrocytes

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15
Q

What does Malaria do with Hemoglobin?

A

Create Hemozoin Crystals

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16
Q

Malaria product that multiplies in Erythrocytes

A

Merozoites

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17
Q

Malaria: After the Erythrocytic phase what two things happen?

A

Some undergo Gametogony, forming male and female Gametocytes which remain in red blood cells and are picked up by other mosquitoes

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18
Q

Malaria: Where does sexual reproduction occur? What happens? Term?

A

In the mosquito’s abdomen. Gametocytes merge to form a Zygote. “Sporogony”

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19
Q

Malaria: Sexual vs Asexual terms? Locations?

A

Sexual: Sporogony (In Mosquito)
Asexual: Schixogony in Erythrocytes

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20
Q

Microscopic diagnosis for Malaria

A

Thin Blood Smear: Rapid & minimal experience
Thick Blood Smear: Accurate & More experience

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21
Q

Malaria reproduction in mosquito

A

Gametocytes merge to form a Zygote. “Sporogony”
Zygote matures to Ookinete –> Oocyst –> Sporoszoites

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22
Q

Quinoline Derivative Mechanism of Action? Term?

A

Interfere with the processing of toxic heme to Hemozoin Crystals in food vacuoles.

Schizonticidal.

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23
Q

Medications to kill Hypnozoites

A

Primaquine (Given with Schizonticidal)

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24
Q

Primaquine Contraindication

A

Anemia & G6PD deficiency
Pregnancy (Hemolysis in Fetus)

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25
Q

Artemisinin Derivative Mechanism of Action,

A

Bind to heme to form free radicals.

Schizonticidal.

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26
Q

First Choice medication for treatment of Chloroquine resistant Malaria?

A

Artemisinin Derivative

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27
Q

Cause of Giardiasis

A

Protozoa

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28
Q

Giardiasis Route

A

Fecal Oral

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29
Q

Giardiasis Tolerant to…

A

Chlorine

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30
Q

Giardiasis common transmission route

A

Drinking and Recreational water

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31
Q

Anti-malaria Contra indicated in Pregnancy.

A

Doxycycline: Teratogenic
Primiquin: Infant cannot be tested for G6PD
Atovaquone-Proguanil: Also if Breasteading

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32
Q

Malaria drugs of choice for pregnant women.

A

Chloroquine and mefloquine are the drugs of choice for pregnant women for destinations with chloroquine-sensitive and chloroquine-resistant malaria, respectively.

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33
Q

First choice medication for Chloroquine Resistant Malaria

A

Artemisinin Derivatives

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34
Q

Artemisinin Derivatives in Pregnancy

A

Safe after the first trimester

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35
Q

Atovaquone-Proguanil in Pregnancy

A

Not recommended

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36
Q

Why are Artemisinin Derivatives not used for prophylaxis?

A

Short half-life

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37
Q

What Anti Malaria drug should always be given in combination.

A

Artemisinin Derivatives

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38
Q

Treatment for Malaria for Pregnant women? Timeframe?

A

First Trimester: Seven-day course of clindamycin and quinine.
Afterwards: ACT

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39
Q

What can cause foul-smelling, fatty Diarrhea?

A

Giardiasis (Beaver Fever)

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40
Q

Where is Loa Loa Found?

A

West and Central Africa

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41
Q

Loa Loa, AKA?

A

African Eye Worm

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42
Q

Loa Loa Infection time?

A

six months to a year.

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43
Q

What is Calabar swelling?

A

Migratory, subcutaneous, painful, or pruritic nodules are produced by adult nematode migration through the skin. i.e. Loa Loa

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44
Q

Agent & vector of elephantiasis?

A

Infection with nematodes (roundworms) of the family Filariodidea that are transmitted through the bites of infected mosquitos.

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45
Q

Rickettsial Infections Case & Types?

A

Bacterial Infections
Spotted fever group (SFG) and the typhus group.

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46
Q

Rickettsia Africae, AKA

A

African tick-bite fever

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47
Q

Rickettsial Infections incubation period.

A

5-14 days.

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48
Q

Symptoms of Rickettsial Infections

A

Fever, headache, malaise, rash, nausea, or vomiting.

Maculopapular, vesicular, or petechial rash or sometimes an eschar at the site of the tick or mite bite.

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49
Q

Rickettsia rickettsii, AKA

A

Rocky Mount Spotted Fever

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50
Q

Rickettsia prowazekii, AKA

A

Epidemic Typhus

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51
Q

Rickettsia prowazekii vector

A

Lice feces, Flying Squirll

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52
Q

Rickettsia typhi vector

A

Rat fleas

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53
Q

Rickettsia rickettsii risk factors

A

Age over 40
Wooded Areas
Exposure to dogs

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54
Q

Rickettsia rickettsii hallmark signs

A

Macules (Flat, non-itchy rash) blanches on pressure. Starts at the wrists and ankles and spreads to the trunk, hands, and feet.

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55
Q

Rickettsia prowazekii Hallmark

A

Red Macular rash, which starts on the trunk. Spares hands feet, and head.

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56
Q

What Typhus can remain dormant? Name?

A

Rickettsia Prowazekii
Epidemic Typhus
Brill-Zinsser Disease

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57
Q

Rickettsia typhi names

A

Murine / Endemic Typhus

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58
Q

Rickettsia typhi Hallmark

A

Red Macular rash, which starts on the trunk. Spares palms & soles .

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59
Q

Where to contract Rickettsia africae?

A

In Southern Africa, Safaris occur in clusters with exposure during safari tours, game hunting, and bush hiking.

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60
Q

Tickborne Encephalitis Incubation

A

4-28 days

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61
Q

Tickborne Encephalitis location

A

Western and northern Europe through to northern and eastern Asia

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62
Q

How do you get Tickborne Encephalitis other than ticks?

A

TBE may also be acquired by ingestion of unpasteurized dairy products

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63
Q

Tickborne Encephalitis infection agent

A

Flavivirus

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64
Q

Tickborne Encephalitis vector

A

Ixodes Tick

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65
Q

Tickborne Encephalitis subtypes. Severity?

A

European, Siberian, and Far Eastern.
Far Eastern subtype is often associated with a more severe disease course.

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66
Q

The country with the most reported Tickborne Encephalitis

A

Russia

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67
Q

Common season to contract Tickborne Encephalitis

A

Early and Late Summer

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68
Q

Comorbidity of Tickborne Encephalitis

A

Older Age

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69
Q

Chickungunya vector

A

Aedes Mosquito

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70
Q

Chickungunya pattern

A

Chikungunya virus often causes large outbreaks with high attack rates, affecting one-third to three-quarters of the population.

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71
Q

Aedes Mosquito breading patterns

A

Lay their eggs in domestic containers that hold water, including buckets and flowerpots.

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72
Q

Chickungunya presentation

A

Sudden onset high fever
Joint pains are typically bilateral and symmetric.
Rash usually occurs after onset of fever. It typically involves the trunk and extremities but also can include the palms, soles, and face.

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73
Q

Chickungunya Treatment

A

Supportative

74
Q

Chickungunya agent

A

Alphavirus.

75
Q

Denge agent

A

Flavivirus, 1, 2, 3 or 4.

76
Q

Denge vector

A

Aedes Mosquito

77
Q

Where to contract Denge?

A

Eastern Africa, South Central America, Mexico, India, SE Asia
Dengue is more of a risk in urban and residential areas than is malaria.

78
Q

Denge Incubation

A

5-7 days.

79
Q

Denge Hallmark

A

Positive Tourniquet Test (Fluid leakage)

80
Q

Dengue Treatment

A

Supportive

81
Q

Dengue medications to avoid

A

Aspirin (acetylsalicylic acid), and other nonsteroidal anti-inflammatory drugs (such as ibuprofen) because of their anticoagulant properties.

82
Q

Japanese Encephalitis agent

A

Flavivirus

83
Q

Japanese Encephalitis Vector

A

Culex Mosquito

84
Q

Bancroftian filariasis prevelance

A

90% of lymphatic filariasis cases and the most common etiology of acquired lymphedema. It is the second leading infectious cause of disability worldwide after leprosy.

85
Q

Bancroftian filariasis complication

A

Elephantiasis

86
Q

Leishmania vector

A

Sand Fly

87
Q

Leishmania types

A

Cutaneous (Most typical)
Viceral (More Severe)
Mucisal (destroys mucosa)

88
Q

Leishmania agent

A

Protozoa

89
Q

Leishmania treatment

A

Supportive

90
Q

Lyme Disease Vector

A

Ixodes Tick

91
Q

Lyme Disease Hallmark

A

Bulls Eye Rash

92
Q

Lyme Disease Complications

A

Bells Palsy
Cardiac Abnormaiities

93
Q

Plague Agent

A

Bacteria Yersinia Pestis

94
Q

Plague vector

A

Rodent Fleas

95
Q

Plague incubation

A

< One week

96
Q

Lasa Fever Location

A

West Africa (Nigeria and West Coast)

97
Q

Lasa Fever Vector

A

Rat Feces and Urine

98
Q

Lasa Fever side effect

A

Deafness

99
Q

Rift Valley Location

A

Eastern Africa

100
Q

Rift Valley Fever Vector

A

Aedes Mosquito

101
Q

Atovaquone-Proguanil, AKA

A

Malarone

102
Q

What medications can facilitate the contraction of Typhoid?

A

Antacids, H2 Blockers, & PPIs

103
Q

Age Relationship for Typhoid Fever

A

Children are more suseptable

104
Q

Typhoid Fever Incubation Period

A

5 - 21 days

105
Q

Typhoid Fever Hallmarks

A

Week 1: Stepwise Fever
Week 2: Rose Spots
Week 3: Intestinal Bleeding

106
Q

What is the most common bacterial diarrhea?

A

Enterotoxic E. Coli (ETEC) 1/3

107
Q

Most common Viral Diarrhea?

A

Norovirus

108
Q

Most common Protozoal Diarrhea?

A

Giardia Lamblia

109
Q

Where to contract Scrub Typhus

A

Asia

110
Q

Scrub Typhus Vector

A

Mites

111
Q

Treatment for Jellyfish

A

Rinse with Seawater
Apply Vinegar
Apply hot water

112
Q

What is Ciguatera?

A

Most common food poisoning caused by consuming reef fish contaminated with ciguatoxins

113
Q

Ciguatera poisoning timeframe?

A

Three - six hours

114
Q

Ciguatera poisoning presentation?

A

GI followed by neuro.
Hot Cold
Metallic taste
Bradycardia

115
Q

What is Scombroid?

A

Common food poisoning from eating improperly stored fish with high levels of histamine.

116
Q

Scombroid symptoms?

A

Acute and rapid onset of allergic reaction symptoms.

117
Q

Scombroid Key Facts (2)

A

Peppery, sharp, salty taste or bubbly feel.
Cooking & freezing will not destroy histamine.

118
Q

Scombroid treatment

A

Antihistamines

119
Q

Paralytic Shellfish Poisoning charactistics.

A

Most common shellfish poisoning.
PSP is found in temperate and tropical waters, typically during or after phytoplankton blooms.
Most common after eating muscles & clams.

120
Q

Paralytic Shellfish Poisoning Timing & Symptoms

A

<60 minutes
Numbness & Tingling
Neaseau, Vomiting, & Diarrrhea
Respiratory failure.

121
Q

Neurotoxic shellfish poisoning (NSP)

A

Shellfish poisoning.

122
Q

The most common fish for Scombroid?

A

Tuna and Blue

123
Q

How to get Anisakidosis?

A

Raw Fish, Worm that lives in the Stomach.

124
Q

What can cause cellulitis and tissue necrosis after saltwater exposure?

A

Vibrio vulnificus

125
Q

What causes Hot tub folliculitis

A

Pseudomonas aeruginosa

126
Q

What does Naegleria fowleri cause?

A

Meningoencephalitis

127
Q

What survives chlorinated water?

A

Cryptosporidium

128
Q

What is Angiostrongylus cantonensis

A

Parasitic nematode worms (Round worm)

129
Q

Angiostrongylus cantonensis (AKA)

A

Rat Lungworm

130
Q

What can Angiostrongylus cantonensis cause?

A

Meningitis

131
Q

Transmission route for Angiostrongylus cantonensis?

A

Rat Feces, Snails, Humans

132
Q

Transmission route for Listeria Monocytongenes?

A

Deli meats, soft cheeses, unpasteurized milk and dairy products, and ready-to-eat foods

133
Q

Risk Group for Listeria Monocytongenes?

A

Pregnant women, newborns, older adults, and individuals with weakened immune systems.

134
Q

What is Toxoplasmosis?

A

Protozoan parasite Toxoplasma gondii.

135
Q

Sources for Toxoplasmosis?

A

Kitty Litter
Undercooked or raw meat from infected animals

136
Q

Risk Group for Toxoplasmosis?

A

pregnant women and individuals with weakened immune systems

137
Q

What is Rice water stools?

A

Colorless odorless diarrhea

138
Q

Cholera diarrhea description.

A

Colorless odorless diarrhea

139
Q

What Malaria medication has a loading dose?

A

Tafenoquine daily x 3

140
Q

Clinical sign of Yellow Fever? Name?

A

Slow Heart Rate with Fever. Faget’s sign.

141
Q

Yellow Fever clinical presentation. Timing.

A

Infection, 3-6 days
Remission, 48 hrs
Intoxication. Fever, jaundice, oliguria, hemorrhage

142
Q

Leprosy cause / name?

A

Bacteria / Hansen’s Dx.

143
Q

Stages of Amebiasis (two)

A

Cyst (Infective)
Transforms to Trophozoite in Small Intestine and invades mucosa of the large intestine.

144
Q

Signs of Amebiasis

A

Dysentery
Liver abscesses

145
Q

Tape worm characteristic (discomfort)

A

Pain in AM releived by eating.

146
Q

Pork tapework condition AKA / Vector

A

Taeniasis / T. Solium

147
Q

Complication of T. Solium (AKA)

A

Injestion of eggs. Cause person to become host. Cystecircosis & Neurocystecircosis.
Pork tapeworm

148
Q

What is Brucellosis, AKA, Where to contract, Characteristic

A

Bacterial Infection
Malta / Mediterranean Fever
Contact with birthing animals or unpasteurized dairy
Fever and night sweats with Moldy odor

149
Q

What is Botulism? Source? Characteristic Findings?

A

Neuroparalytic bacteria
Ingestion from improperly stored food (No taste)
Symmetric descending paralysis (Floppy Baby)

150
Q

Measeals Accelerated

A

Two doses one month apart

151
Q

Oral Typhoid vaccine Characteristics

A

6 Y/O
Every other day, on empty stomach
Not for Pregnant or immunocompromised
Must be refrigerated

152
Q

Children & DEET. Minimum age and concentration.

A

Minimum Age 2 months.
Max 35% DEET
Children under 2 months should be kept under a net.

153
Q

MMR schedule and acceleration

A

Normal 1 year and 4-6 years.
Accelerated 1 year plus one month
Can be given at 6 months but then as Normal.

154
Q

Typhoid Vaccination & Children

A

IM: > 2 Yrs
Oral: >6 Yrs

155
Q

Calf pain and Conjunctival Suffusion are symptoms of?

A

Leptospirosis

156
Q

Vaccines contraindicated in breastfeeding?

A

Yellow Fever (<9 months)
Smallpox

157
Q

Number of virus particles to contact Yellow Fever

A

1000

158
Q

Malaria Medication to avoid with renal Impairment?

A

Atovaquone-proguanil

159
Q

What Malaria prophylaxis can increase the effect of warfarin?

A

Atovaquone-proguanil

160
Q

What Malaria prophylaxis can exacerbate psoriasis.

A

Chloroquine

161
Q

What Malaria prophylaxis should be taken with a meal.

A

Doxycycline

162
Q

Where are you most likely to find p. ovale?

A

West Africa

163
Q

Causes of Bloody Diarrhea

A

Salmonella
Shigella
Enterohemorrhagic E.Coli
Campylobacter
Entamoeba Histolyticia

164
Q

What infection can orchitis (inflammation of the testicles)

A

Mumps

165
Q

What is Herpes B virus primarily associated with

A

macaque monkeys

166
Q

What kind of study give you an odds ratio?

A

Case Control

167
Q

What kind of study demonstrates relative risk

A

Cohort

168
Q

Travelers who visit rural areas or farms with cattle, sheep, goats, or other livestock may be exposed to

A

Brucellosis and Q Fever

169
Q

Narrowing Pulse Pressure is a symptom of

A

Denge

170
Q

Polio Vaccine Routine and Accelerated

A

Three doses
Two four to eight weeks
Third six to twelve months later
Accelerated: Four weeks apart

171
Q

Japanese Encephalitis Vaccine Routing and Accelerated

A

Two doses 28 days apart
If over 18 Y/O can do seven days apart

172
Q

Safe Chlorine in Hottubs and pools

A

Hottubs 2-4 ppm
Pools 1-3 ppm

173
Q

What is Tenesums?

A

The feeling of not emptying your bowel.

174
Q

Minimum Age for Scopolamine Patch

A

12 Yrs

175
Q

What can you get cleaning fish tanks?

A

Mycobacterium marinum

176
Q

Name of disease associated with complicated Leptospirosis?

A

Weil’s disease. Hemorrhagic syndrome.

177
Q

Illness associated with larger fish

A

Ciguatera

178
Q

Where can you get Tetrodotoxin?

A

Pufferfish

179
Q

Minimum age for Influenza vaccine

A

Six Months

180
Q

Minimum age for JE vaccine

A

Two Months

181
Q

Minimum age for Menicocial vaccine

A

Two Months

CTH (6 decks)

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