CTH Flashcards
What is Naegleria?
Where is it found?
Naegleria is a free-living ameba.
It is commonly found in warm fresh water (such as lakes, rivers, and hot springs) and soil.
How does Naegleria fowleri infect people?
Naegleria fowleri infects people when water containing the ameba enters the body through the nose.
Where is Naegleria fowleri found?
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.
What organism causes Amebiasis
Protozoa
Amebiasis transmission route
Fecal Oral - Male-male sex
Amebiasis symptoms
Cramps
Diarrhea (bloody)
Weight loss
Four kinds of Atnhrax
Cutaneous, Ingestion, Injection, & Inhalation
Medication used to treat GI Worms (Helminth)
Mebendazole
Types of Malaria
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
Malaria Fevers
P knowlesi is daily
P vivax and P ovale malaria, every 48 hr, tertian
P malariae every 72 hours, quartan malaria
What does a mosquito inject to cause Malaria?
Sporozoites
Malaria type and name of reproduction in Hepatocytes?
Asexual
Schixogony
Malaria post-reproduction in Hepatocytes
Merozoites
Term and phase for Merozoites feeding
Endocytosis in Erythrocytes
What does Malaria do with Hemoglobin?
Create Hemozoin Crystals
Malaria product that multiplies in Erythrocytes
Merozoites
Malaria: After the Erythrocytic phase what two things happen?
Some undergo Gametogony, forming male and female Gametocytes which remain in red blood cells and are picked up by other mosquitoes
Malaria: Where does sexual reproduction occur? What happens? Term?
In the mosquito’s abdomen. Gametocytes merge to form a Zygote. “Sporogony”
Malaria: Sexual vs Asexual terms? Locations?
Sexual: Sporogony (In Mosquito)
Asexual: Schixogony in Erythrocytes
Microscopic diagnosis for Malaria
Thin Blood Smear: Rapid & minimal experience
Thick Blood Smear: Accurate & More experience
Malaria reproduction in mosquito
Gametocytes merge to form a Zygote. “Sporogony”
Zygote matures to Ookinete –> Oocyst –> Sporoszoites
Quinoline Derivative Mechanism of Action? Term?
Interfere with the processing of toxic heme to Hemozoin Crystals in food vacuoles.
Schizonticidal.
Medications to kill Hypnozoites
Primaquine (Given with Schizonticidal)
Primaquine Contraindication
Anemia & G6PD deficiency
Pregnancy (Hemolysis in Fetus)
Artemisinin Derivative Mechanism of Action,
Bind to heme to form free radicals.
Schizonticidal.
First Choice medication for treatment of Chloroquine resistant Malaria?
Artemisinin Derivative
Cause of Giardiasis
Protozoa
Giardiasis Route
Fecal Oral
Giardiasis Tolerant to…
Chlorine
Giardiasis common transmission route
Drinking and Recreational water
Anti-malaria Contra indicated in Pregnancy.
Doxycycline: Teratogenic
Primiquin: Infant cannot be tested for G6PD
Atovaquone-Proguanil: Also if Breasteading
Malaria drugs of choice for pregnant women.
Chloroquine and mefloquine are the drugs of choice for pregnant women for destinations with chloroquine-sensitive and chloroquine-resistant malaria, respectively.
First choice medication for Chloroquine Resistant Malaria
Artemisinin Derivatives
Artemisinin Derivatives in Pregnancy
Safe after the first trimester
Atovaquone-Proguanil in Pregnancy
Not recommended
Why are Artemisinin Derivatives not used for prophylaxis?
Short half-life
What Anti Malaria drug should always be given in combination.
Artemisinin Derivatives
Treatment for Malaria for Pregnant women? Timeframe?
First Trimester: Seven-day course of clindamycin and quinine.
Afterwards: ACT
What can cause foul-smelling, fatty Diarrhea?
Giardiasis (Beaver Fever)
Where is Loa Loa Found?
West and Central Africa
Loa Loa, AKA?
African Eye Worm
Loa Loa Infection time?
six months to a year.
What is Calabar swelling?
Migratory, subcutaneous, painful, or pruritic nodules are produced by adult nematode migration through the skin. i.e. Loa Loa
Agent & vector of elephantiasis?
Infection with nematodes (roundworms) of the family Filariodidea that are transmitted through the bites of infected mosquitos.
Rickettsial Infections Case & Types?
Bacterial Infections
Spotted fever group (SFG) and the typhus group.
Rickettsia Africae, AKA
African tick-bite fever
Rickettsial Infections incubation period.
5-14 days.
Symptoms of Rickettsial Infections
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.
Rickettsia rickettsii, AKA
Rocky Mount Spotted Fever
Rickettsia prowazekii, AKA
Epidemic Typhus
Rickettsia prowazekii vector
Lice feces, Flying Squirll
Rickettsia typhi vector
Rat fleas
Rickettsia rickettsii risk factors
Age over 40
Wooded Areas
Exposure to dogs
Rickettsia rickettsii hallmark signs
Macules (Flat, non-itchy rash) blanches on pressure. Starts at the wrists and ankles and spreads to the trunk, hands, and feet.
Rickettsia prowazekii Hallmark
Red Macular rash, which starts on the trunk. Spares hands feet, and head.
What Typhus can remain dormant? Name?
Rickettsia Prowazekii
Epidemic Typhus
Brill-Zinsser Disease
Rickettsia typhi names
Murine / Endemic Typhus
Rickettsia typhi Hallmark
Red Macular rash, which starts on the trunk. Spares palms & soles .
Where to contract Rickettsia africae?
In Southern Africa, Safaris occur in clusters with exposure during safari tours, game hunting, and bush hiking.
Tickborne Encephalitis Incubation
4-28 days
Tickborne Encephalitis location
Western and northern Europe through to northern and eastern Asia
How do you get Tickborne Encephalitis other than ticks?
TBE may also be acquired by ingestion of unpasteurized dairy products
Tickborne Encephalitis infection agent
Flavivirus
Tickborne Encephalitis vector
Ixodes Tick
Tickborne Encephalitis subtypes. Severity?
European, Siberian, and Far Eastern.
Far Eastern subtype is often associated with a more severe disease course.
The country with the most reported Tickborne Encephalitis
Russia
Common season to contract Tickborne Encephalitis
Early and Late Summer
Comorbidity of Tickborne Encephalitis
Older Age
Chickungunya vector
Aedes Mosquito
Chickungunya pattern
Chikungunya virus often causes large outbreaks with high attack rates, affecting one-third to three-quarters of the population.
Aedes Mosquito breading patterns
Lay their eggs in domestic containers that hold water, including buckets and flowerpots.
Chickungunya presentation
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.
Chickungunya Treatment
Supportative
Chickungunya agent
Alphavirus.
Denge agent
Flavivirus, 1, 2, 3 or 4.
Denge vector
Aedes Mosquito
Where to contract Denge?
Eastern Africa, South Central America, Mexico, India, SE Asia
Dengue is more of a risk in urban and residential areas than is malaria.
Denge Incubation
5-7 days.
Denge Hallmark
Positive Tourniquet Test (Fluid leakage)
Dengue Treatment
Supportive
Dengue medications to avoid
Aspirin (acetylsalicylic acid), and other nonsteroidal anti-inflammatory drugs (such as ibuprofen) because of their anticoagulant properties.
Japanese Encephalitis agent
Flavivirus
Japanese Encephalitis Vector
Culex Mosquito
Bancroftian filariasis prevelance
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.
Bancroftian filariasis complication
Elephantiasis
Leishmania vector
Sand Fly
Leishmania types
Cutaneous (Most typical)
Viceral (More Severe)
Mucisal (destroys mucosa)
Leishmania agent
Protozoa
Leishmania treatment
Supportive
Lyme Disease Vector
Ixodes Tick
Lyme Disease Hallmark
Bulls Eye Rash
Lyme Disease Complications
Bells Palsy
Cardiac Abnormaiities
Plague Agent
Bacteria Yersinia Pestis
Plague vector
Rodent Fleas
Plague incubation
< One week
Lasa Fever Location
West Africa (Nigeria and West Coast)
Lasa Fever Vector
Rat Feces and Urine
Lasa Fever side effect
Deafness
Rift Valley Location
Eastern Africa
Rift Valley Fever Vector
Aedes Mosquito
Atovaquone-Proguanil, AKA
Malarone
What medications can facilitate the contraction of Typhoid?
Antacids, H2 Blockers, & PPIs
Age Relationship for Typhoid Fever
Children are more suseptable
Typhoid Fever Incubation Period
5 - 21 days
Typhoid Fever Hallmarks
Week 1: Stepwise Fever
Week 2: Rose Spots
Week 3: Intestinal Bleeding
What is the most common bacterial diarrhea?
Enterotoxic E. Coli (ETEC) 1/3
Most common Viral Diarrhea?
Norovirus
Most common Protozoal Diarrhea?
Giardia Lamblia
Where to contract Scrub Typhus
Asia
Scrub Typhus Vector
Mites
Treatment for Jellyfish
Rinse with Seawater
Apply Vinegar
Apply hot water
What is Ciguatera?
Most common food poisoning caused by consuming reef fish contaminated with ciguatoxins
Ciguatera poisoning timeframe?
Three - six hours
Ciguatera poisoning presentation?
GI followed by neuro.
Hot Cold
Metallic taste
Bradycardia
What is Scombroid?
Common food poisoning from eating improperly stored fish with high levels of histamine.
Scombroid symptoms?
Acute and rapid onset of allergic reaction symptoms.
Scombroid Key Facts (2)
Peppery, sharp, salty taste or bubbly feel.
Cooking & freezing will not destroy histamine.
Scombroid treatment
Antihistamines
Paralytic Shellfish Poisoning charactistics.
Most common shellfish poisoning.
PSP is found in temperate and tropical waters, typically during or after phytoplankton blooms.
Most common after eating muscles & clams.
Paralytic Shellfish Poisoning Timing & Symptoms
<60 minutes
Numbness & Tingling
Neaseau, Vomiting, & Diarrrhea
Respiratory failure.
Neurotoxic shellfish poisoning (NSP)
Shellfish poisoning.
The most common fish for Scombroid?
Tuna and Blue
How to get Anisakidosis?
Raw Fish, Worm that lives in the Stomach.
What can cause cellulitis and tissue necrosis after saltwater exposure?
Vibrio vulnificus
What causes Hot tub folliculitis
Pseudomonas aeruginosa
What does Naegleria fowleri cause?
Meningoencephalitis
What survives chlorinated water?
Cryptosporidium
What is Angiostrongylus cantonensis
Parasitic nematode worms (Round worm)
Angiostrongylus cantonensis (AKA)
Rat Lungworm
What can Angiostrongylus cantonensis cause?
Meningitis
Transmission route for Angiostrongylus cantonensis?
Rat Feces, Snails, Humans
Transmission route for Listeria Monocytongenes?
Deli meats, soft cheeses, unpasteurized milk and dairy products, and ready-to-eat foods
Risk Group for Listeria Monocytongenes?
Pregnant women, newborns, older adults, and individuals with weakened immune systems.
What is Toxoplasmosis?
Protozoan parasite Toxoplasma gondii.
Sources for Toxoplasmosis?
Kitty Litter
Undercooked or raw meat from infected animals
Risk Group for Toxoplasmosis?
pregnant women and individuals with weakened immune systems
What is Rice water stools?
Colorless odorless diarrhea
Cholera diarrhea description.
Colorless odorless diarrhea
What Malaria medication has a loading dose?
Tafenoquine daily x 3
Clinical sign of Yellow Fever? Name?
Slow Heart Rate with Fever. Faget’s sign.
Yellow Fever clinical presentation. Timing.
Infection, 3-6 days
Remission, 48 hrs
Intoxication. Fever, jaundice, oliguria, hemorrhage
Leprosy cause / name?
Bacteria / Hansen’s Dx.
Stages of Amebiasis (two)
Cyst (Infective)
Transforms to Trophozoite in Small Intestine and invades mucosa of the large intestine.
Signs of Amebiasis
Dysentery
Liver abscesses
Tape worm characteristic (discomfort)
Pain in AM releived by eating.
Pork tapework condition AKA / Vector
Taeniasis / T. Solium
Complication of T. Solium (AKA)
Injestion of eggs. Cause person to become host. Cystecircosis & Neurocystecircosis.
Pork tapeworm
What is Brucellosis, AKA, Where to contract, Characteristic
Bacterial Infection
Malta / Mediterranean Fever
Contact with birthing animals or unpasteurized dairy
Fever and night sweats with Moldy odor
What is Botulism? Source? Characteristic Findings?
Neuroparalytic bacteria
Ingestion from improperly stored food (No taste)
Symmetric descending paralysis (Floppy Baby)
Measeals Accelerated
Two doses one month apart
Oral Typhoid vaccine Characteristics
6 Y/O
Every other day, on empty stomach
Not for Pregnant or immunocompromised
Must be refrigerated
Children & DEET. Minimum age and concentration.
Minimum Age 2 months.
Max 35% DEET
Children under 2 months should be kept under a net.
MMR schedule and acceleration
Normal 1 year and 4-6 years.
Accelerated 1 year plus one month
Can be given at 6 months but then as Normal.
Typhoid Vaccination & Children
IM: > 2 Yrs
Oral: >6 Yrs
Calf pain and Conjunctival Suffusion are symptoms of?
Leptospirosis
Vaccines contraindicated in breastfeeding?
Yellow Fever (<9 months)
Smallpox
Number of virus particles to contact Yellow Fever
1000
Malaria Medication to avoid with renal Impairment?
Atovaquone-proguanil
What Malaria prophylaxis can increase the effect of warfarin?
Atovaquone-proguanil
What Malaria prophylaxis can exacerbate psoriasis.
Chloroquine
What Malaria prophylaxis should be taken with a meal.
Doxycycline
Where are you most likely to find p. ovale?
West Africa
Causes of Bloody Diarrhea
Salmonella
Shigella
Enterohemorrhagic E.Coli
Campylobacter
Entamoeba Histolyticia
What infection can orchitis (inflammation of the testicles)
Mumps
What is Herpes B virus primarily associated with
macaque monkeys
What kind of study give you an odds ratio?
Case Control
What kind of study demonstrates relative risk
Cohort
Travelers who visit rural areas or farms with cattle, sheep, goats, or other livestock may be exposed to
Brucellosis and Q Fever
Narrowing Pulse Pressure is a symptom of
Denge
Polio Vaccine Routine and Accelerated
Three doses
Two four to eight weeks
Third six to twelve months later
Accelerated: Four weeks apart
Japanese Encephalitis Vaccine Routing and Accelerated
Two doses 28 days apart
If over 18 Y/O can do seven days apart
Safe Chlorine in Hottubs and pools
Hottubs 2-4 ppm
Pools 1-3 ppm
What is Tenesums?
The feeling of not emptying your bowel.
Minimum Age for Scopolamine Patch
12 Yrs
What can you get cleaning fish tanks?
Mycobacterium marinum
Name of disease associated with complicated Leptospirosis?
Weil’s disease. Hemorrhagic syndrome.
Illness associated with larger fish
Ciguatera
Where can you get Tetrodotoxin?
Pufferfish
Minimum age for Influenza vaccine
Six Months
Minimum age for JE vaccine
Two Months
Minimum age for Menicocial vaccine
Two Months