disaster medicine/abuse Flashcards
tag color:
red:
yellow:
green:
black:
immediate, life threatening
delayed, non life threatening
minimal, minor injuries
expectant deceased or expected to die
vectors: like anthrax
how are they released?
some places they are released?
aerosol
water supply
subway
major social events
category A bioterrorism agents:
highest priority agents, they can grow easily, are sturdy and resistant to destruction, can infect large numbers of people
some examples are:
anthrax, smallpox, plague, botulism, tularemia, viral hemorrhagic fever
smallpox:
incubation:
vulnerable to what?
how is it spread?
12 days bacterial superinfx (encephalitis, keratitis, corneal ulcerations)
airborne or contact
tx of small pox?
cidofovir (not super effective)
prevention of small pox?
VIG (caccinia immune globulin) among exposed individuals
anthrax: red papular lesions occur when?
after 2 weeks of exposure
what does the red papular lesion become in anthrax?
progresses to necrotic ulceration and black eschar
anthrax: inhalaion: like a URI that progresses to what?
sepsis, delirium, lethargy/somnolence, meningeal irritation
Anthrax: GI: diffuse adb pain, D and fever
what else can occur?
hematemsis, melena, bowel perf
tx of anthrax:
cipro or doxy
what can be used for post exposure prophylaxis when no other options are avaliable?
monoclonal antibodies (human anthrax globulin)
plague is caused by what?
yersinia pestis (fleas/rats)
3 forms of plague:
bubonic:
septicemic:
Pneumonic:
inflammaion of tonsils, adenoids, spleen, thymus, severe lymph node swelling (buboes)
bacteremia, fever, chills, internal bleeding
most severe, contagios, potential for bioterrorism
testing for plague:
bubonic:
speticemic:
penumonic:
buboes fluid sampling
blood culture
cxr, sputum culture
tx for plague:
Gent, doxy, CIPRO
Tularemia: tick borne
glandular: ulceroglandular: oculoglandular: penumonic: typhoidal:
painful lymph nodes, fever, chills, HA, fatigue
same with skin ulcers
eye pain, redness, discharge, ulcer on insid eof eyelid
sore throat, mouth ulcers, V, D (poorly cooked wild animals meat or contaminated water)
URI
rare but serious, fever, fatigure, hepato/splenomegaly
tests for tularemia?
blood/sputum cultures to check for F tularenia or check for AB in blood (PCR)
tx for tularemia:
streptomycin, gentamycin, doxy
NO CIPRO!!!!!!!
ebola, dengue, lassa, yellow fever, marburg HF are all what?
viral hemorrhagic fever
viral hemorrhagic fevers interfere with what?
clotting
what can viral hemorrhagic fevers progress to?
shock, CNS malfunction, demerium, hepatorenal failure
tx for viral hemorrhagic fever?
no tx, some immunizations (antiviral ribavirin may help shorten course)
Q fever is caused by what?
coxiella burnetti
this is a latent component that resurfaces months to years later causing damage to heart, liver, brain or lungs
Q fever
transmitted from animals, livestock or sheep, mild initial may not rquire tx
q fever (coxiella burnetti)
recurrence in q fever requires ab for how long?
18 months
testing for q fever:
antibodies to coxiella burnetti, echo
tx for q fever?
antibotics or valve replacement
west nile, eastern equine, japanese, tick born encephalitis are all what?
viral encephalitis
Headache, flulike symptoms, nausea, vomiting, anorexia, lethargy, nuchal rigidity
what dxs?
viral encephalitis
tests for viral encephalitis?
lumbar puncture, HEAD CT/mri, eeg, brain biopsy
tx is symptomatic
staphylococcal entertoxin B: food poisoning, bad meat, dairy, bakery
how long do symptoms show up?
4-10 hours later, N/V/D!!
can give zofran if its bad
salmonella:
water borne-streams, food posioning, fever, D
how long does it last, how can we test it?
7-10 days
stool culture
(can possible give cipro but usually symptomatic tx)
Nerve agents:
affect both main types of what?
cholinergic (muscarinic and nicotinic)
Sarin, tabun, Soman, VX are all what?
nerve agents
miosis and rhinorrhea, along with bronchorrhea, paralysis, death, LOC, seizures can all occur with what?
nerve agents
nerve agents or cyanide are what chemiclas?
quick onset
liquid exposure:
vapor exposure:
how long till symptoms develop?
delayed symptoms, require prolonged exposure
rapid onset
tx for nerve agents:
Atropine!!!
pralidoxime chloride, diazepam if seizures
blood agents:
cyanide:
low concentrations: flushing, cherry red, anxious,
high concentrations:
15 seconds:
30 seconds:
3-5 min:
6-10 min:
anxious, hyperventiliation
seizures
apnea
asystole
cyanide: tx:
amyl nitrate pearls
combo of hydroxocobalamin, sodium nitrite and sodium thiosulfate is ideal
sulfur mustard gas, lewisite are what?
blister agents
skin redness, burns, conjunctivitis, upper airway iritiation
tx: vaseline, cough suppressants, O2
phosgene, chlorine, ammonia these are what?
choking agents
delayed chest tightness, pulmonary edema
wash eyes, flush, airway manangement
mace, pepper spray, tear gas
crowd/riot control
check opthalmic ph
tx: wash, SABA, O2, eye irrigation
1 leading cause of death b/w 1-12 months of age?
child abuse
failure to meet child’s basic needs?
neglect
mc reported and confirmed child abuse?
neglect
failure to thrive, recurrent skin infx or gastroenteritis, occiptial alopecia from lying on back all day?
neglect in early infancy
weight gain on hospitilization and unimmunized
neglect
bowel disorders, anorexia, soiling onself, failing in school, disruptive behavior, fears, withdrawn, these can all correlate with what?
physical abuse
doubel bubble sign on xray from abdominal trauma
duodenal hematoma from physical abuse
retinal hemorrhages and intracerebral hemorrhage associated with what?
shaken baby syndrome
spiral fractures or multiple fractures of different stages of healing?
physical abuse
