ID-Bioterrorism Flashcards

1
Q

Describe the gram stain of anthrax? What do you see on imaging? What are the clinical features

A

Gram positive box car shaped
You see a widened mediastinum on CXR

Clinical features include low grade fever, myalgia, malaise, headache, cough, chest pain, dyspnea. You often see a black eschar cutaneous lesion

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2
Q

How is anthrax diagnosed?

A

PCR of blood, tissue samples

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3
Q

How do you treat suspected anthrax?

A

levo, cipro, or doxy, should be given to all people with suspected case of anthrax

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4
Q

What is the monoclonal ab available for anthrax?

A

Raxibacumab

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5
Q

What are the clinical symptoms of smallpox?

A

High fever, headache, vomiting, backache

Rash: first appears on the buccal and pharyngeal mucosa, then spreads to the skin: face, arms, legs, hands and feet

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6
Q

How does the smallpox rash evolve?

A

It evolves from macules, to papules, vesicles to pustules, and eventually crust over

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7
Q

How do you treat smallpox?

A

Supportive care

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8
Q

What do you do for people exposed to smallpox?

A

Given them vaccinia within three days.

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9
Q

What causes the plague?

A

Yersinia pestis, usually a bite from an infected flea but can also be aerosolized

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10
Q

How does pneumonic plague evolve? What are the clinical symptoms?

A
  • It arises from hematogenous spread of a bubo (an infected, swollen lymph node) but may be primary from direct inhalation
  • Sudden high fever, pleuritic chest discomfort, productive cough, hemoptysis
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11
Q

Treatment for the plague?

A

Streptamicin or gentamicin for 7-10 days

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12
Q

What is prophylaxis for the plague?

A

Doxycycline or levofloxacin

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13
Q

What causes botulism?

A

Clostridium botulinum

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14
Q

What are the ways we would be concerned of botulism becoming a biological threat?

A

inhaled or ingested in food

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15
Q

What are the clinical features of botulism?

A

cranial nerve palsies and a descending flaccid paralysis

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16
Q

How do you diagnose botulism

A

Confirm it’s presence in blood, stool samples

17
Q

How do you treat botulism?

A

Anti-botulinum toxin and supportive care

18
Q

How do you prevent botulism?

A

Antibotulinum antitoxin

19
Q

How could tularemia be used as a biological threat?

A

Requires low inoculation to infect someone

20
Q

Describe pneumonic tularemia

A

nonproductive cough, dyspnea, substernal or pleuritic chest pain

21
Q

How is tularemia diagnosed best?

A

Culture and other testing data are often negative. PCR is really the only way to rapidly diagnose it.

22
Q

How do you treat tularemia?

A

Severe disease: Streptomycin, gentamicin

Nonsevere disease: doxycycline, ciprofloxacin