Infectious Disease

Question 1

What is the epidemiology of rocky mountain spotted fever

Answer 1

Southeastern and south central regions of uS. TIcks, wild animals and dogs as reservoir

Question 2

How does RMSF present?

Answer 2

Causes a vasculitis:

• fever
• headache
• rash
• myalgias
• change in mental status
• maculopapular or petechial rash- USUALLY BEGINS PERIPHERALLY ON WRIST AND ANKLE AND SPREADS CENTRALLY

Question 3

What are the laboratory features of RMSF

Answer 3

Leukopenia, anemia, elevated liver enzymes and BR, hyponatremia

Question 4

What is the epidemiology of tularemia

Answer 4

rabbits, hares and ticks but can have direct contact with infected animals and aerosol transmission or contaminated water/meat
- arkansas, missouri, tennessee and texas between april and october

Question 5

What is the clinical presentation of tularemia?

Answer 5

ulceroglandular form most common:
- fever
- regional lymphadenopathy
- ulcer/ papule at site of innoculation
- pharyngitis
myalgias
HSM
vomiting

Can also have occular, pulmonic involvement.

Question 6

How do you treat tularemia

Answer 6

amikacin, gentamcyin, streptomycin

Question 7

what is the epidemiology of leptospirosis?

Answer 7

contaminated farm ponds and animal slaughterhouses; wild and domestic animals

Question 8

What is the clinical manifestation of leptospirosis?

Answer 8

1) anicteric (90%)- abrupt onset fever, headache, subconjunctival suffsion. Next get immune mediated phase charac by uveiitis, meningitis, fever, rash
2) icteric (Weil syndrome)- sever illness with liver failure, renal failure, hemorrhage, myocarditis

Question 9

What is the first phase of lyme disease? What are the clinical manifestations

Answer 9

Early localized disease- 3 days to 4 weeks
Clinical features: erythema migrans at site of tick bite. fever malaise, arthralgias
ANTIBODIES TO B. BURGDORFERI ABSENT

Question 10

What are the late manifestations of Lyme disease? 20% untreated cases

Answer 10

4-8 weeks

• multiple circular lesions
• flu like illness
• neuritis (7th nerve palsy)
• aspetic meningitis
• carditis- transient alternating heart block
• Lyme arthritis- most common. knee >90% cases. chronic and intermittently flaring

Question 11

what type of bacteria is yersinia pestis?

Answer 11

gram negative coccobacillus

Question 12

What is the most common helminthic infection of humas

Answer 12

ascaris lumbricoides

Question 13

What is Loffler syndrome?

Answer 13

Pneumonitis- cough, wheeze, dyspnea and mild hemoptysis from infection with ascaris during larval migratory phase (larvae migrate to lungs)

Question 14

What are the clinical presentations of necator americanus infections- most common hookwork

Answer 14

intensely pruritis dermatitis at site of hookwork entry
hypochromic microcyic anemia- can be severe
hypoproteinemia and edema
growth delay, neurodevelopmental delay secondary to chronic infection.

Question 15

What are the clinical manifestations of trichuris trichiura (whipworm)

Answer 15

1) Dysentery Syndrome- acute bloody diarrhea with mucus. Commonly associated with diarrhea
2) Chronic colitis-can mimic IBD and cause growth retardation
3) rectal prolapse- chronic infection with heavy infestation

Question 16

What clinical presentation suggests visceral larva migrans

Answer 16

young child playing in sandbox and playground contaminated with dog and cat feces

Question 17

what is the epidemiology of cysticercosis- taenia solium

Answer 17

ingestion of eggs of the pork tapeworm- the larvae causes disease.
humans obligate host

Question 18

What is the most common and serious manisfestation of cysticerosis

Answer 18

presence of cysts in the brain- neurocystercicosis

- SEIZURES. non-enhancing ring lesions.