Zoonosis Flashcards
A 26 year old male farm worker from Te Horo presents to Wellington ED acutely unwell. He has had symptoms of headache, chills, rigours, myalgia, nausea and abdominal pain. On examination he has a high fever and a rash. He has no recent travel history and has been otherwise well. Which of the following test should be ordered for diagnosis?
Question 1Select one:
Bloods for PCR
Urine for culture
Bloods for culture
Urine for PCR
Leptospirosis
Diagnosed with blood PCR in first week, then urine PCR >1 week (when no longer septicaemic)
Mr Douglas comes into your GP clinic complaining of fatigue. He appears unkempt and sad and talks slowly and in a monotone voice. You think he may be depressed.You remember that several weeks ago he came to see you with fever, headache and chills as well as some abdominal pain and some weird eye signs. Mr Douglas is a farmer and has recently been on holiday in South East Asia.Which of the following statements is TRUE?
Question 2Select one:
Mr Spirochete’s depression couldn’t have anything to do with his past illness 3 weeks ago
Swimming in lakes would help prevent getting this illness as water will wash the pathogen off the skin.
The illness Mr Spirochete has can only come from tropical overseas locations and is not found in NZ
Mr Spirochete probably has Lyme disease
Mr Spirochete probably has Leptospirosis
Mr Spirochete probably has Leptospirosis
Mr bond is a 45yo farmer who has come into your practice in the rural oasis of Gore, Central Otago. He has had generic flu-like symptoms of high fever, muscle aches and headaches for the past 5 days. He is particularly anxious after using Tamiflu within the 1st 48 hours of possibly being exposed to the influenza virus and that it must certainly be something else. He also unusually has a rash, red eyes and some abdominal pain. He says he may have come into indirect contact with animal urine. You have a infectious agent at the top of your differential based on this history. What is it and how would you like to test/investigate for it?
Question 3Select one:
Leptospirosis - urine PCR
Campylobacteriosis - stool culture via a selective medium
Toxoplasmosis - Head MRI
Leptospirosis - blood +/- urine PCR
Campylobacteriosis - PCR - Selective for enteric pathogens of significance via the primer
Leptospirosis - blood +/- urine PCR
You are a 5th year medical student at a ID conference talking about how human animal interface in a factor in disease emergence. An ID consultant asks for clarification on this, you mention 5 factors, one of which is wrong.Which one is wrong?
Question 4Select one:
Agriculture practices
Climate change
Hunting or capture of wild animals
Molecular determinants of host range
Distribution of vectors/hosts
Climate change
Steve is a 42 year old man who milks cows on a farm for a living. He’s also an “outdoors-y kind of bloke” who enjoys hunting, fishing, tramping and all those sorts of things. He’s come to see you, the GP, because he has a four day history of feeling feverish with sore muscles, headache and some abdominal pain. His wife made him come see you because his eyes looked “all red and weird” and finds it odd that he’s shivering despite wearing a puffer jacket inside with the fireplace going. He tells you that he forgot to wear his safety gloves and visor one morning at work about 2 weeks ago but thought nothing of it at the time.When you examine Steve he has a temperature of 39.5 deg C and he does indeed have oedematous and reddened conjunctivae. You suspect a zoonotic infection. Based on the zoonotic infection that Steve most likely has, which of the following statements is false regarding aspects of management?
Question 5Select one:
Do blood and urine samples for PCR analysis. He might be eligible for ACC if this infection was contracted at work.
Report to the Medical Officer of Health, as this is a notifiable infection. Reassure Steve that this is anonymous reporting.
Give doxycycline 100mg bd or amoxicillin 500mg q6h
Advise him that consistent use of PPE (personal protective equipment) is essential for preventing infections like this in the future.
Do blood cultures and await result before starting treatment.
Do blood cultures and await result before starting treatment.
Jeremy is a 29 year old male seeing you about low mood. He was let go from his job one month ago at the abbatoir down Ngauranga Gorge. He says that they officially let him go because he got caught for a health and safety violation (for not wearing gloves). He says heaps of staff get caught without gloves and the real reason he got fired was for taking too many sick days. He has recovered from his “flu” and is no longer having high fevers, headaches and muscle pains. He has not been overseas recently, and has had no unwell contacts. He still feels exhausted and says that this is the most depressed he has ever felt. You suspect that all of these issues point to a physical cause for his symptoms, what disease do you think is the most likely explanation for his presentation?
Question 6Select one:
HIV - he probably suffered from the classic acute phase flu-like illness and remains immune compromised
Tuberculosis - he has had an untreated acute infection that has entered a latency period
Leptospirosis- his “flu” likely represents the acute phase, with depression and fatigue as a post-infection syndrome
Chronic Fatigue Syndrome - he suffered a viral infection and has developed chronic fatigue as a post-viral sequelae
Leptospirosis- his “flu” likely represents the acute phase, with depression and fatigue as a post-infection syndrome
John is a 34 year old farmhand who has presented to ED with fever, rigors, myalgia conjunctival suffusion and abdominal pain for the last two days. On further questioning you find out that he cut his arm while working last week, and he did not cover it up until the evening, leaving it open for the whole day. You suspect that he may have a leptospirosis infection. How would you diagnose this?
Question 7Select one:
urine PCR only
Blood and urine PCR
Sputum PCR
stool culturev
Blood and urine PCR
Patient X is a 22 year old male who has come in today with mild to moderate diarrhea and crampy abdominal pain that started 2 days ago on the background of fever, headache, myalgia and feeling generally unwell 24 hours before the symtpoms of diarrhea and abdominal pain. He has otherwise been well previously. He has recently come back from his parent’s farm last week where he mentions he may have drunk some milk that was not pasteurized. Stool culture was ordered and tests was positive for a pathogenic organism. What is the most likely organism and what is the best treatment?
Question 8Select one:
Leptospires+Doxycycline 100mg BD poAmoxicillin 500mg q6h po
Leptospires+Penicillin G 1.5 MU IV q6h
Camphylobacter+No Antibiotics
Toxoplasma gondii+PyrimethamineSulfadizineClindamycinTrimethoprim-sulfamethoxazole
Camphylobacter+Erythromycin 400 mg, four times daily, for five days
Camphylobacter+No Antibiotics
Sarah, a normally well 24 year old female with no past medical history, comes to you as she has been feeling depressed and fatigued lately.She thinks this might be due to her recent secondment to Balclutha. However upon closer questioning she only began feeling this way following a week-long illness about 1/12 ago where she experienced fevers, headache, myalgias, nausea and abdominal pain. She also noted her eyes had been very red. At the time she wondered if she had caught something from the cows she had been patting one weekend. You also note a large amount of granulation tissue on her forearm which she explains is a graze she acquired after a nasty mountain-biking accident - coincidentally the day before she went cow-patting.Upon physical examination, no abnormalities were noted.Given her history what do you think is the most likely explanation for her presentation?
Question 9Select one:
Recovering from Campylobacteriosis
Post-viral fatigue
Leptospirosis
Situational depression and fatigue
Toxoplasmosis
Leptospirosis
Jay is a farmer from Whanganui who has recently been badly affected by bad flooding. She had to be evacuated to the local college by civil defense where she unfortunately started getting sick with a fever, headache, muscle pains and rigors. Her partner noticed her eyes looked odd as well. They come to you, a TI placed in Whanganui who has also been affected by the flood and ask what’s wrong and what treatment she might need.
Question 10Select one:
Campylobacter infection - Erythromycin or ciprofloxacin
Leptospirosis infection - Doxycycline or ciprofloxacin
Leptospirosis infection - Doxycycline or amoxicillin
Campylobacter infection - Erythromycin or amoxicillin
Leptospirosis infection - Erythromycin or penicillin
Leptospirosis infection - Doxycycline or amoxicillin
A 45 year old European women who lives with her husband and 2 cats presents to the GP with a fever of 38.3 degrees C for a period of 7 days. She has been experiencing trouble keeping up with her chores, mostly due to feeling “rubbish” for the last week. Upon examination she is found to have swollen lymph nodes in her neck. She thinks she may have the flu. What is the most likely cause of her illness and what is the recommended next step in management?
Question 11Select one:
Leptospirosis - Amoxicillin after confirmation of blood serology results
Toxoplasmosis - needs urgent treatment with ciprofloxacin.
Toxoplasmosis - advise to keep oral hydration up as is usually self limiting.
Leptospirosis - Doxycycline while awaiting blood serology results
Toxoplasmosis - advise to keep oral hydration up as is usually self limiting.
