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Infectious Disease > Zoonotic Diseases > Flashcards

Zoonotic Diseases Flashcards

1
Q

Rocky Mtn. Spotted Fever causative agent

A

Rickettsia rickettsii

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2
Q

Vector of Rocky Mtn. Spotted Fever

A

dog tick

Rocky Mtn. wood tick

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3
Q

Reservoir of Rocky Mtn. Spotted Fever

A

small woodland animals, domestic cats/dogs, deer

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4
Q

Geographic distribution Rocky Mtn. Spotted Fever

A

North Atlantic & S. Central regions of US, N. America, C. America, S. America

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5
Q

Peak incidence of Rocky Mtn. Spotted Fever

A

late spring and early summer

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6
Q

Rocky Mtn. Spotted Fever clinical manifestations

A

Classic RMSF rash of centripetal inward spreading macular rash

  • begins at wrists, forearm, and ankles
  • spreads inward toward the trunk
  • palms and soles involved in 80% of cases
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7
Q

Rocky Mtn. Spotted Fever Severe disease

A

really messed up: effects skin, neuro, muscle, GI, cardiac, etc.

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8
Q

Rocky Mtn. Spotted Fever diagnostics

A

Serology for R. rickettsia antibodies showing a 4 fold increase in IgG antibodies
Immunohistochemical detection of R. rickettsia in skin biopsy
PCR detection of ABs in eschar, blood, skin biopsy

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9
Q

Rocky Mtn. Spotted Fever treatment

A

doxycycyline
chloramphenicol alternative when pregnant (monitor for pancytopenia)

  • less adverse reactions/improved outcome with early treatment
  • fever w/o rash common in elderly and African Americans
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10
Q

Rocky Mtn. Spotted Fever prevention

A

avoid ticks and early removal of attached ticks

more severe infections in males, alcoholics, elderly, African Americans, immunocompromised, patients with G6PD deficiency

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11
Q

centripetal rash

A

Rocky Mtn. Spotted Fever

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12
Q

Lyme disease causative agent

A

Borrelia burdorferi (spirochete)

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13
Q

Lyme disease reservoir

A

white footed mouse

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14
Q

Lyme disease geographic distribution

A

Endemic areas: northeastern seaboard, midwest, west coast

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15
Q

Lyme disease peak incidence

A

spring through fall and peak in summer

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16
Q

Lyme disease description

A

tickborne spirochetal zoonosis that affects skin, joints, nervous system, and heart

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17
Q

Lyme disease stages

A

early lyme stage
acute disseminated infection
late lyme disease

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18
Q

Lyme disease early lyme stage

A
  • erythema migrans bull’s eye rash
  • constitutional sx
  • HA
  • GI sx: hepatitis, pharyngitis
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19
Q

Lyme disease acute disseminated infection

A
  • neurological manifestations: BILATERAL BELL PALSY

- cardiac manifestations: AV Block

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20
Q

Lyme disease late lyme disease

A
  • neurological: chronic encephalopathy, memory impairment, psychiatric disturbances, hypersomnolenece (just want to sleep alllllll the time)
  • ARTHRITIS!!
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21
Q

Lyme disease diagnostic teasting

A

Clinical dx: erythema migrans rash from endemic areas - treat empirically

serology: most important tests to cofirm clinical suspicion - ELISA during first month of illness & Western Blot

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22
Q

Lyme disease treatment

A

Early localized dz:

  • confined to skin: 10 days ABX
  • spread beyond skin: extended tx to 20-30 days
  • oral doxycycline for 21 days (not in pregnancy or kids <8yrs)
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23
Q

Lyme disease treatment alternatives

A

amoxicillin

cefuroxime

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24
Q

Lyme disease treatment for pregnancy and PCN allergy

A

erythromycin

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25
Q

Lyme disease treatment with complications

A

prolonged ABX tx 30-60 days

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26
Q

erythema migrans rash

A

Lyme disease

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27
Q

Tularemia causative agent

A

Francisella tularensis

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28
Q

Tularemia reservoir

A

furry “go get ‘em” guys: rabbits, hares, squirrels, voles, prairie dogs

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29
Q

Tularemia vector

A

dog tick
Rocky Mtn. wood tick
long star tick

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30
Q

Tularemia geographic distribtuion

A

worldwide and primarily in N. hemisphere

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31
Q

Tularemia peak incidience

A

april through october and peak in June/July

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32
Q

Tularemia trasnmission

A
  • handling infected animal tissues/fluids
  • bites from infected arthropods
  • direct contact
  • inhalation of infective aerosols
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33
Q

Ulceroglandular/Glandular Tularemia

A
  • MC form of tularemia
  • cutaneous papule forms at site of bite/inoculation
  • enlarged lymph nodes
  • pustule suppurates and ulcerates
  • eschar may form
  • glandular tularemia: similare presentation w/o ulceration
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34
Q

Oculoglandular tularemia Tularemia

A
  • occurs with inoculation into eye
  • ulcerated conjunctiva
  • preauricular node enlargment
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35
Q

Oropharyngeal Tularemia

A
  • ingestion of contaminated food/water
  • stomatitis, exudative tonsillitis, pharyngitis
  • lymphadenopathy of cervical or retropharyngeal nodes
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36
Q

Tularemia pneumonia

A
  • inhalation of contaminated aersols or from bacterial spread from local site to lungs
  • MUCH more serious and mortality rates of 30%
  • AKA lawnmower tularemia
  • ARDS
  • PNA w/ hilar LAD, dry cough, SOB, chest pain
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37
Q

Tularemia other types

A

typhoidal (systemic with fever, chills, diarrhea) and tularemic sepsis

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38
Q

Tularemia tularemic sepsis

A

severe and often fatal

SIRS occurs with shock and DIC

patient is toxic appearing and may become comatose

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39
Q

Tularemia management

A

Streptomycin: IM BID x 10days
Gentamicin: IM/IV once a day for ten days

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40
Q

Tularemia need to know

A

painful preauricular lymphadenopathy is hallmark of oculoglandular Tularemia

  • distingues if from cat scratch dz, TB, syphilis
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41
Q

Relapsing fever causative agent

A

Borrelia hermsii, B. parkeri, B. duttoni, B. miyamotoi

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42
Q

Relapsing fever vector

A

soft body ticks

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43
Q

Relapsing fever reservoir

A

humans

rodents

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44
Q

Relapsing fever geographic distribution

A

Western US: incl. WA

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45
Q

Relapsing fever clinical manifestations

A
  • Abrupt onset fever, chills, tachycardia, N/V, arthralgia, severe HA
  • HSM
  • Rashes: macular, papular petechial
  • Recurs every 1-2 weeks with 3 to 10 relapses
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46
Q

Relapsing fever febrile episodes

A
  • end with crisis collection of sx:
  • Chill phase: very high fever (106) with delirium, agitation, tachycardia
  • Flush phase: drenching diaphoresis, rapid decrease in body temp, transient hypotension
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47
Q

Relapsing fever diagnostics

A
  • spirochetes in blood smear during fevers
  • anti-borrelia antibody
  • CSF abnormalities if meningeal involvement
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48
Q

Relapsing fever complications

A

iritis
uveitis
cranial nerve and neuropathies

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49
Q

Relapsing fever pregnancy complications

A

spontaneous abortion
premature birth
neonatal bath

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50
Q

Relapsing fever DDx

A 
malaria
leptospirosis
meningococcemia
yellow fever
typhus
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51
Q

Relapsing fever tx

A

doxycycline
tetracycline
erythromycin

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52
Q

Dengue fever vector

A

mosquito

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53
Q

Dengue fever reservoir

A

human

nonhuman primates

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54
Q

Dengue fever geographic distribution

A

tropical

subtropical

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55
Q

Dengue fever clinical manifestations

A
  • acute febrile illness
  • rash
  • retroorbital HA
  • can progress to dengue hemorrhagic fever or dengue shock syndrome
  • see saddleback pattern with subsequent infections
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56
Q

Dengue hemorrhagic fever phases

A

febrile
critical
recovery

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57
Q

tourniquet test

A

Dengue fever

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58
Q

Febrile phase of Dengue Hemorrhagic fever

A

fever, HA, easy bruising, epistaxis, positive tourniquet test

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59
Q

Critical phase of Dengue Hemorrhagic fever

A
  • GI hemorrhage
  • plasma leakage into chest/peritoneal cavities
  • occurs after fever breaks
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60
Q

Recovery phase of Dengue Hemorrhagic fever

A
  • white islands in a sea of red rash

- pt begins to feel better

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61
Q

saddleback pattern

A

Dengue fever

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62
Q

white islands in a sea of red rash

A

Dengue fever

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63
Q

Dengue fever managment

A
  • supportive
  • acetaminophen
  • no NSAIDs due to thrombocytopenia
  • avoid mosquitoes
64
Q

Zika causative agent

A

zika virus of flaviviridae family

65
Q

Zika vector

A

Aedes aegypti, A. albopictus

66
Q

Zika reservoir

A

human

nonhuman primates

67
Q

Zika distribution

A

tropical/subtropical regions

68
Q

Zika clinical manifestations

A
  • acute febrile mosquito-borne illness
  • similar to and milder than dengue fever
  • 80% are ASx or afflicted with mild disease
  • microcephaly in pregnancy
69
Q

Zika male effects

A

detected in semen up to 3-6 months after initial infection

70
Q

Zika diagnosis

A

serological

71
Q

Zika treatment

A

Supportive

NSAIDs avoided until dengue ruled out

72
Q

Zika prevention

A
  • avoid mosquitos
  • transmitted by sex, blood transfusions, vertically
  • condoms for at least 8 weeks after return from Zika areas
73
Q

Ebola Hemorrhagic Fever causative agent

A

Ebola virus from family filoviridae

74
Q

Ebola Hemorrhagic Fever reservoir

A

fruit bats

75
Q

Ebola Hemorrhagic Fever geographic distribution

A

W. & C. Africa

76
Q

Ebola Hemorrhagic Fever transmission

A
  • dz of humans/primates with a very high mortality
  • consumption of bushmeat
  • human to human contact with bodily fluids
  • contact with dead infected bodies
77
Q

Ebola Hemorrhagic Fever clinical manifestations

A

Initial: flu-like then maculopapular rash
Severe: renal failure, DIC, hemorrhage
Hemorrhage: hematochezia, petechiae, ecchymosis, mucsal bleeding, hematemesis

78
Q

Fruit bats

A

Ebola Hemorrhagic Fever

79
Q

Ebola Hemorrhagic Fever diagnostics

A
  • ELISA, IgM/IgG, PCR
80
Q

Ebola Hemorrhagic Fever treatment

A
  • supportive

- experimental treatments and vaccines are being pursued

81
Q

Mosquito-Borne encephalitis: Western Nile Virus vector

A

Culex spp. mosquito

82
Q

Mosquito-Borne encephalitis: Western Nile Virus geographic distribution

A

worldwide

83
Q

Mosquito-Borne encephalitis: Western Nile Virus manifestations

A
  • ASx or flu-like
  • transient maculopapular rash
  • encephalitis in <1%
  • may have polio-like acute flaccid paralysis
  • mortality for neuroinvasive dz is 20%
  • 50% of survivors of encephalitis have neurological sequelae
84
Q

Mosquito-Borne encephalitis: Western Nile Virus treatment

A

supportive

85
Q

Mosquito-Borne encephalitis: Western Equine Encephalitis vector

A

mosquito

86
Q

Mosquito-Borne encephalitis: Western Equine Encephalitis geographic distribution

A

N. S. America: rural areas west of Mississippi

87
Q

Mosquito-Borne encephalitis: Western Equine Encephalitis manifestations

A
  • ASx or flu-like

- Neuroinvasive in 0.1%

88
Q

Mosquito-Borne encephalitis: Japanese Encephalitis vector

A

mosquito

89
Q

Mosquito-Borne encephalitis: Japanese Encephalitis geographic distribution

A

Asia

W. Pacific

90
Q

Mosquito-Borne encephalitis: Japanese Encephalitis manifestations

A
  • ASx or flu-like

- <1% neuroinvasive

91
Q

Mosquito-Borne encephalitis: Japanese Encephalitis treatment

A

Supportive

VACCINE AVAILABLE

92
Q

Mosquito-Borne encephalitis: Eastern Equine Encephalitis geographic distribution

A

N, C., S. America and Caribbean

93
Q

Mosquito-Borne encephalitis: Eastern Equine Encephalitis manifestations

A

Most severe mosquito borne illness in US

Mortality from neuroinvasive cases is 30%

94
Q

Hantavirus Pulmonary Syndrome transmission

A

inhalation of aerosolized virus from infected rodent excreta, saliva, urine

95
Q

Hantavirus Pulmonary Syndrome Clinical manifestations phases

A

prodromal, cardiopulmonary, convalescent

96
Q

Hantavirus Pulmonary Syndrome cardiopulmonary phase (lasts 24-48hrs)

A

severe dyspnea
cough
pulmonary edema
circulatory collapse

ventilation required

97
Q

Hantavirus Pulmonary Syndrome convalescent phase

A

begins with onset of massive diuresis

98
Q

Four corners area, Hanford, Tricities location

West of mississippi

A

Hantavirus Pulmonary Syndrome

99
Q

Hantavirus Pulmonary Syndrome management

A

Early tx in ICU for cardiopulmonary phase

Antiviral ribavirin may help some in early stages

100
Q

Sin nombre virus

A

Hantavirus

101
Q

Plague causative agent

A

yersinia pestis

102
Q

Plague vector

A

rat flea

103
Q

Plague reservoir

A

rats, mice, rodents, foxes, coyotes, wild cats

104
Q

Plague geographic distribution

A

SW US, S. America, Africa, Asia

105
Q

Plague: Bubonic plague

A
  • MC form of dz
  • lymphadenopahthy from replication (bubo)
  • bubos ulcerate and open
  • blood cots leading to arteriolar obstruction and acral gangrene: black death
106
Q

Plague: Pneumonic plague

A
  • inhale aerosolized Y. pestis bacilli
  • hematogenous spread to pneumonia, hemoptysis, malaise, myalgias
  • rapid decline 24 hrs from onset with DIC, circulatory shock, resp. failure
107
Q

Plague: Speticmic Plague

A

sudden onset of febrile illness w/o bubo formation
rapid onset of hypotension and shock
very high mortality rate

108
Q

Plague treatment

A

Streptomycin, Gentamicin

109
Q

Rabies reservoir

A

all mammals - mostly common in bats, raccoons, skunks, foxes

MC worldwide cause of rabies: DOGS

110
Q

Rabies infection

A

wound severity, wound location in relation to nerves, and relative distance from the brain decides the risk of infection

111
Q

Rabies geographic distribution

A

worldwide

IN US: MCC by wild animals BATS and not dogs as they’re vaccinated

112
Q

Rabies general characteristics

A

Devastating, fatal viral encephalitis

Contracted in a scratch or bite from infected saliva

Corneal transplant

113
Q

Rabies clinical manifestations

A
  • Once Sx present, invariably fatal
  • pain, pruritis, or paresthesias at bite/scratch
  • prodromal
  • hydrophobia: foam at mouth
  • coma and death
114
Q

Rabies types

A

furious rabies

paralytic rabies

115
Q

Furious Rabies

A
  • MC
  • hyperactivity
  • disorientation
  • aggressive, bizarre behavior
  • excessive salivation

Acting like a crazed animal

116
Q

Paralytic Rabies

A
  • lethargic
  • loss of coordination
  • confusion
  • stupor
  • ascending paralysis
117
Q

Rabies diagnosis

A

Negri bodies histologically

118
Q

Rabies treatment (post-exposure)

A
  • clean wound with soap/water
  • wild animals: capture if can, destroy, and lab histology preformed
  • healthy animal in an endemic area: capture and quarantined for ten days
119
Q

Rabies treatment (post-exposure) hospital management

A

passive immunization: rabies immunoglobulin into wound and glute
active immunization: administer anti-rabies vaccine 3x IM

120
Q

DOG

A

Rabies

121
Q

Cat Scratch Disease: causative agent

A

Bartonella henselae

122
Q

Cat Scratch Disease: vector

A

cat flea

123
Q

Cat Scratch Disease reservoir

A

cat

kittens more likely to carry bacteria

124
Q

Cat Scratch Disease transmission

A

cat is infected and then infects a human

125
Q

Cat Scratch Disease clinical manifestations

A
  • small papular/nodular lesion
  • linear papules/nodules
  • Rare/severe: meningitis, osteomyelitis, endocarditis
  • parinauds oculoglandular
  • HIV/AIDS can get peliosis hepatitis or bacillary angiomatosis
126
Q

Parinaud’s oculoglandular syndrome of Cat Scratch Disease

A

granulomatous conjunctivitis with preauricular lymphadenopathy

127
Q

Cat Scratch Disease treatment

A

azithromycin

128
Q

Pateurella multocida: gram stain

A

gram negative encapsulated rod

causes infections in wounds related to dogs/cats

129
Q

Pateurella multocida pathogenesis/epidemiology

A

normal flora of most animals
transmission is through bite
don’t suture the wound close as is an anaerobe

130
Q

Pateurella multocida clinical manifestations

A
  • rapidly spreading cellulitis at site of bite
  • complicate to osteomyelitis
  • cat bites esp. problematic due to sharp needle teeth
131
Q

cellulitis

A

Pateurella multocida

132
Q

Pateurella multocida management

A

amoxicillin-clavulanate

133
Q

Chagas disease causative agent

A

Trypanosoma cruzi

134
Q

myocarditis

A

Chagas disease

135
Q

Chagas disease vector

A

reduviid/kissing/assassin bug

136
Q

Chagas disease reservoir

A

opossums, raccoons, armadillos, rodents

137
Q

Chagas disease geographic area

A

endemia in mexico, C./S. America, southern states

138
Q

Chagas disease transmission

A

tropical parasitic zoonoitc infection in feces of vectors

also via blood transfusion, congenitally, organ transplantation, consumption of contaminated food/water

139
Q

Chagas disease acute manifestations

A
  • often mild/ASx
  • chagoma: localized erythema/edema where parasite entered
  • romana sign: painless palepbral edema and conjunctivitis
140
Q

costa rica

A

Chagas disease

141
Q

Chagas disease intermediate/chronic phase

A

may last years to decades before chronic phase

142
Q

Chagas disease chronic

A 
1/3 of pts
dilated cardiomyopathy
megaesophagus
achalasia
megacolon
neuritis
143
Q

new parrot

pet store owner

A

psittacosis

144
Q

Psittacosis causative agents

A

chlamydia psittaci

145
Q

Psittacosis reservoir

A

birds

146
Q

Psittacosis transmission

A

inhaled aerosolized feces of birds

147
Q

Psittacosis clinical manifestations

A 
Severe HA
Pneumonia
Photophobia
HSM
hepatitis
DIC
148
Q

severe HA with pneumonia

A

Psittacosis

149
Q

Psittacosis diagnostics

A

CXR: lower lobe consolidation
Mild leukocytosis with left shift
Elevated AB titers
Increased LFTs

150
Q

Psittacosis treatment

A

doxycycline
tetracycline
rapid improvement w/in 24 hrs of ABX

pregnant: azithromycin

151
Q

Brucellosis resevoir

A 
sheep
swine
cattle
dogs
bison
152
Q

Brucellosis distribution

A

worldwide

153
Q

Brucellosis transmission

A

raw milk

unpasteurized cheese

154
Q

Brucellosis clinical manifestations

A
  • Bone and joint involvement
  • Chronic disease >1 yr
  • May relapse/reoccur w/o proper ABX tx
155
Q

Brucellosis treatment

A

ciprofloxacin + doxycycline or ciprofloxacin + rifampin

Infectious Disease (8 decks)

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