Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BIIC > Zoonotic Infections > Flashcards

Zoonotic Infections Flashcards

1
Q

Bartonella species zoonotic infections

A 
1. Characteristics
  A. Gram (-) bacilli
  B. Aerobic
  C. Intracellular pathogen of blood and reticuloendothelial cells (RES)
  D. Motility varies w/ species
2. Epidemiology 
  A. Most species worldwide
    1. Exception: B. Bacilliformis only in S. America
  B. Hosts: 
     1. B. Bacilliformins: humans
     2. B. Quintana: humans
     3. B. Henselae: cats 
  C. Vectors: 
     1. B. Bacilliformins: sandfly
     2. B. Quintana: body louse
     3. B. Henselae: cat flea?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

B. Bacilliformis

A
  1. Only S. America
  2. Biphasic disease
    A. Oraya fever (acute)
    B. Verruga (chronic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Oraya fever

A 
B. Bacilliformis- acute infection  
1. Sandfly bite
2. Multiplication in blood stream
3. RBC fragility 
4. Clearance of RBCs by RES -> oraya fever
5. Presentation
  A. Incubation period ~3wks 
  B. Fever
  C. Malaise
  D. Myalgia
  E. Headache
  F. Rapidly worsening anemia 
  G. Andes mountains of Peru, Columbia, and Ecuador
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Verruga

A

B. Bacilliformis - chronic infection
1. Presentation
A. Red-purple skin lesions (wart-like)
B. Recurrence/persistence months to yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

B. Quintana zoonotic infections

A
  1. Trench fever (described WWI)
  2. Transmission: body louse feces
  3. Multiply in RES cells
  4. Presentation
    A. Severe headache
    B. Sudden onset fever
    C. Weakness
    D. Rash
    E. Pain in long bones
    F. 5 day fever recurrence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

B. Henselae zoonotic infections

A
  1. Cat scratch fever
  2. Infect RES and lymph nodes
  3. Bacteremia and septicemia can occur in immunocompromized pts
  4. Often benign in kids
  5. Presentation
    A. 3-50 days chronic regional lymphadenopathy: can last for months
    B. Mild fever/malaise 50% cases
    C. Systemic disease rare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Bacillary angiomatosis

A
  1. Usually immunocompromized pts
  2. B. Henselae
    A. Skin (superficial)
    B. Liver
    C. Lymph nodes
    D. Spleen
  3. B. Quintana
    A. Skin
    B. Sub-q tissue
    C. Bone
    D. Less systemically dangerous
  4. Dx
    A. History
    B. Serology: DFA or IFA
    C. Rarely cultured: hard to grow
    D. PCR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pasturella multocida

A
  1. Dog and cat bites
  2. Cellulitis
  3. Osteomyelitis
  4. Presentation
    A. Hx of bite
    B. Acute onset redness, pain, swelling
  5. Gram (-) coccobacilli
  6. Aerobic or facultative aerobe
  7. Oxidase+/catalase+
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Leptospirosis interrogans zoonotic infections

A
  1. Animal urine
  2. Two main human diseases
    A. Leptospirosis
    1. Fever
    2. Chills
    3. Headache
    4. Vomiting
    5. Rash
      B. Weil disease (ictohemorrhagic leptospirosis)
    6. Jaundice
    7. Conjunctival injection
    8. Pet rats
    9. Liver and kidney failure
  3. Spirochete
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ixodes tick

A

Coinfection possible

  1. Lyme disease- Borrelia burgdorferi
  2. Anaplasmosis- anaplasma phagocytophilum
  3. Babesiosis- babesia microti
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Lyme disease

A 
Borrelia burgdorferi
1. Stage 1: early localized 
  A. Bullseye rash (erythema migrans)
  B. Flu-like illness
    1. Fever/chills
    2. Malaise
2. Stage 2: early disseminated 
  A. Arthralgia/arthritis: wks to no later
  B. Facial nerve paralysis
  C. Cardiac disease: rare
3. Stage 3: late chronic
  A. Months to years later
  B. Chronic skin, nervous system, and joint involvement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Relapsing fever

A

Borrelia burgdorferi

  1. Transmitted by body lice
  2. Fever 3-5 days
  3. Afibrile 4-10 days
  4. 2nd fever attack
  5. Repeats 3-10 fever recurrences
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Anaplasma phagocytophilum

A
  1. Human granulocyte anaplasmosis
  2. Obligate gram (-) intracellular
  3. Infects
    A. Leukocytes
    B. Erythrocytes
    C. Platelets
  4. Morulae
  5. Incubation 5-21 days
  6. Rarely severe/fatal
  7. Nonspecific presentation
    A. Fever/chills
    B. Myalgia
    C. Vomiting
    D. Flu-like
    E. Wt loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Babesiosis

A
  1. Babesia microti
  2. Tick vector
  3. Incubation 7-10 days
  4. Presentation
    A. Fever
    B. Malaise
    C. Fatigue
    D. Sweats
    E. Nausea
  5. More severe elderly and young
  6. Can be mistaken for malaria
  7. Blood smear
    A. Maltese cross/tetrad = diagnostic
    B. Rings very similar to malaria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Erlichia chaffeensis

A
  1. Human monocyte erlichiosis
  2. Lone star tick
  3. Ambylomma americanum
    A. Obligate intracellular
    B. Gram (-)
    C. Prefer monocytes
    D. Morulae
    E. Incubation 5-21 days
    F. Can be severe/fatal
    G. Nonspecific presentation
    1. Fever/chills
    2. Myalgia
    3. Vomiting
    4. Flu-like
    5. Wt loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Rocky Mountain spotted fever

A 
Rickettsia rickettsii 
1. Most serious tick-Bourne disease
2. 50% fatal
3. Presentation
  A. Rash 2-4 days after fever (systemic vasculitis)
    1. Includes palm and soles
  B. Headache
  C. Nausea/vomiting
  D. Mausoleum pain
  E. Anorexia 
4. Multiply in endothelial cells of small vessels
17
Q

Rickettsia prowazekii

A 
1. Vectored by human lice
  A. Homeless population 
2. Epidemic typhus, 6-30% fatal
3. Presentation 
  A. Fever
  B. Chills 
  C. Malaise
  D. Rash
    1. Spares palms and soles 
    2. Begins trunk and spreads out
18
Q

Rickettsia typhi

A 
“Murine typhus”
1. Vectored by fleas
  A. Rodent probs
2. Presentation 
  A. Fever
  B. Chills 
  C. Malaise
  D. Rash
    1. Spares palms and soles 
    2. Begins trunk and spreads out
19
Q

Rickettsia characteristics

A
  1. Technically gram (-) but doesn’t gram stain well
  2. Giemsa stain
  3. Intracellular coccobacilli
  4. Immunofluorescence or IHC used in dx
20
Q

Approach to bite management

A 
1. Ensure neurovascular status
  A. Look for bone and/or joint involvement 
2. Ensure tetanus vaccine status
3. Treat/prevent infection
  A. Rabies 
    1. Vaccine + immunoglobin if no prior vaccine
    2. Only vaccine if prior vaccine and whole series completed 
  B. Antibiotics targeted at specific pathogens 
    1. Most common: amoxicillin-clavulonic acid orally
    2. IV antibiotics
       A. Bone/joint involvement
       B. Significant tissue injury 
4. Wound care 
5. Closure: usually left open to heal
  A. Exceptions: facial wounds
  B. Never close on hands/feet
  C. Not human or cat bites
  D. Can close superficial dog bites
  E. Criteria 
    1. Uninfected 
    2. <24 hrs old
    3. Not hand/foot
    4. Not immunocompromised
21
Q

Human bites

A
  1. 10-34 y/o group
  2. Summer, weekends
  3. Breast bites associated w/ sexual abuse
  4. Arm bites >2.5 cm associated w/ child abuse
  5. Categories
    A. Clenched fist injuries (CFIs)
    1. Typically fight bites
      B. Occlusive: most common in kids
    2. Lower infection rate than adults
    3. Still need antibiotics
  6. Bacteria
    A. Staph and strep most common
    B. Bactericides and corynebacterium
    C. Eikinella corrodens
    1. Cause 30% infected bites
    2. Resistant most antibiotics
      A. Clindamycin
      B. Erythromycin
      C. Antistaphylococcal penicillins
      D. 1st generation cephalosporins
    3. Tx: amoxicillin-clavulonic acid
    4. Cause blood culture (-) endocarditis
22
Q

Cat bites

A
  1. F>M
  2. Upper extremity, hands, and fingers
  3. 80% own pet
  4. Sharp narrow teeth can break off
  5. 80% infected (12-24 hrs)
    A. Osteomyelitis and joint injury, abscesses
    B. Pasturella multocida
    1. 31% mortality rate from sepsis
      C. Cellulitis (50%)
      D. Tenosynovitis (20%)
    2. Requires surgery
      E. Osteomyelitis (15%)
      F. Abscess (11%)
    3. Requires drainage
  6. Obtain X-rays
  7. Cat scratch fever
    A. Bartonella henselae
    B. Antibiotics usually ineffective but given anyway
    C. Avoid incision and drainage
23
Q

Dog bites

A
  1. 4.5 million/yr in US
  2. Males 5-9 y/o
  3. Arms and hands: adults
  4. Face, head, and neck: kids
    A. Inc risk life-threatening injury and cosmetic defect
    B. Death
    1. Carotid avulsion
    2. Penetrating skull injury
    3. Brain injury
    4. Meningitis
  5. Excerpt up to 400lbs/in^2 -> crush injuries
    A. Contusion w/o penetrating skin
    1. Consider compartment syndrome
      B. Hand = inc infection and morbidity
    2. Tenosynovitis
    3. Septic arthritis
    4. Abscesses
    5. Traumatic digit amputation
  6. Infection: 30% bites
    A. Pasturella
    B. Staph
    C. Strep
    D. Neisseria
    E. Moraxella
    F. Bacteroides
    G. Fusobacterium
    H. Capnocytophaga canimorsus
    1. Usually immunocompromised
    2. Mortality: 30%
      A. Endocarditis
      B. Meningitis
      C. Sepsis
  7. X-rays
24
Q

Snake bites

A 
1. Inc mortality
  A. SE Asia
  B. India
  C. Brazil
  D. Africa
2. 45,000 bites/yr in US
  A. 8,000 venomous 
  B. 10 deaths 
  C. 2015 Idaho: 8 bites reported 
  D. 1983-2011: only 31 deaths rattlesnake bites 
3. Most deaths young, elderly, and inappropriately treated pts 
4. Toxic snakes
  A. Vipers (crotalids)
  B. Elapids 
5. Inc incidence: NC, AR, TX, and GA
6. 97% lower extremity
25
Q

Viper (crotalid) bite presentation

A
  1. Rattlers
  2. Copperheads
  3. Severity varies
  4. 25% dry bites = no venom
    A. No oozing at site
  5. Locally cytotoxic venom
    A. Cell injury
    1. Pain
    2. Swelling
    3. Ecchymosis
    4. Hemorrhagic bullae
    5. Necrosis
    6. Compartment syndrome rare
      B. Systemic
    7. Nausea
    8. Fatigue
    9. Fasciculations
    10. Metallic taste
    11. DIC
    12. Pulmonary edema
    13. Shock
    14. Death (usually prox bites)
    15. Possible muscle necrosis
      C. IgE mediated anaphylaxis
      D. Gram (-) infections
26
Q

Viper (crotalid) bite management

A 
1. Antivenin ASAP
  A. Indications
    1. Progression local injury
    2. Coagulopathy 
    3. Systemic effects 
  B. Dose dependent on symptoms 
  C. ADRs
     1. Anaphylaxis 
     2. Serum sickness
     3. Febrile response
2. Constriction band, no tourniquets 
3. Infection prevention 
4. Pain meds
27
Q

Elapid bites

A
  1. Coral snakes
  2. Spitting cobra
  3. Black mamba
  4. Bites uncommon (Usually fingers, climbers)
  5. Venom= neurotoxic
    A. Binds ACh receptors irreversibly
    B. Symptoms
    1. Ptosis
    2. Paresthesia
    3. Double-vision
    4. Dysphasia
    5. Aphasia
    6. Descending paralysis/muscle weakness
    7. CN dysfunction
    8. Resp failure (COD)
      C. Management
    9. Antivenin if severe
    10. Usually supportive care
28
Q

Gila monster bites

A 
1. Presentation - local
  A. Pain
  B. Swelling
  C. Weakness
  D. Hypotension w/ severe bites 
2. Neurotoxic venom
  A. Glands along lower jaw
3. No reported deaths
4. Can cause MI
5. Gram (-) infection
29
Q

Brown recluse bites

A
  1. Dark, quarter sized
  2. Woodpiles, cellars
  3. Inc toxic very young and elderly
  4. Presentation
    A. Initially painless
    B. Volcano lesion
    C. Ischemic necrosis
    D. Hemolysis
    E. Thrombocytopenia
    F. Renal failure
  5. Tx
    A. No ice
    B. Dapsone
    1. Not in G6PD pts
      C. Hyperbaric chamber
      D. Surgical debridement
      E. No antivenin typically
30
Q

Black widow bites

A
  1. Red hourglass
  2. Outhouses, dumps, woodpiles
  3. Aggressive
  4. Toxin = latrotoxin
    A. Destabilized neuronal mem by opening ionic channels -> ACh depletion
  5. Presentation
    A. Immediate pain
    B. Target lesion at site
    C. Nausea
    D. Vomiting
    E. Abdominal cramping
    F. Severe muscle spasms
    G. Cardiac arrhythmias
  6. Tx
    A. Ice
    B. Pain meds
    C. Calcium gluconate
    D. Benzodiazepines IV
    E. Antivenin for systemic symptoms
31
Q

Scorpion stings

A
  1. Only dangerous ones in US in AZ
  2. Nocturnal: under rocks, logs, floor crevices
  3. Several proteins in venom
    A. Neurotoxin -> repetitive axon firing by activating Na+ channels
  4. Presentation
    A. Local
    1. Immediate pain
    2. Edema
    3. Erythema
    4. Numbness
    5. Weakness
    6. Tapping on site = severe pain
      B. Systemic
    7. Anxiety
    8. Restlessness
    9. Spasms
    10. Nausea
    11. Vomiting
    12. Xs salivation
    13. Sweating
    14. Hyperthermia
    15. Roving eye movements
    16. Myoclonus
    17. Priapism
    18. HTN
    19. Hemiplasia
    20. Syncope
    21. Cardiac arrhythmias
    22. Resp arrest
  5. Tx
    A. Ice
    B. Pain meds (opiates)
    C. Benzodiazepines IV
    D. Nitroprusside for HTN
    E. Antivenin: only for severe
32
Q

Hymenoptera stings

A 
Bees, wasps, and fire ants 
1. Toxicity from body’s response to venom
  A. Local skin rxn
    1. Irritation
    2. Itching 
    3. Redness
    4. Swelling
    5. Immediate pain
  B. Allergic rxn
    1. Anaphylaxis most severe
       A. IgE mediated 
       B. W/in 30 min of sting 
       C. CV collapse
         1. Ischemia
         2. Hypotension/shock
         3. Arrhythmias 
       D. Resp compromise
          1. Laryngeal edema
          2. Bronchospasm
          3. Strider
  C. Delayed rxn: ~10 days after 
     1. Serum sickness-like 
  D. Delayed systemic toxicity 
     1. Delayed 8-24 hrs
     2. Multi-organ failure
        A. DIC
        B. AKI
        C. Neurologic symptoms 
2. Tx 
  A. Ice
  B. Pain meds
  C. IV antihistamines
  D. IV corticosteroids 
  E. IV NSAIDS
33
Q

Marine animal stings

A 
Jellyfish (nematocysts), sting rays, and urchins
1. Venom
  A. Local skin rxn
    1. Isolated except box jellyfish
    2. Intense pain
  B. Nausea/vomiting
  C. Diarrhea
  D. Cramping
  E. Resp arrest = box jellyfish
    1. Most lethal 
2. Management
  A. Pluck out stinger, no scrubbing
    1. Ensure no foreign bodies 
  B. Hot water 90 min
  C. Vinegar may help
  D. Topical lidocaine 
  E. Stingray lacerations 
    1. Repair +/- antibiotics 
       A. Cover vibrio, gram (-) rod
          1. Necrotizing fasciitis and sepsis 
          2. Ciprofloxacin, tetracycline, sulfamethoxazole/trimethoprim
34
Q

Scabies infestations

A

Sarcoptes scabiei
1. Burrow under skin, ID w/ magnifying glass
2. Deposit eggs and larvae
3. Lesions isolated or widespread
A. Confused for: impetigo, atopic dermatitis, drug eruption
4. Tx: permethrin cream
A. Contraindicated in young - neurotoxin

35
Q

Bed bug infestation

A
  1. Hard to clear house of
  2. Feed off blood
  3. Presentation
    A. Red, itchy papule
  4. Fumigation and wash/toss bedding/clothes
36
Q

Carpet beetle infestations

A 
Similar to bed bugs 
1. Possible dermatitis
2. Papulovesicular rash
  A. Intensely pruritic
  B. Can become bullous 
3. Management same as bed bugs
37
Q

Flea infestations

A
  1. Usually cause symptoms in people sensitive to them
  2. Complications/infection caused by scratching -> secondary infection
  3. Prevent thru treating pets and fumigation
  4. Rash similar to lice, mites, and scabies
    A. Typically on ankles and waist line
    B. Can be hemorrhagic
38
Q

Head lice (pediculosis)

A
  1. Scalp hair, body, genitalia
  2. Most common infestation in US
  3. Kids 3-12 y/o
    A. 40% kids affected
  4. Symptoms
    A. Intense pruritus
    B. Red maulers or wheals
  5. DDx
    A. Tines
    B. Seborrheic dermatitis
    C. Atopic dermatitis
    D. Eczema
    E. Scabies
    F. Folliculitis
    G. Contact dermatitis
  6. Dx: ID lice/nits on hair shaft
  7. Tx: permethrin 1%
    A. Repear 1 wk
    B. Remove nits
    C. Clean everything cloth
    D. AAP recommends kids don’t miss school

BIIC (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions