Zoos

Question 1

Ddx of purulent inguinal nodes?

Answer 1

(BCLAT)Bartonella Henslae, Tick borne tularemia (glandular), Chancroid, staph aureus, lymphogranuloma venereium

Question 2

Clinical findings, tx, of cat scratch disease?

Answer 2

B.Henselae with 80% <21 year old acute suppurative lymphadenitis proximal to bite, scratch, lick of young cat. Can see encephlaitis, stellate retinitis (lipid exudates forming macular star on optho). Tx with azithromycin

Question 3

microbiological features of bartonella?

Answer 3

slow growing weakly gram negative rod

Question 4

Clinical features of B.Bacilliformis?

Answer 4

Andes, Peru, sand fly bite. Oroya fever(initial)–>verruga peruana (hemangioma- like nodules in skin/mucous membranes). Tx: Ciprofloxacin (Oroya); Azithro (vp)

Question 5

What would you see on biopsy for cat scratch lymphadenopathy?

Answer 5

lymph node shows central abscess formation surrounded by palisaded histiocytes

Question 6

what does bartonella quintana do/vector?

Answer 6

Pediculus humanus var. corporis causing bacteremia in the homeless, endocarditis, trench fever - The disease is classically a five-day fever of the relapsing type, rarely exhibiting a continuous course. The incubation period is relatively long, at about two weeks. The onset of symptoms is usually sudden, with high fever, severe headache, pain on moving the eyeballs, soreness of the muscles of the legs and back, and frequently hyperaesthesia of the shins.

Question 7

what are the HIV associated bartonella species?

Answer 7

Bacillary cutaneous angiomatosis (henselae or quintana), Bacillary peliosis (henslae), lytic osteomyelitis (quintana),

Question 8

features of bacillary peliosis?

Answer 8

caused by b.Henslae, also known as hepatosplenic bacillary peliosis. See on CT hypodense center +/- contrast enhancing rim with blood filled spaces on warthin starry stain. Peliosis hepatis is an uncommon vascular condition characterised by multiple, randomly distributed, blood-filled cavities throughout the liver

Question 9

skin finding for anthrax?

Answer 9

pruritic paule on skin with ulceration, little vesicules form around ulcer.

Question 10

microbio features of anthrax?

Answer 10

aerobic encapsulated gram positive bacilli

Question 11

microbio features associated with tularemia?

Answer 11

GN cocobacillus

Question 12

who gets Tularemia?

Answer 12

farmers, veterinarians, hunters skinning animals

Question 13

what symptoms is suggestive of tularemia?

Answer 13

ulceroglandular>glandular»oculoglandular, pharyngeal, typhoidal, pneumonic

Question 14

who gets pneumonic tularemia?

Answer 14

bioterroism, landscapers, mowers

Question 15

how would you diagnose tularemia?

Answer 15

via serology. needs chocolate agar

Question 16

tx of tularemia? prophylaxis drug?

Answer 16

streptomycin, gentamycin, cipro in milder case. Prophylaxis is with doxycycline

Question 17

vector/host for plague?

Answer 17

rodent flea bite/praire dogs

Question 18

Endemic plague locations?

Answer 18

New Mexico, California, Arizona, colorado

Question 19

symptoms of plague?

Answer 19

fever, nausea, swollen painful lymph nodes

Question 20

microbio of the plague?

Answer 20

yersinia pestis is a gram negative coccobacillus with bipolar staining bacilli with safety pin appearance

Question 21

treatment of plague?

Answer 21

streptomycin»doxy,cipro

Question 22

how do you get leptispirosis?

Answer 22

spirochetes excrete in urine, survive in water. Exposed intact skin to animal urine (cow, pigs, dogs, racoons, rats, mice) in summer and early fall

Question 23

Key symptoms of leptospirosis?

Answer 23

Fever, myalgia, headache, CONJUNCTIVAL SUFFUSION +/-rash (red conjunctiva with jaundice eyes, no inflammatory exudate)

Question 24

Treatment of leptospirosis?

Answer 24

outpatient = doxycycline, inpatient IV penicillin

Question 25

how do you get brucellosis?

Answer 25

exposure to unpatureized cheese, uncooked meat.

Question 26

early symptoms of brucellosis?

Answer 26

acute/indolent onset fever, aches, with hepatosplenmoegaly.

Question 27

late symptoms of brucellosis?

Answer 27

bone, liver, SACROILLITIS, tendons, CNS

Question 28

Treatment of brucellosis?

Answer 28

doxycycline + rifampin or monotherapy strep/gent. Bacrtrim in kids/pregos

Question 29

Lab findings in brucellosis?

Answer 29

WBC normal/low, anemia, thrombocytopenia

Question 30

Acute treatment of Q fever?

Answer 30

doxycycline or levofloxacin or azithromycin

Question 31

chronic treatment of q fever?

Answer 31

doxycycline + hydroxychloroquine

Question 32

how do you get Q fever?

Answer 32

inhale spores from farm animals/cats in straw, manure, parturient tissue.

Question 33

symptoms of Q fever?

Answer 33

acute pneumonia, chronic endocarditis, granulomatous hepatitis

Question 34

wild game, tick on wild game, squirrles, beavers zoonotic

Answer 34

Tularemia

Question 35

eating unpateurized cheese from overseas zoonotic

Answer 35

brucellosis

Question 36

handling overseas animal hides/hairs zoonotic

Answer 36

anthrax

Question 37

animal urine on intact skin zoonotic

Answer 37

leptospirosis

Question 38

culture negative endocarditis in a homeless patient? zoonotic

Answer 38

bartonella quintana

Question 39

culture negative endocarditis in patient with animal exposure? zoonotic

Answer 39

coxiella burnetti

Question 40

tender lymph node with zoonotic?

Answer 40

bartonellosis, tularemia, plague

Question 41

sacroiliits zoonotic association?

Answer 41

brucellosis

Question 42

Slaughterhouse, veterinations, cats giving birth zoonotic association?

Answer 42

q fever

Question 43

fever and jaundice zoonotic

Answer 43

leptospirosis