Term
| What is the Agent in Malaria? |
|
Definition
Plasmodium sp.
-P. Vivax
-P. falciparum
-P. ovale
-P. malariae |
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Term
| What is the vector for malaria? |
|
Definition
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Term
| What are the symptoms of malaria? |
|
Definition
| High fevers, shaking chills, sweats, flu-like symptoms, headache, and anemia (dependent on species) |
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Term
| How is Malaria Diagnosed? |
|
Definition
| Microscopic examination; serologic tests |
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Term
| Malaria is the _____ biggest cause of death from infectious diseases world wide |
|
Definition
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Term
| Use one word to describe fevers due to malaria |
|
Definition
| cyclic. Each different type of malaria presents with a fever that follows a different cyclical pattern (the fever spikes when the cells are dividing) |
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Term
| In order to protect themselves from malaria, travelers receive chemoprophylaxis which is ________ weekly starting 1 week before arrival and continuing 4 weeks after departure. What are 3 other drug options if the area you are traveling to is resistant to the above mentioned drug? |
|
Definition
-chloroquine
-Atovaquone-proguanil, doxycycline, mefloquine |
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Term
| What are 4 protective measures one can take against contracting malaria? |
|
Definition
-mosquito nets while sleeping
-dwellings with screens
-wear protective clothing
-mosquito repellent (DEET) |
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Term
| What are 5 examples of Arboviral Infections? |
|
Definition
-eastern equine encephalitis (EEE)
-western equine encephalitis (WEE)
-St. louis encephalitis (SLE)
-lacrosse encephalitis (LAC)
- West nile virus encephalitis |
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|
Term
| At what time of year is arboviral encephalitis most common? |
|
Definition
often occurs from June through September, when arthropods are most active
in milder parts of the country, where arthropods are active late into the year, cases can occur into the winter months |
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Term
| What are the symptoms of arboviral infections? |
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Definition
-majority of human infections are asymptomatic or may result in a non-specific flu-like syndrome
-onset may be insidious or sudden with fever, HA, myalgias, and malaise
-Infection can lead to encephalitis, with a fatal outcome or permanent neurologic sequelae |
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Term
| How are arboviral infections diagnosed? |
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Definition
| serologic tests; IFA/EIA (enzyme-linked immunosorbent assay) for IgG/IgM |
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Term
| What is the tx for arboviral infections? |
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Definition
| Supportive care, reduce swelling of the brain; antibiotics are not effective and no effective antiviral drugs have yet been discovered |
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Term
| St. Louis Encephalitis is predominantly seen in states bordering the _______ River |
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Definition
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Term
| In what demographic is LAC typically seen? What is characteristic of the encephalitis that it can cause? |
|
Definition
-younger children
-can cause a very severe encephalitis that can go on to have long term sequelae, it effects the nervous system and the pt's never really fully recover |
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Term
| What state had the highest prevalence of West Nile Virus in 2010? |
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Definition
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Term
| What are the three groups of bacterial infections? |
|
Definition
-mycobacterial disease (TB)
-spirchetal disease
-bacteria |
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Term
| What are the two different forms of mycobacterial disease? |
|
Definition
-Tuberculosis
-Atypical mycobacterial disease (TB that is nonhuman but humans can still get it) |
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Term
| What is the leading cause of infectious disease mortality worldwide? What fraction of the world population is infected? |
|
Definition
Tuberculosis
1/3 of the world population is infected |
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Term
| During what decade was there a resurgence in the US of TB? |
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Definition
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Term
| What population is at a much higher risk of becoming infected with TB? |
|
Definition
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Term
| What is the fatality rate for untreated TB? |
|
Definition
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Term
|
Definition
| mycobacterium tuberculosis |
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|
Term
| If you thought you were exposed to TB, would you go get a TB test the following day and expect it to be accurate? |
|
Definition
| No. Tuberculin reactivity 2-12 weeks after initial infection |
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Term
| What is the transmission of TB? |
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Definition
| Via microscopic droplets released into the air by a person with active TB who coughs, speaks, sneezes, spits, laughs, or sings |
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Term
| What are the symptoms of latent TB and active TB? |
|
Definition
-latent: bacteria remain inactive and cause no symptoms, not contagious
-active: symptomatic and contagious: cough, unexplained weight loss, fatigue, fever, night sweats, chills, loss of appetite |
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Term
|
Definition
| PPD tuberculin skin test; followed with a chest x-ray; culture identification of MTB from induced sputum |
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Term
What is the treatment for TB? What are 4 things that the exact drugs and length of treatment depend on?
-How long is the antibiotic treatment?
-what are 4 possible antibiotics to use? |
|
Definition
-exact drugs and length of treatment depend on age, health, possible drug resistance, the form of TB (latent or active) and its location in the body
-Antibiotics for at least six-nine months
-Isoniazid (INH); Rifampin; Ethambutol; Pyrazinamide |
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Term
| Most people with active TB who have had appropriate drug treatment for at least two _______ are no longer contagious |
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Definition
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|
Term
| Who is more likely to have TB in the US, US born persons or foreign born persons? |
|
Definition
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|
Term
| What is the "face" of the TB patient in TN? |
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Definition
| The face of the TB patient in TN is the old white man who comes in with a cough. Most likely he was exposed young, never knew, as he aged he's become immunocompromised and the bacteria was able to overcome his immune system |
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Term
| What are three complications with TB and antibiotic use: are the antibiotics effective? how long must they be taken to be effective? What does improper use lead to? What type of therapy works best? |
|
Definition
-antibiotics are effective, but must be taken for several months; additionally side effects lead to compliance issues
-improper use of antibiotics lead to resistance, including multi drug resistance, mortality rate 50%
-Directly observed therapy (DOT) works best to prevent antibiotic resistance |
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Term
| Multidrug resistant TB (MDR TB) is resistant to at least _____ of the 1st line TB drugs |
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Definition
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Term
| Extensively drug-resistant TB (XDR TB) is resistant to _______ and __________ plus at least ____ of the 2nd line drugs |
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Definition
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Term
| What is the agent in atypical mycobacterium disease? |
|
Definition
| any non tuberculosis mycobacteria (NTM) |
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Term
| NTM are ubiquitous in nature and found in ______,______,_____,and _______. Approx how many species are there? Is there evidence of person to person transmission? |
|
Definition
-soil, food, water, and animals
-100 species
-no evidence of person to person transmission (many cases transmitted from bird to human) |
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|
Term
What are the symptoms of atypical mycobacterium disease?
clinical presentation varies by _________ and _____ of______ |
|
Definition
fever, night sweats, weight loss, abdominal pain, fatigue
clinical presentation varies by species and site of entry |
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Term
| How is atypical mycobacterium disease diagnosed? |
|
Definition
| culture from a sterile site |
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Term
| WHat does the treatment for atypical mycobacterium disease depend on? |
|
Definition
| Exact drugs and length of treatment depend on species, drug susceptibility, and the site of infection |
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Term
| What is the agent in RMSF? |
|
Definition
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Term
| What is the vector for RMSF? |
|
Definition
| The American Dog tick and the Lone Star Tick |
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Term
| What is the incubation period for RMSF? |
|
Definition
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Term
| What are some symptoms for RMSF? |
|
Definition
| -high fever, severe HA, myalgias, N/V, abd pain |
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Term
| The rash for RMSF usually is not apparent until how many days after onset? |
|
Definition
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|
Term
| Describe the rash associated with RMSF: how does it begin? where is it? what occurs later in its course? What percentage have the rash within the first 3 days? |
|
Definition
-begins as 1 to 5 mm pink macules
-in ankles, wrists, forearms, spreads centrally
-petechia occur later
-rash may be asymmetric, localized, or absent
-less than 50% |
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|
Term
|
Definition
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Term
| What is the treatment for RMSF? |
|
Definition
| doxycycline (100 mg BID; 5-7 days) |
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Term
| What is the mortality in RMSF? |
|
Definition
10-40% untreated
5% treated |
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|
Term
| What is the median time to death in RMSF? |
|
Definition
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|
Term
| How many pts with RMSF have no reported tick bite? |
|
Definition
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|
Term
| What time of year is RMSF common? What age groups? |
|
Definition
Summer months
-55+ and 5-9 yo's |
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Term
| What is the agent in ehrlichiosis? |
|
Definition
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Term
| What is the vector in Ehrlichiosis? |
|
Definition
|
|
Term
| What is the incubation period for Ehrlichiosis |
|
Definition
|
|
Term
| what are the symptoms for Ehrlichiosis |
|
Definition
high fever, sever HA, myalgias, N/V, abd pain
-rash less common, seen in 30% |
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|
Term
| What is the only way to tell the difference between this and RMSF? Does it really matter if you find out exactly which one it is? |
|
Definition
-serology
-not really, you will treat both with doxycycline |
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|
Term
| What is the treatment for Ehrlichiosis? |
|
Definition
| doxycycline 100 mg BID 5-7 days |
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|
Term
| What is the mortality in Ehrlichiosis? |
|
Definition
|
|
Term
| Where, Who and When for Ehrlichiosis? |
|
Definition
Where: Eastern US (missouri, arkansas, oklahoma)
Who: 55+ yo's
When: summer months |
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Term
| What is the agent in Lyme disease? |
|
Definition
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|
Term
| What is the difference between ehrlichia chafeensis (HME) and anaplasma phagocytophila (HGA)? |
|
Definition
| the reactivity of the RBC (?) |
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|
Term
| What is the vector in lyme disease? |
|
Definition
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|
Term
| What is the name for the rash associated with lyme disease? |
|
Definition
erythema migrans
rash >5 cm |
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|
Term
| Lyme disease shows evidence of manifestation in what three body systems? |
|
Definition
musculoskeletal
neurologic
CV |
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|
Term
| Where is lyme disease most common? |
|
Definition
|
|
Term
What is the acute treatment for lyme disease?
late disease? |
|
Definition
doxycycline 100 mg BID
amoxicillin 500 mg TID
cefurozime acetil 500 mg BID
for 14 days
-late disease depends on symptoms |
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|
Term
| Who does lyme disease usually affect? |
|
Definition
| Male children and older adults |
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|
Term
| What is the agent for southern tick associated rash illness (STARI)? |
|
Definition
|
|
Term
| what is the vector for STARI? |
|
Definition
|
|
Term
| What are the symptoms for STARI? |
|
Definition
-erythema migraines like rash >8cm
-fatigue
-HA
-stiff neck
-arthralgia
-myalgia
-occasional fever |
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|
Term
| What is controversial about STARI? |
|
Definition
| it has been identified but they have yet to be able to grow it in the lab |
|
|
Term
| What is the tx for STARI? |
|
Definition
| doxycycline 100 mg BID; 14 days |
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|
Term
| What is the agent in syphillis? the incubation period? |
|
Definition
Treponema pallidum
3 weeks (range 10-90 days) |
|
|
Term
| How is syphilis passed from person to person? |
|
Definition
through direct contact with a syphilis sore which occur mainly on the external genitals, vagina, anus, or in the rectum (also on lips/ in mouth)
-Sexually transmitted |
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|
Term
| Can pregnant women with syphilis pass it along to their babies? |
|
Definition
| yes, its called congenital syphilis |
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|
Term
| What about the incubation period with syphilis makes it hard to track? |
|
Definition
| People with multiple multiple partners have trouble figuring out who they have been with during the incubation period, since the period is so long |
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Term
| Describe the symptoms of the primary, secondary, late and latent stages of syphilis. |
|
Definition
-primary: small sore/chancre
-secondary: rash begins on the trunk, eventually overs entire body, even the palms and soles
-late and latent: can last for years, can present as difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, dementia |
|
|
Term
| What is the infectious part of syphilis? |
|
Definition
the open wounds
chancres completely resolve without treatment within 6 weeks |
|
|
Term
| What race/gender/sexual behavior category has the highest rate of primary and secondary syphilis? |
|
Definition
| white and black MSM population |
|
|
Term
| How is syphilis diagnosed? |
|
Definition
Rapid plasma reagin (RPR) test
T pallidum particle agglutination (TP-PA) test |
|
|
Term
| What is the treatment for syphilis? |
|
Definition
penicillin
dose and duration cary and depend on the stage of disease |
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