23 - Rabies Flashcards Preview

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Flashcards in 23 - Rabies Deck (36)
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1
Q

Rabies infection

A
Acute inectious fatal viral disease of most warm-blooded animals
Common in
- wolves
- bats
- cats
- dogs
2
Q

Rabies affects?

A

Attacks the CNS

3
Q

Types of rabies?

A

Bat rabies (avian rabies)

Terrestrial rabies

4
Q

3rd most reported type of rabies recent years?

A

Bat rabies - avian rabeis

5
Q

Avian rabies is commonly foun din?

A

Raccoons
Skunks
Bats

6
Q

Terrestial rabies in US is found in? (Animals)

A

cats

  • east coast: raccoons
7
Q

World wide MC vector of rabies?

A

Dog
NHP is #2
(Non human primate)

8
Q

What animal doesnt spread rabies well?

A

Rodents
- they die before spreading

Except groundhog

9
Q

Human to human rabies transmission?

A

Corneal transplants

Organ transplants

10
Q

Bats and rabies?

A

Any exposure to bats while in a state of altered consciousness (including sleep) constitutes an exposure to rabies

You gettin the shot

11
Q

Rabies genus?

A

Lyssavirus

12
Q

Rabies transmission?

A

Enters muscles and replicates locally

Enters spinal ganglia - replicates again
- moves up the coard

Migrates to gray matter
- limbic system - midbrain - hypothalamus

13
Q

How does rabies spread from victim to victim?

A

The efferent nerves transport virus -> salivary glands in high concentrations

14
Q

Rabies incubation?

A

5 days to 7 yrs

Average 1-3 months

15
Q

Factors that increase disease manifestations?

A

Quantity of virus in saliva
- drool vs bite
Species of animal

Site of bite (head/neck = bad)

Antirabies treatment

16
Q

Phases of rabies?

A
  1. Incubation - post bite
  2. Prodromal period - 2-10 days
  3. Acute neurologic period - 2-7 days
    - furious rabies
    - paralytic rabies
  4. Dead period - UTC
17
Q

Incubation period s/s?

A

Asymptomatic

No antibody response

18
Q

Prodromal period s/s?

A

Virus enters CNS

Nonspecific s/s

  • malaise
  • ha
  • chills
  • anorexia
  • fever
  • pharyngitis

Paresthesia or pain

19
Q

Pathognomonic for prodromal rabies?

A

Paresthesia or pain - maybe prickly itchy feeling at inoculation site

20
Q

Acute nuerologic - furious rabies s/s?

A
Agitation
Restlessness
Biting
Hallucinations
Episodic - 5 min episodes
Hyperacity
Thrashing
Confusion 
- fever + HA
21
Q

Furious rabies can be triggered by?

A

Visual, auditory or tactile stimuli

22
Q

Paralytic rabies s/s?

A
Aka - dumb or apathetic rabies
(20% of cases)
- pt is quiet
- paralysis from outset
- fever + HA
23
Q

Neurologic period physical findings?

A
Delirium
Restlessness
Seizures
Aniscoria
Lacrimation
Perspiration
Drooling
Hydrophobia
Aerophobia
Psychosis
Thrashing
Aphasia
Mydraisis 
Salivation
Postural HOTN
Muscular fasciculations
24
Q

Pathognomonic for rabies neurologic period?

A

Hydrophobia

Aerophobia

25
Q

Rabies eventually leads to?

A

Coma (w/in 10 days of onset)

Recovery unlikely

26
Q

Rabies diagnosis

A

Typically clinical

RFFIT: Serum rapid fluorescent focus inhibition test
Nuchal skin biopsy
Saliva test - takes 2 weeks

27
Q

MR reliable rabies test in the 1st week?

A

Eosinophilic cytoplasmic inclusinos - negri bodies
- 70% of cases

PATHOGNOMONIC

28
Q

Rabies ddx?

A
Tetanus
Guilliain-barre 
Viral encephalitis
Transverse myelitis
CVA
Intracranial mass
Epilepsy
Atropine poisoning
Creutzfeld-jacob disease
Psychosis
29
Q

Rabies tx?

A

Passive and active immunization

Immediate vigorous wound clensing

30
Q

Rabies vaccines?

A

HDCV - Human diploid cell vaccine

PCEC - purified chick embryo vaccine

31
Q

Preexposure vaccine?

A

Primary immunization
- days 0, 7, 21 or 28

Booster

32
Q

Post exposure rabies vaccine?

A

No prior vaccine
HDCV/PCEC - days 0, 3, 7, 14

Prior vaccine - days 0 and 3

33
Q

Rabies passive immmunization?

A

HRIG - immune globuine

  • infiltrated around the wound
  • remaining into glute (opposite side of active vaccine)

DONt exceed 20 IU/kg

34
Q

Extremely critical to rabies tx?

A

Wound clensing

Vaccine booster q 2 yrs (CDC) or q 1 yr (WHO)

Corticosteroids decrease antibody response

35
Q

Wound closure for suspected rabies?

A

Secondary - DO NOT close the wound

36
Q

I’m not sure what my spirit animal is

A

But i’m confident it has rabies