Rabies

Question 1

What is the incubation period of rabies? (Harrison pp 1300)

Answer 1

20 - 90 days

Question 2

The virus is known to bind in what areas of the brain? (Harrison pp 1300)

Answer 2

Nicotinic acetylcholine receptors on postsynaptic membranes

Question 3

It spread via _____ along peripheral nerves toward the CNS in a retrograde fast axonal transport. (Harrison 1300)

Answer 3

Centripetally

Question 4

It spread via _____ along sensory and autonomic nerves. (Harrison pp 1300)

Answer 4

Centrifugal

Question 5

What is the most characteristic pathologic findings in rabies? (Harrison pp 1301)

Answer 5

Negri bodies

Question 6

It is an eosinophilic cytoplasmic inclusion that are usually observed in what areas of the brain? (Harrsion pp 1301)

Answer 6

Purkinje cells of the cerebellum

Pyramidal neurons of the hippocampus

Question 7

What is the earliest specific neurologic symptoms of rabies? (Harrison pp 1301)

Answer 7

Paresthesias

Pain or pruritus near the site of the exposure

Question 8

What are the 2 types of acute neurologic forms of rabies? (Harrison pp 1301)

Answer 8

Encephalitic Rabies (80%)
Paralytic Rabies

Question 9

What type of acute neurologic forms of rabies that involved early brainstem involvement which result in hydrophobia and aerophobia? (Harrison pp 1301)

Answer 9

Rabies encephalitis

Question 10

The combination of hypersalivation and pharyngeal dysfunction and also responsible for the classic appearance of what? (Harrison pp 1301)

Answer 10

Foaming at the mouth

Question 11

What are the expected laboratory findings with patient infected with rabies? (Harrison 1302)

Answer 11

CBC normal
CSF - mild mononuclear cell pleocytosis with mildly elevated protein levels
CT scan: normal

Question 12

It is the flaccid paralysis in limbs progression to quadriparesis with facial paralysis. (Harrison 1302)

Answer 12

Paralytic Rabies

Question 13

It occurs in young especially females, and is characterized by behavoiral changes, autonomic instability, hypoventilation and seizures. (Harrison pp 1303)

Answer 13

Anti-N-methyl-D-aspartate receptor encephalitis

Question 14

What involved in Postexposure prophylaxis? (Harrison 1303)

Answer 14

Local wound care
Active immunization
Passive immunization

Question 15

If RIG is not immediately available, it should be administered NO later than how many days after the 1st vaccine dose? (Harrison pp 1303)

Answer 15

7 days

Question 16

What should be the dose and duration apart if vaccine will be administered in patient with rabies? (Harrison 1304)

Answer 16

Four 1 mL doses of rabies vaccine should be administered at the IM in the deltoid sites with the following days: 0, 3, 7, 14

Question 17

If patient will be given with RIG (Human) or RIG (Equine), what are the doses? (Harrison 1303- 1304)

Answer 17

Human: 20 IU/KG
Equine: 40IU/KG

Question 18

What is the primary schedule for Pre exposure Rabies vaccination? (Harrison pp 1304)

Answer 18

0, 3, 21 or 28 - if previously unvaccinated

additional of 0 and 3 days - if previously vaccinated