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Clin Med- P > Vector Born Diseases > Flashcards

Vector Born Diseases Flashcards

1
Q

what are vectors?

A

organisms that transmit infections from one host to another (but are not infected themselves).
They are Asymptomatic carriers of parasites and pathogens that attack humans or other animals.

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2
Q

_______ is a leading cause of illness and death in the tropics and subtropics. As many as 100 million people are infected yearly

A

Dengue infection

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3
Q

are there vaccines for dengue? what about the most effective treatment?

A

There are not yet any vaccines to prevent infection with dengue virus (DENV) and the most effective protective measures are those that avoid mosquito bites

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4
Q

what is dengue caused by?

A

any one of four closely related dengue viruses
DENV 1, DENV 2, DENV 3, DENV 4
All are Flavivirus family members

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5
Q

In the Western Hemisphere, the _____ _______ _______ is the most important vector of dengue viruses

A

Aedes aegypti mosquito

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6
Q

what is a characteristic symptom of dengue?

A

Muscle and bone pain (“Breakbone Fever”)

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7
Q

what is a sever form of Dengue fever ?

A

DHF is a more severe form of dengue infection, with more severe bleeding
Can be fatal if unrecognized and not treated in a timely manner

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8
Q

With good medical management, mortality due to DHF is

A

< 1%

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9
Q

is serology helpful for dengue?

A

NO

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10
Q

overall treatment for dengue is what?

A

all are SELF-LIMITED - so txt is supportive (as long as theyre not hemorrhagic- if so they NEED IV fluid)

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11
Q

Dengue is easily confused with what other disease? what is the major difference?

A

chikungunya but this one has no hemorrhagic form

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12
Q

what are prevention methods for dengue?

A

Avoid times of high mosquito activity in endemic areas (dusk, dawn)
Use DEET, long sleeves and pant legs

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13
Q

chikkungunya is carried by what organism?

A

carried by Aedes aegypti and Aedes albopictus mosquitos (same as dengue)

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14
Q

Zika virus: similar to dengue, but ____ _____.

A

Similar to Dengue, but less severe, often asymptomatic

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15
Q

what are the symptoms of zika?

A

often asymptomatic

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16
Q

what is the vector for Zika?

A

Aedes egyptii mosquito

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17
Q

What is the major concern with Zika?

A

Appears to cause microencephaly of developing fetuses, and is now considered to be a major public health risk

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18
Q

Zika can be transmitted from who?

A

infected males

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19
Q

how long to wait if you want to get pregnant or have unprotected sex but were exposed to Zika?

A

Wait 2 mo if female only is exposed, 3 mo if male or both

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20
Q

lyme disease: what is it and what environments does it prefer?

A

Spirochete: prefers viscous environments. (oral cavity, gut)

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21
Q

what is the common reservoir for lyme disease ?

A

white footed mouse (wild mouse)

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22
Q

what is the Most common vector borne disease in USA?

A

Lyme disease

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23
Q

lyme disease invades …

A

blood and tissues of warm blooded animals

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24
Q

what are the vectors for lyme disease ? (weeds maybe…)

A

Vector: Ixodes ticks, I. scaularis (E), I. pacificus (W), I. ricinus (Europe)

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25
Q

what size ticks have lyme?

A

VERY small ones - highest rate of viral transmission

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26
Q

ticks with lyme must stay attached for __ to ___ hrs to infect

A

Must remain attached for 36-48 hr to infect

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27
Q

characteristic sign of lyme disease - early stage

A

Erythema Migrans, non-puritic, “target/bullet rash”

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28
Q

what is the secondary stage of lyme disease show?

A

more severe constitutional symptoms : high fever, meningismus, headache, pain

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29
Q

what type of complications does lyme disease cause? (what particular body systems)

A

neuro and cardiac

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30
Q

late stage lyme disease occurs __ to ___ after the bite

A

weeks to months

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31
Q

what three complications occur with late stage lyme disease

A

Lyme arthritis: monoarticular large joints
Cardiac: Heart block, check an EKG
Neurologic: psych, CNS, encephalopathy

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32
Q

Dx for early, secondary and late stage lyme disease?

A

early lyme disease - dont see good serology
secondary- EIA and western blot
late stage - IgG +

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33
Q

Post- exposure prophylaxis for lyme disease

A

PEP (post-exposure prophylaxis): maybe single dose of doxycycline within 72 hr

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34
Q

treatment for lyme disease (actual disease with rash)

A

about 2-3 wks of oral Tx

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35
Q

Encephalopathy/itis or severe neural involvement: what is the treatment? (maybe weeds)

A

IV therapy x 30 d (longer than 2-3wks)

36
Q

overall: early or late stage lyme disease, what is the treatment?

A

2-3 wks abx

37
Q

agent for rocky mountain spotted fever?

A

Agent:Rickettsia rickettsii gram negative intracellular bacteria

38
Q

what does spotted mountain spotted fever cause?

A

Thrive within cells that line small- to medium-sized blood vessels ( vasculitis which leads to vasculitic rash (which means it wont blanch))

39
Q

what is the vector for rocky mountain spotted fever?

A

ticks: Dermacentor variabilis (American dog tick), and

D. andersoni (wood tick)

40
Q

characteristic sign of rocky mountain spotted fever

A

vascular rash

41
Q

Dx of rocky mountain spotted fever: what two things do you need ?

A

Rash in < 3 days since tick bite (90% of people)

Indirect immunofluorescent antibody (IFA)

42
Q

how long is the incubation period before symptoms (other than rash) of rocky mountain spotted fever ?

A

one week

43
Q

treatment for rocky mountain spotted fever ? what about pregnancy?

A

Treatment:: Doxycycline 100 mg PO/IV BID for at least 5-7 d, including 3 d after fever is gone
In pregnancy: Still doxy (concern for bone and tooth enamel formation- but the risk is low for this)

44
Q

how many cases/yr of malaria worldwide ?

A

300-500 million cases/yr worldwide

45
Q

what are the agents that cause malaria?

A

protozoan- 4 kinds

46
Q

which is the worst (most deadly, can be rapidly fatal) of the 4 agents that cause malaria?

A

protozoan Falcifparum

47
Q

what is the vector for malaria?

A

Anopheles mosquitoes

48
Q

what is the reservoir for malaria?

A

Humans are only known host (the reservoir and the target)

49
Q

malaria: Symptoms triggered by ____ _____, mediated by ____, _____, ____ and _____

A

schizont rupture;mediated by TNF, cytokines, pyrogens (IL-1,6), and cellular debris

50
Q

for malaria, ___ is different for different regions

A

drug resistance

51
Q

what are some drugs for malaria treatment?

A
  1. malarone

2. quinine sulfate + Clindamycin, Tetracycline or Doxycycline

52
Q

what are the three parts to malaria prevention?

A

Vector control
Permethrin treated bed nets
Insect repellent (DEET)

53
Q

what can you do for chemoprophylaxis of malaria?

A

Malarone, start it before you travel to exposed area and continue taking when you get back (for a period of time)

54
Q

what is the rabies virus? agent, family, genus, and type of virus

A

Agent: Rabies virus
Family Rhabdoviridae
Genus Lyssavirus
Enveloped, single stranded RNA

55
Q

what are the vectors for rabies? (5)

A

Infected corneal grafts
Animal saliva on open skin
Inhalation of bat secretions (any casual contact with a bat)
Bites of infected animals: Dogs, cats, foxes, coyotes, skunks, raccoons, jackals, wolves, and bats

56
Q

rabies cases:
In 3rd world, __% by dogs.
N. America, Europe __% by dogs.

A

In 3rd world, 90% by dogs.

N. America, Europe 5% by dogs.

57
Q

post exposure prophylaxis for rabies: 2 part

A
  1. human rabies immunoglobin

2. Vaccination

58
Q

what is the dosage for the rabies vaccine for PEP?

A

1 ml vaccine IM on days 0, 3, 7 14

59
Q

what does arboviral mean?

A

Arboviral = “arthropod-borne viral”

60
Q

what are the agent, vector, and vaccine for arboviral encephalitis?

A

Agent: Alphavirus, Togaviridae

Vector: Multiple mosquito species, sometimes ticks

Usually no vaccines (for people)

61
Q

arboviral enchephalitis is most common in what animal?

A

horses

62
Q

what are two major syndromes of arboviral encephalitis?

A

West Nile Encephalitis and Yellow Fever

63
Q

what is the treatment for all syndromes of arboviral encephalitis?

A

supportive, no anti-virals available

64
Q

vector for yellow fever

A

Aedes mosquitoes

65
Q

vector for west nile enceph.

A

culex mosquitoes

66
Q

West Nile Encephalitis: Most infections are ________ (__%), more severe in _____ ______

A

Most infections asymptomatic (80%), more severe in older persons

67
Q

what are the hosts for west nile?

A

birds

68
Q

Dx of west nile

A

IgM antibody to WNV

IgM doesn’t cross BBB

69
Q

incubation and possible symptoms of west nile (maybe weeds)

A

Incubation 2-14 days

Can cause motor weakness, respiratory difficulty, GI complaints common

70
Q

agent, vector and host of yellow fever

A

Agent: Flavivirus
Vector: Aedes aegypti mosquitoes
Host: nonhuman primates

71
Q

which is the most lethal of the arboviruses?

A

yellow fever

72
Q

what organs are most damaged by yellow fever?

A

Liver, Kidneys show most damage

73
Q

incubation and possible signs of yellow fever (maybe weeds)

A

Incubation 3-6 days

Fever, severe HA, myalgias, nausea, short “remission phase”

74
Q

pathology of the toxic phase of yellow fever (maybe weeds) (6parts)

A 
High fever, severe pain, vomiting
Hepatic jaundice, coagulopathies
Hemorrhages, “black vomit”
Bradycardia, acute tubular necrosis
CNS symptoms, lethargy, coma
Death
75
Q

how do you Dx yellow fever?

A

Diagnosis: Serum (IgM) ELISA

76
Q

how do you treat and prevent yellow fever?

A

Treatment: None
Prevention: Yellow fever vaccine
(YF-VAX) is a live, attenuated virus vaccine

77
Q

what type of disease is typhus? what is the usual vector?

A

A rickettsial disease, usual vector is an arthropod (tick, flea, mite, lice )

78
Q

Rickettsial Disease: Symptoms vary but ____, _____ and _____ are common.

A

HA, fever, malaise

79
Q

Dx and Txt of rickettsial Disease

A

Diagnosis by specific antibodies

Treatment by antibiotics, no vaccines

80
Q

which rickettsial diseases have the human louse as the vector?
what are the agents for each of these? (weeds)

A

Epidemic Typhus
Agent: R. prowazkeii

Trench Fever
Agent: B. quintanta

81
Q

what are unique symptoms to epidemic typhus and trench fever? (weeds maybe )

A

confusion and photophobia

82
Q

Agent and vector for Murine Typhus

A

Murine Typhus
Agent: R. typhi
Vector: Rat fleas

83
Q

Vector for Cat-Flea Rickettsiosis

A

Cat-flea Rickettsiosis

Agent: R. felis

84
Q

one Txt option for Rickettsial Disease? (maybe weeds)

A

Doxycycline 100mg po bid x 7 days

85
Q

where can you look for reccomendations on travel vaccines?

A

CDC yellow book

Clin Med- P (124 decks)

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