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Flashcards in 9-8 Zoonoses Deck (16)
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1

A: Which Brucella species is MOST COMMON for Human infection and MOST VIRULENT

B: Which Brucella species is least common

A: [Brucella melitensis (from Sheep and Goats)] = MOST COMMON of human infections and most virulent. 

B: Brucella canis (from dogs) = least common and generally laboratory acquired

2

A: Why are Lab workers at risk when working with Brucella? 

B: List the populations at risk for Brucella Infection (4) 

C: What category Bioterrorism is Brucella? 

A: Laboratory workers inhale [Brucella Aerosols] which are dangerous

B: 
-Farmers
-Veterinarians 
-Abattoirs  
-[Laboratory Workers] 

C: Brucella is a CATEGORY B INFECTIOUS AGENT! 

3

2 Examples of Category C Bioterrosim Agents 

B: What's the Criteria for this (3) 

Nipah virus
and hantavirus

B: emerging pathogens that could be engineered for mass dissemination in the future because of
1.  availability;
2.  ease of production and dissemination; and
3. potential for major health impact 

4

A: Brucella Pathogenesis (3 steps) 

B: Where do the organisms actually replicate 

C: What is the Host rxn to this

D: Natural recovery for the host depends on what? 

 1st: Organisms penetrate skin or mucous membranes
2nd: Phagocytosized by macrophages and monocytes
3rd: Carried to spleen, liver, bone marrow, lymph nodes and kidneys

B: Organisms multiply INSIDE macrophages in RE system and are able to live inside cells because they BLOCK PMN Degranulation 

C: Host reaction is the formation of small granulomas

D: Recovery depends on [T-Cell Mediated Immunity] ONLY 

5

A: What is [Erythritol predilection]? 

B: What bacteria causes this? 

Erythritol predilection explains why animals have abortions and sterility. 
-MACs process Brucella antigens and present them to T cells which excrete lymphokines responsible for attracting cells to the area of infection---> Abortion. 


B: Brucella 

6

A: Brucella Clinical Manifestations: (2) 

B: What are the 3 Organomegaly's it causes

C: Bone-related Sx of Brucella (2) 

D: Cardiovascular-related sx of Brucella 

Brucella Clinical Manifestations: 

A:
1st: Initial = Nonspecific sx (Malaise/ weakness/ myalgias)

2nd:[GI sx] and  [Intermittent Undulant Fever] caused by Brucella sequestering in granulomas of tissue and [bone marrow] 

B: Also causes [Hepatomegaly / Splenomegaly / Lymphadenopathy] 

C: [Osteolytic Lesions] and [Bone Sacroilitis] 

D: [Brucella Endocarditis] --> may requires valve replacement 

7

A: Brucella Diagnosis (2) 
-------------------------------------------------------------------------------
B: Brucella Characteristics 
1. shape and gram stain
2. How does it physically look 
3. Which Agar and what does it require? 

C: Tx 

A:
1.  Blood and [bone marrow] Cultures with EXTENDED incubation time
2. Elevated [Febrile Agglutinin Titer] 
-------------------------------------------------------------------------------
B: LAB: 
-gram negative coccobacilli 
-appears like "fine sand" 
-GROWS on Chocolate Agar but requires PROLONGED INCUBATION and enriched media 

C: Tx
-Oral tetracyclines + [aminoglycosides-gentamycin/streptomycin] 
C2: Relapse may occur becuz some Brucellosis can be chronic 

8

Who are most at risk for [Francisella Tularensis] infection? (3) 

(AKA Tularemia) 
1. Hunters
2. People exposed to [Dermacenter Ticks]

3. Lab Workers (from inhaling infectious aerosol when dealing w/infected animal) 

9

List the 6 Clinical Manifestations of [Francisella Tularensis] 

"Francis FORCUT theTick b4 SYMPTOMS" 

1.  Fever and malaise 2-5 days after exposure 

2.  [Oropharyngeal Exudative Pharyngitis]

3. Regional Lymphadenopathy

4. Conjunctivitis (unilateral) after aersol/water exposure

5. Ulceroglandular Papule at bite site

6. Typhoidal Infection = HIGH MORTALITY = Fever/Wt loss/Prostration

10

[Francisella Tularensis] Diagnosis: 

1. Which Stain. 
1B: Special Requirements (3)? 

2. Serologic Dx

Tularemia: Diagnosis
1. IFA 

1B:

• Culture requires [SulfHydryl] to grow -

 •Chocolate Agar 
•DOES NOT GROW ON ROUTINE MEDIA


2.  Serologic Dx: acute and
convalescent agglutinin antibody titers
• Single serum may reflect previous exposure

11

A: Transmission for [Yersinia Pestis] (3) AKA ____

 

B: Lab Studies with pts infected with [Yersinia Pestis] (2) 

Transmission for [Yersinia Pestis] (3) AKA PLAGUE
1. Flea Bite
2. Direct Contact w/infected tissue
3. INHALING infected aerosols or from pt with pulmonary dz

B:
-WBC count between 10K to 20K
-normal Platelet or [low Platelet due to DIC]

12

[Bubonic Plague] Clinical Syndrome
1. What happens 1st 

2. What happens 2nd 

B: Mortality Rate 

C: What Bacteria is this caused by? 

Bubonic Plague
1st: Bubo thts painful + Fever up to 1 week after bite

2nd:  Lethargy with INTENSE BUBO PAIN hours after Bubo formation

 

B: 75% mortality if untreated 

C: [YERSINIA PESTIS] 

13

[Septicemic Black Plague] Clinical Syndrome

A: Sx (6)

B: Where does "Black Death" come from? 

C: What is the fatality rate so high with [Septicemic Plague]

D: What Bacteria is this caused by? 

Septicemic Black Plague

A: "PBS Did Favors Daily for Blacks "

-Pediatric Shock

-BLACK Hemorrhagic Splotches--> "BLACK Death"

-Septic Shock

-DIC

-Fever

-Delirum 

B: [Black hemorrhagic splotches] gave rise to the name “Black Death”

C: 100% of pts. become septic with + blood cultures –  Fatality rate high due to delay in Dx and Tx

D: [YERSENIA PESTIS] 

14

[Pneumonic Plague] Clinical Syndrome

1. Pathogenesis 

2. Sx
-Initially (4) 
-secondarily 

3. How do these pts become infectious 

4. What happens, if untreated

5. What bacteria causes this

[Pneumonic Plague]
1. Plague bacillus reaches lungs by hematogenous spread or by inhalation of infectious aerosol from plague pt. with cough.
 
2.Initially: Fever, headache, malaise, confusion
2nd:  Pts. develop cough, chest pain, hemoptysis.

3: Sputum usually purulent and contains [plague bacillus]
(Patient highly infectious)

4. Quickly followed by sepsis / death unless therapy initiated within one day following onset of symptoms

5. YERSINIA PESTIS 

15

A: [Yersinia Pestis] Colonies grow slowly on ______ media and after 48 hrs can have a ______ or ______ appearance under stereoscope

B: [Yersinia Pestis] grow faster at ______ TEMPERATURES

C: MOTILE OR [NON-MOTILE] 

D: What family? 

A: [Yersinia Pestis] Colonies grow slowly on ORDINARY media and after 48 hrs can have a “fried egg” or “beaten copper” appearance under stereoscope

B: [Yersinia Pestis] grow faster at COLDER TEMPERATURES

C: NON-MOTILE 

D: Enterobacteriaceae 

16

A: Tx for [Yersinia Pestis] (2) 

B: Alternative Tx (2) 

C: INEFFECTIVE TX (2) 

D: Chemoprophylaxis 

E: Vaccines available? 

A: Tetra + Streptomycin 

B: alternatives include gentamicin or chloramphenicol,  

C: Penicillin's and cephalosporin's are not effective in treating plague

D: Chemoprophylaxis with tetracycline


E: Vaccines are available for high risk pt