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2025 PHPM Royal College Study - based on AN Summary Notes > CD - HPV, Lyme, West Nile, Zika, Campy > Flashcards

CD - HPV, Lyme, West Nile, Zika, Campy Flashcards

(78 cards)

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1
Q

what is the agent for HPV infection and how many types are there (1)

A

1- over 200 distinct types of human papillomaviruses have been identified

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2
Q

what is the reservoir for HPV (1)

A

1- humans

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3
Q

what are risk factors for acquiring HPV -
‘sexual behaviours’ - 5
‘substance use’ - 1
‘immunosuppression’ - 2

(8)

A

1- lifetime number of sexual partners
2- history of previous STIs
3- history of sexual abuse
4- MSM (for men)
5- inconsistent condom use
6- tobacco or marijuana use
7- immunosuppression
8- HIV infection

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4
Q

what is the mode of transmission for HPV (2)

A

1- vertical
2- contact (direct epithelial to epithelial contact)

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5
Q

what is the incubation period for HPV - range (1)

A

1- range = 1-20 months

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6
Q

what is the communicable period for HPV - general (1)

A

1- Presumably communicable during the acute infection and during persistent infection

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7
Q

what percentage of Canadians, if unimmunized against HPV, will have an HPV infection at some point? (1)

A

1- 75% of Canadians unimmunized against HPV will have an HPV infection at some point

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8
Q

what is the typical clinical presentation of HPV (1)

A

1- most HPV infections are asymptomatic

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9
Q

do you need to treat HPV infections (1)

A

1- no - most HPV infections are self-limiting

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10
Q

how long does it generally take for HPV infections to resolve without treatment (1)

A

1- HPV infections generally resolve within 24 months without treatment

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11
Q

what are the high-risk HPV types (7)

A

16, 18, 31, 33, 45, 52, 58

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12
Q

what disease can the high-risk HPV types lead to (1)

A

1- cancer

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13
Q

what kinds of cancer can the high-risk HPV types lead to -

go from bottom to the top of body

(8)

A

1- vulva
2- vagina
3- cervical
4- penis
5- anogenital
6- anus
7- oropharynx
8- mouth

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14
Q

what are the low-risk HPV types (2)

A

6, 11

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15
Q

what kind of disease do the low-risk HPV types cause (1)

A

1- genital warts

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16
Q

which HPV vaccines are authorized for use in Canada (2)

A

1- gardasil-9 (HPV9)
2- cervarix (HPV2)

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17
Q

which HPV types does gardasil-9 protect against (1)

A

1- gardasil-9 protects against the 9 types of HPV mentioned - 6, 11, 16, 18, 31, 33, 45, 52, 58 - i.e. both low and high-risk

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18
Q

which HPV types does cervarix protect against (1)

A

1- HPV 16 and 18

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19
Q

how effective are current HPV vaccines at preventing cervical cancer and its precursors? (1)

A

1- VERY - efficacy of HPV9 vaccine against types 16- and 18-related cervical disease is nearly 100%

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20
Q

how effective are current HPV vaccines at preventing genital warts (1)

A

1- VERY - efficacy against external genital lesions related to HPV types 6, 11, 16, or 18, including genital warts, is 95% to 99%

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21
Q

how effective are current HPV vaccines at preventing high-grade disease

A

1- VERY - efficacy against high grade disease related to HPV types 31, 33, 45, 52, and 58 contained in HPV9 vaccine is over 96%

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22
Q

what is the recommended dosing of HPV9 for immunocompetent individuals age 9-20 (1)

A

1- one-dose schedule

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23
Q

what is the recommended dosing of HPV9 for immunocompetent individuals age 21-26, and 27+ (1)

A

1- two-dose schedule

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24
Q

what is the recommended dosing of HPV9 for Individuals who are immunocompromised and/or living with HIV, regardless of age (1)

A

1- three-dose schedule

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25
what are the indications for getting HPV vaccine in girls and women (7)
Prevention of : 1- vulvar ca 2- vaginal ca 3- anal ca 4- oropharyngeal and other head and neck cancers 5- genital warts 6- precancerous lesions 7- cervical cancer
26
what are the indications for getting HPV vaccine in boys and men (4)
1- anal ca 2- oropharyngeal and other head and neck cancers 3- genital warts 4- precancerous lesion (anal intraepithelial neoplasia)
27
In July 2020, the Federal Drug Administration in the USA approved indication of HPV vaccine for prevention of head and neck cancer - why is this a hot topic? (1)
1- because prior to this, HPV vaccine was only approved for use in the prevention of anogenital-related cancers
28
what are some reasons for seeing increasing trends in STIs - host factors (4)
1- increased number of sexual partners 2- unprotected intercourse 3- substance use 4- increased awareness of (and getting) testing
29
what are some reasons for seeing increasing trends in STIs - agent factors (2)
1- antimicrobial resistance 2- synergistic interactions between microbes
30
what are some reasons for seeing increasing trends in STIs - environment factors (4)
1- changes in case definitions and/or clinical guidelines 2- new medical treatments (e.g. PrEP) 3- social media and dating apps 4- changes to tests (e.g. increased sensitivity)
31
what is the Pan Canadian STBBI Framework for Action (1abcd)
The framework sets out a 1a- vision, 1b- desired outcome, 1c- strategic goals, and 1d- guiding principles for reducing the health impact of STBBIs in Canada
32
what are the 4 pillars and 1 underlying foundation of the Pan Canadian STBBI Framework for Action (5)
1- prevention 2- testing 3- initiation of care and treatment 4- ongoing care and support 5- supportive environments
33
what are some reasons for emerging infectious diseases related to host (5)
1- vulnerable (made to be) populations 2- lifestyle behaviours 3- occupational factors 4- travel/tourism 5- migration
34
what are some reasons for emerging infectious diseases related to agent (2)
1- food/water quality 2- animal health
35
what are some reasons for emerging infectious diseases related to environment (8)
1- inequities (in SDoH) 2- prevention measures 3- terrorism 4- global trade 5- climate changes 6- natural environment 7- surveillance/reporting 8- healthcare system
36
what is the agent for lyme disease (1)
1- Borrelia burgdorferi
37
what is the reservoir for lyme disease (2) - MD
1- mice 2- deer
38
what is the mode of transmission for lyme (1)
1- vector-borne (Ixodes scapularis [black legged/deer tick], pacificus, and angustus)
39
what is the incubation period for lyme disease - range (1)
AROUND 1 MONTH 1- 3-32 days
40
is there a communicable period for lyme (1)
1- NO, there is no person-to-person transmission/spread
41
what are the 4 stages of clinical presentation for lyme (4) - EELP
1- early local 2- early disseminated 3- late 4- post-lyme disease syndrome
42
what is the clinical presentation of early local lyme - FEM FHAM (7)
1- fever 2- erythema migrans (bulls eye rash) 3- myalgias 4- fatigue 5- headache 6- arthralgias 7- malaise
43
what is the clinical presentation of early disseminated lyme - MC MAC (5)
1- multiple erythema migrans rashes 2- carditis 3- meningitis 4- arthralgias 5- cranial nerve palsies
44
what is the clinical presentation of late lyme - EROC (4)
1- encephalopathy 2- recurrent arthritis 3- optic neuritis 4- carditis
45
what is the clinical presentation of post-lyme disease syndrome - CSF (3)
1- cognitive impairment 2- subjective MSK pains 3- fatigue
46
what is Post-exposure prophylaxis (PEP) for lyme (1) and for what weight category What is the criteria for starting PEP (3) - BTS
PEP is single dose doxycycline 200 mg PO x 1 if >45 kg; weight-based if < 45kg Treat (PEP) with doxycycline only if ALL OF THE FOLLOWING: 1- tick was blacklegged 2- tick was attached for >24h (twenty-four) 3- doxy is given within 72 hours of tick being removed (seventy-two)
47
is there contact management for lyme (1)
1- NO, not applicable
48
what are things you can do to mitigate risk of acquiring lyme - LIAA (4)
1- long pants/shirts (wear) 2- insect repellant that has DEET or icaridin 3- avoid tick-infested areas 4- active surveillance is done in Canada via Canadian Lyme Sentinel Network (CaLSeN)
49
what is the reservoir for west nile virus (WNV) (1)
1- birds
50
what is the mode of transmission for WNV (2)
1- vector-borne (culex mosquitoes) 2- blood-borne (transfusion, organ transplantation)
51
what is the incubation period for WNV - range (1)
1- 2-21 days
52
what is the communicable period for WNV (1a) and why (1b)
1a- <7 days in immunocompetent persons 1b- live virus stays in infected person’s blood for 4-7 days
53
what is the most common clinical presentation for WNV (1)
1- majority of cases are asymptomatic
54
if there are symptoms, what is the clinical presentation for WNV - I-HMF (1)
1- mild influenza-like illness (ILI) - headache, myalgia, fever
55
what are rare (<1% of cases) symptoms of WNV - N-MEA (1)
1- neurological symptoms (meningitis, encephalitis, acute flaccid paralysis)
56
what is case management for WNV (2)
1- supportive management 2- educate that case should not donate blood or organs until 8 weeks have past since date of infection
57
what is contact management for WNV (1)
1- none - not applicable
58
what can you do to mitigate risk of acquiring WNV - 4Ds (3)
1- DEET insect repellant when outdoors 2- Dress with long sleeve tops/pants 3- Drain standing water 4- Dusk to Dawn (limit time spent outdoors in these hours)
59
what is the reservoir for zika virus (1)
1- likely humans
60
what is the mode of transmission for zika - VBVS (4)
1- vector-borne (aedes aegypti - mosquito) 2- blood-borne 3- vertical 4- sexual
61
what is the incubation period for zika - average (1)
1- 3-14 days
62
what is the communicable period for zika (1)
1- unclear
63
what is the most common clinical presentation of zika (1)
1- 75% of cases are asymptomatic
64
if there are symptoms, what is the clinical presentation of zika - MR GCFH (6)
1- myalgias 2- rash 3- GBS 4- conjunctivitis (purulent) 5- fever 6- headache
65
what are features of congenital zika syndrome - H-COMA (5)
1- hypertonicity/seizures 2- club foot 3- ocular anomalies 4- microcephaly 5- abnormal brain development
66
what is case management for zika (1)
1- supportive management, no treatment 2- serology recommended only for pregnant women who are symptomatic, have travel hx, or sexual partner with travel hx to zika-endemic region
67
what is contact management for zika (1)
1- none, not applicable
68
what can you do to mitigate risk of acquiring zika - personally, and as per CATMAT (2)
1- measures to prevent mosquito bites 2- CATMAT no longer recommends that pregnant travellers avoid zika-endemic regions or take special precautions to prevent sexual transmission while abroad or upon return
69
what is the ddx for for GI symptoms that usually resolve within 24 hours - ABC-SENS (7)
1- Staph Aureus enterotoxin 2- Bacillus Cereus enterotoxin 3- Clostridium perfringens 4- Salmonella 5- E. Coli 6- Norovirus 7- Shigella
70
**what is the ddx for GI illnesses that cause bloody diarrhea - "Your Shit Smells Extra Crappy" (5)
1- yersinia 2- shigella 3- salmonella 4- e. coli 5- campylobacter
71
what is the agent for campylobacter enteritis (campy) (1)
1- campylobacter jejuni
72
what is the reservoir for campy (3)
1- poultry 2- cattle 3- pets
73
what is the mode of transmission for campy (2)
1- direct contact - fecal-oral 2- ingestion (undercooked meat)
74
what is the incubation period for campy - range (1)
1- 1-10 days
75
what is the communicable period for campy (1)
1- it is shed in feces for days to weeks
76
what is the clinical presentation of campy - NDA-FM (5)
1- nausea/vomiting 2- diarrhea, bloody or non 3- abdominal pain 4- fever 5- malaise
77
what is case management for campy (1)
1- exclude food handlers, HCW, daycare staff/attendees until symptoms have resolved for 24h
78
what is contact management for campy (2)
1- exclude symptomatic contacts 2- test asymptomatic contacts if outbreak

2025 PHPM Royal College Study - based on AN Summary Notes (29 decks)

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