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Public Health > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

(T/F) The majority of outbreaks in laboratory settings are related to known accidents.

A

False!

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2
Q

Accidents are less likely to be the cause of lab facility outbreaks, whereas over 80% of cases are related to:

A

infectious aerosols

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3
Q

Many lab facility outbreaks occur at ________, which take a major economic loss if this occurs, therefore biosafety measures are extensive.

A

universities

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4
Q

What is the goal of biosafety?

A

prevent infections (inside & outside lab)

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5
Q

(T/F) Biosafety levels 1-4 are from lowest hazard to increased hazard.

A

True

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6
Q

(T/F) Biosecurity Level 1 agents cause disease in humans but with quick recovery or treatment available.

A

False (unknown to cause disease in healthy humans)L

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7
Q

List the 3 main examples of pathogens present in a Biosecurity Level 1 facillity.

A
  1. Bacillus subtilis
  2. Saccharomyces cerevisiae
  3. E. coli (avirulent strains)
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8
Q

(T/F) PPE is necessary in all levels of biosecurity.

A

False (not required in Level 1 & 2)

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9
Q

Biosecurity Level 2 indicates moderate hazards, where _______ and _______ are available.

A

vaccination
antibiotics

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10
Q

List 5 examples of Biosecurity Level 2 pathogens.

A
  1. Measles
  2. Salmonella enterica
  3. Staph
  4. Toxoplasma
  5. Hepatitis B
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11
Q

_________ are not required in Level 2 facilities unless the lab produces highly concentrated or aerosolized pathogens.

A

biosafety cabinets

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12
Q

What equipment is plexiglass with a vent that pulls air in via negative pressure to present contaminated aerosol spread in the lab?

A

biosafety cabinets

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13
Q

(T/F) Autoclaves are not required in each Level 2 facility.

A

True (but require nearby access)

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14
Q

Level 3 facilities deal with serious or potentially lethal diseases spread via:

A

inhalation

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15
Q

(T/F) Level 3 facilities deal with serious and potentially lethal diseases which are not treatable or preventable.

A

False (serious/lethal but ARE treatable or preventable)

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16
Q

Level (2/3) is more common than (2/3).

A

2, 3

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17
Q

What is the “hallmark” of a Level 3 facility?

A

redundancy (ALWAYS having back-ups –> gloves, autoclaves, etc)

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18
Q

List 4 potential pathogens in Level 3 biosafety facilities.

A
  1. Mycobacterium tuberculosis
  2. St. Louis Encephalitis Virus
  3. Coxiella burnetii
  4. Bacillus anthracis
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19
Q

For Level 3 biosafety labs, there are a few additional facility requirements. List 4 of them.

A
  1. separate isolation zone (away from traffic)
  2. double-door entry
  3. directional inward airflow
  4. single-pass air (NO recirculation!)
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20
Q

Room penetrations such as plugs need to be sealed in a Level ___ biosafety lab.

A

3

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21
Q

Which biosafety level requires use of PPE? What does PPE stand for?

A

Level 3
Personal Protective Equipment

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22
Q

BSL-3 Ag is a type of Level 3 biosafety that has a special concern for pathogen exposure to:

A

agriculture

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23
Q

(T/F) All Level 3 biosafety facilities have hyperfiltered air prior to entrance.

A

False (ONLY BSL-3Ag)

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24
Q

What special facility difference is present in BSL-3 Ag that is not used in regular BSL 3?

A

floor drains (collect liquid from animals in tanks which will be autoclaved)

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25
Q

What method is used for carcass disposal in BSL-3 Ag?

A

tissue digestor (liquefies & sterilizes tissues)

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26
Q

Biosecurity Level 4 includes serious and lethal diseases (with/without) available prevention and treatment.

A

without

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27
Q

All pathogens in Biosafety Level 4 facilities are:

A

viruses

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28
Q

The new method for BSL 4 uses conventional biosafety cabinets and _______ suits.

A

space (higher protection than PPE)

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29
Q

What must workers in BSL 4 do prior to exiting the lab?

A

chemical shower followed by conventional shower

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30
Q

List 3 examples of agents in a BSL 4 facility.

A
  1. Ebola virus
  2. Herpes B virus
  3. Lassa fever virus
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31
Q

List 4 major routes of infection that occur in lab settings.

A
  1. parenteral (needles)
  2. spills (skin, mucous membranes)
  3. ingestion / eyes
  4. aerosols
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32
Q

The Antiterrorism & Effective Death Penalty Act in 1996 initially came about after concern when a member of the Aryan Nations acquired __________ from American Type Culture Collection by mail border.

A

Yersinia pestis (plague)

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33
Q

The Antiterrorism & Effective Death Penalty Act in 1996 lists agents with severe risk to public health & safety as well as procedures for:

A

transfer of agents

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34
Q

Select agents and toxins listed in the Antiterrorism & Effective Death Penalty Act are listed as possible bioterrorism potential. They require inspection by _______ or ______ and facilities of BSL ____ or ____.

A

CDC or USDA
BSL 3 or 4

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35
Q

3 corporations are responsible for determining select agents and toxins as possible bioterrorism threats. What are they? And what kind of pathogens are they concerned with?

A
  1. Health & Human Services (human pathogens)
  2. USDA (zoonotic)
  3. Overlap (human to animal OR animal to human)
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36
Q

List the 5 biggest human pathogen bioterrorism threats listed by the Health & Human Services.

A
  1. botulism toxins
  2. Coxiella burnetii
  3. Yersinia pestis
  4. Francisella tularensis
  5. Ebola virus
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37
Q

The select bioterrorism threats listed by the Health & Human Services are inspected by _______.

A

CDC

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38
Q

The USDA lists zoonotic select bioterrorism potential agents such as _______________.

A

Foot & Mouth Disease Virus

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39
Q

The USDA lists zoonotic bioterrorism select agents such as Foot and Mouth Disease virus and is inspected by __________.

A

USDA only

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40
Q

The select bioterrorism agents that include overlap, meaning can spread from humans to animals or animals to humans, include which two agents? And what corporation inspects them?

A

Bacillus anthracis
Burkholderia mallei

CDC

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41
Q

What broad, but still active Act was passed regarding restrictions on obtaining and shipping of select bioterrorism agents after 9/11?

A

USA Partiot Act (2001)

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42
Q

List 5 categories of people who are restricted from accessing select agents with bioterrorism potential.

A
  1. individuals indicted (crime > 1 year prison)
  2. fugitive
  3. illegal alien
  4. mental institution stay
  5. dishonorable armed service discharge
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43
Q

List the 2 possible penalties for violating select agent use and restrictions.

A
  1. civil money (fine)
  2. criminal (prison)
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44
Q

Those that violate select agent use and restrictions can be fined up to $___________ and in prison for up to ________.

A

250,000
5 years

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45
Q

What is the “driving force” for Biosecurity Levels?

A

emerging disease threats

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46
Q

__________ has the purpose to keep agents WITHIN a facility while _________ has the purpose to keep pathogens from entering the facility in the first place.

A

biocontainment
biosecurity

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47
Q

Biosecurity is mostly related to which type of animals? Why?

A

food animals (reduce costs & protect food supply)

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48
Q

What are the 3 main biosecurity principles?

A
  1. isolation / quarantine
  2. resistance
  3. santiation
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49
Q

Which biosecurity principle involves the following:

“keep animals healthy by good nutrition, environmental, and other practices so they are less likely to become infected”

A

resistance

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50
Q

List the 5 possible routes of transmission which determine biosecurity measures.

A
  1. direct contact
  2. fomites
  3. aerosols
  4. ingestion
  5. vectors
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51
Q

List the 3 steps of cleaning & disinfection for biosecurity practices.

A
  1. remove organic matter
  2. wash & rinse
  3. disinfection
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52
Q

(T/F) Using a concentration greater than labelled for disinfectants can increase its efficacy.

A

False (can be LESS effective)

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53
Q

In terms of vector control regarding biosecurity practices, ________ ________ prevents egg laying of arthropod vectors, such as minimizing long vegegation.

A

source reduction

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54
Q

Bacillus anthracis is a (aerobic/anerobic) _______-forming bacteria.

A

aerobic
endospore

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55
Q

List the 2 toxins used by Bacillus anthracis.

A
  1. lethal toxin
  2. edema toxin
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56
Q

Bacillus anthracis uses lethal toxin which is composed of ___________ + __________.

A

lethal factors + protective antigen

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57
Q

What allows for Bacillus anthracis to bind to cell receptors?

A

protective antigen

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58
Q

Edema toxin of Bacillus anthracis is composed of ___________ + __________.

A

edema factor + protective antigen

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59
Q

Both lethal and edema toxins for Bacillus anthracis are encoded on _______ plasmid.

A

pXO1

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60
Q

The capsule for Bacillus anthracis is encoded on ______ plasmid and has what function?

A

pXO2
anti-phagocytic

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61
Q

How is Bacillus anthracis transmitted?

A

ingestion of spores (soil/water)

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62
Q

Once Bacillus anthracis spores are ingested, how do they enter the tissues?

A

enter abrasion in GI tract

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63
Q

Bacillus anthracis replicates in ________ cells and goes to the lymph nodes before bacteremia and toxemia.

A

phagocytic

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64
Q

(T/F) Outbreaks of anthrax often occurs at the human level.

A

False (see cases but see animal outbreaks)

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65
Q

List the 4 disease forms of Anthrax.

A
  1. cutaneous anthrax
  2. gastrointestinal anthrax
  3. pulmonary anthrax
  4. injection anthrax
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66
Q

95% of Anthrax cases are what form?

A

Cutaneous Anthrax

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67
Q

In Cutaneous Anthrax, spores enter via:

A

abrasion/break in skin

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68
Q

(T/F) Cutaneous Anthrax often leads to bacteremia/toxemia and later death.

A

False (slow-developing, NOT usually leading to these)

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69
Q

Cutaneous Anthrax often causes a painful, malignant pustule lesion with a necrotic center called:

A

black eschar

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70
Q

(T/F) The black eschar caused by Cutaneous Anthrax is treatable.

A

True

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71
Q

Which form of Anthrax is RARE in the US?

A

Gastrointestinal

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72
Q

How is GI anthrax transmitted?

A

ingested meat

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73
Q

The form of Anthrax also known as “Woolsorter’s Disease” is:

A

Pulmonary Anthrax

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74
Q

Which form of Anthrax is a form of concern for biological weapons?

A

pulmonary anthrax

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75
Q

How is Pulmonary Anthrax transmitted?

A

inhalation of spores

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76
Q

What unique sign is seen in Pulmonary Anthrax?

A

bi-phasic (initial flu illness followed by acute phase of respiratory distress + toxemia)

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77
Q

Pulmonary Anthrax leads to respiratory distress and death within:

A

24 hours

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78
Q

What is injection anthrax related to?

A

heroin injection / addiction

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79
Q

Where did injection anthrax outbreak in 2009-2013?

A

germany, scotland, england

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80
Q

(T/F) Anthrax is a potential bioterrorism agent due to ability for secondary spread from human-to-human.

A

FALSE (NOT secondarily spread between people)

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81
Q

What is the best way to prevent Anthrax?

A

vaccination

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82
Q

In veterinary medicine, _______ _______ is a live spore vaccine which makes toxin but has no _________ for virulence.

A

Sterne Strain
capsule

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83
Q

Anthrax Vaccine Adsorbed (AVA) and British Anthrax Vaccine Precipitated (AVP) are both ________ vaccines.

A

human

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84
Q

(T/F) While the anthrax vaccine is effective, there are long-term effects associated.

A

False

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85
Q

(T/F) Systemic effects can occur due to Anthrax vaccination.

A

True (5-35%)

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86
Q

Anthrax vaccine requires ____ IM injections and an annual booster.

A

5

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87
Q

Plague is caused by:

A

Yersinia pestis

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88
Q

Yersinia pestis is a gram (positive/negative) _______-shaped bacteria.

A

negative
rod

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89
Q

What unique look does Yersinia pestis have when stained?

A

“safety pin”

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90
Q

How is Plague transmitted?

A

flea bite (or direct flea contact)

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91
Q

The most common flea in the US associated with Yersinia pestis transmission is:

A

Oropsylla montanus (California ground squirrel flea, Rock Squirrel flea)

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92
Q

How does a flea transmit plague?

A

bloodmeal from infected animal –> regurg into new host on next bloodmeal

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93
Q

The plague can be transmitted via _______ or _______ cycle.

A

sylvatic
urban

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94
Q

The plague sylvatic cycle is via which animal? Urban cycle?

A

Sylvatic: wild rodent
Urban: rat

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95
Q

List 2 reservoirs for plague.

A

deer mice
ground squirrels

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96
Q

(T/F) Cats are highly susceptible to plague, developing the same disease as humans.

A

True

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97
Q

(T/F) Cats cannot transmit plague to humans.

A

False (can)

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98
Q

(T/F) Although cats can transmit plague to humans, they are POOR vectors of it.

A

True

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99
Q

75% of Feline Bubonic Plague manifests as:

A

submandibular lymphadenitis

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100
Q

After fever, lethargy, and anorexia in cats affected with Feline Bubonic Plague, they develop what two signs prior to death?

A

DIC
multi-organ failure

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101
Q

Dogs are generally (sensitive/resistant) to plague infection.

A

resistant

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102
Q

Dogs that do develop plague develop:

A

general lymphadenopathy

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103
Q

List the 3 clinical syndromes of Plague.

A
  1. bubonic
  2. pneumonic
  3. septicemic
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104
Q

80% of US cases are ________ plague.

A

bubonic

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105
Q

What is the mortality rate for Bubonic Plague?

A

50%

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106
Q

What is the primary sign seen in Bubonic plague?

A

lymphadenopathy

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107
Q

In addition to lymphadenopathy, ________ can be seen in Bubonic plague infection, indicated by a swelling at the inoculation site.

A

buboes

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108
Q

Bubonic plague can lead to secondary ________ plague.

A

pneumonic

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109
Q

________ plague is almost always fatal if not treated within 24 hours from sign onset.

A

Pneumonic

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110
Q

Pneumonic Plague leads to what syndrome characterized by shock and refractory pulmonary edema?

A

Adult Respiratory Disease Syndrome

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111
Q

_________ plague is a complication of the other two forms.

A

septicemic

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112
Q

(T/F) Septicemic Plague is fatal without treatment.

A

True

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113
Q

Septicemic Plague leads to ______, hypotension/shock, and death.

A

DIC

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114
Q

(T/F) Plague is ENDEMIC to the US.

A

True

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115
Q

Where are most cases of plague in the US?

A

southwest (AZ, CO, NM, UT)

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116
Q

Plague is found worldwide except which 2 continents?

A

Australia
Antarctica

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117
Q

Most cases of plague (95%) worldwide occur in:

A

Sub-Saharan Africa + Madagascar

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118
Q

What disease is also known as “Rabbit Fever”?

A

Tularemia

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119
Q

Etiology of Tularemia.

A

Francisella tularensis

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120
Q

Francisella tularensis is a gram (positive/negative) __________.

A

negative
coccobacillus

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121
Q

Francisella tularensis can persist for 3-4 months in what substances? What can it persist in for >3 years?

A

3-4 months: mud, water, dead animals
>3 years: frozen meat

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122
Q

Francisella tularensis is (resistant/sensitive) to disinfectants and heat.

A

sensitive

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123
Q

F. tularensis biovar ________ or MORE virulent than biovar _________.

A

tularensis (Type A)
holarctica (Type B)

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124
Q

Match the F. tularensis biovar to its location:

  1. Eurasia and North America
  2. only North America
A
  1. F. tularensis holarctica
  2. F. tularensis tularensis
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125
Q

Match which F. tularensis biovar goes with each reservoirs:

  1. rabbits, squirrels, ticks
  2. muskrats, voles, mice rats
A
  1. tularensis (Type A)
  2. holarctica (Type B)
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126
Q

List the 4 modes of F. tularensis transmission.

A
  1. direct contact (rabbits/mammals)
  2. ingestion (undercooked meat, water)
  3. vector-borne (arthropods)
  4. aerosols (dust)
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127
Q

(T/F) F. tularensis can be transmitted from person to person.

A

False (unless pneumonic form)

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128
Q

Which vectors can transmit F. tularensis?

A

Ticks (transovarial)
Mosquitos/flies (infrequent in Europe)

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129
Q

What species serve as reservoirs for F. tularensis.

A

MANY mammals (rabbits, beaver, muskrats)
ticks
some birds

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130
Q

F. tularensis requires a (small/large) infectious dose for inoculation and inhalation and a (small/large) infectious dose for oral transmission.

A

small
large

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131
Q

_________ transfer of F. tularensis is possible, seen in a case in 2017 with positive rabbits near a patient’s household.

A

transplantation

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132
Q

Where did cottontail rabbits cause the first human case of F. tularensis and later clusters of pneumonic cases related to mowing from 1930-2003?

A

Martha’s Vineyard

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133
Q

List a few initial signs of F. tularensis infection in humans.

A

sudden fever
chills
headache
myalgia

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134
Q

6 clinical syndromes can occur due to F. tularensis infection. List them.

A
  1. ulceroglandular
  2. glandular
  3. oculoglandular
  4. oropharyngeal
  5. typhoidal
  6. pulmonary
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135
Q

Which clinical syndrome of F. tularensis is most common?

A

ulceroglandular

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136
Q

The Ulceroglandular form of F. tularensis uses ulcers as an entry site and causes ____________ in humans.

A

regional lymphadenopathy

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137
Q

(T/F) The Glandular form of F. tularensis causes ulceration and regional lymphadenopathy.

A

False (NO ulceration)

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138
Q

List 2 manifestations of Oculoglandular Syndrome of F. tularensis.

A
  1. conjunctivitis
  2. regional lymphadenopathy
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139
Q

Which F. tularensis syndrome is the SECOND most common?

A

glandular

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140
Q

Oropharyngeal Form of F. tularensis is transmitted via:

A

ingestion

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141
Q

Oropharyngeal Form of F. tularensis is associated with _________ signs and pharyngitis.

A

gastrointestinal

142
Q

_________ Syndrome of F. tularensis can be acute or septicemic.

A

typhoidal

143
Q

Pulmonary Syndrome of F. tularensis is inhaled and spreads via:

A

bloodstream

144
Q

(T/F) Animals infected with F. tularensis are often seen with ulcerative lesions prior to death.

A

False (often found dead)

145
Q

What unique signs can be seen with rabbits infected with F. tularensis?

A

abnormal behaviors (rubbing nose/feet, muscle twitching)

146
Q

List 3 ways to prevent F. tularensis infection.

A
  1. prevent ticks
  2. protection when handling wildlife
  3. cook wild game thoroughly
147
Q

F. tularensis is a BSL ___ and those working in the lab should undergo antibiotic prophylaxis.

A

3

148
Q

What etiologic agent is responsible for Leptospirosis as a public health concern?

A

Leptospira interrogans

149
Q

Leptospira interrogans is a zoonotic ________.

A

spirochete

150
Q

What is the most common route of transmission for Leptospirosis?

A

urine contact (water, soil, vegetation)

151
Q

_______ are incidental hosts for Leptospirosis, therefore it occurs rarely.

A

humans

152
Q

A human’s _________ or being in a (developed/developing) country increases the risk of leptospirosis.

A

occupation
developing

153
Q

What serves as a reservoir for Leptospirosis? Ans which species is the most important?

A

wild mammals
rats

154
Q

_______ are carriers for Leptospirosis.

A

dogs

155
Q

(T/F) Leptospirosis is currently re-emerging worldwide.

A

True

156
Q

50% of human cases in the US are in which state?

A

Hawaii

157
Q

List the 2 forms of Leptospirosis.

A
  1. non-icteric
  2. icteric
158
Q

What 2 major signs are seen with NON-icteric Leptospirosis?

A
  1. flu-like (headache, myalgia, fever, chills)
  2. progression to menginitis
159
Q

Icteric Leptospirosis is also known as:

A

Weil’s Disease

160
Q

In addition to jaundice, fever, conjunctivitis, rash, hepatomegaly, and meningitis, what eventually to Leptospirosis fatality?

A

renal & hepatic failure

161
Q

Leptospirosis is identified by seeing spirochetes in:

A

proximal renal tubules

162
Q

What 3 tissues can be cultured to diagnose Leptospirosis?

A

body fluids
CSF
urine

163
Q

What test can detect rising antibody titers for Leptospirosis?

A

Microscopic Agglutination Test (MAT)

164
Q

(T/F) Human vaccination is the best way to prevent Leptospirosis.

A

False! (only dogs vaccinated)

165
Q

(T/F) Dogs vaccinated for Leptospirosis can still become infected and shed it in their urine, therefore, spreading it to humans.

A

True

166
Q

Which pathogen is a potential REVERSE zoonosis where humans appear to be primarily affected and spread to animals?

A

Helicobacter

167
Q

Helicobacter pylori is a gram (negative/positive) _______-shaped bacteria.

A

negative
rod

168
Q

What is Helicobacter pylori’s oxygen requirement?

A

microaerophilic

169
Q

Helicobacter pylori is (motile/non-motile) with multiple ________ flagella.

A

motile
polar

170
Q

Where is Helicobacter located in the body? What kind of pH does it survive in?

A

stomach
low pH

171
Q

Which two researchers won the Nobel Prize by ingesting Helicobacter pylori themselves?

A

Robin Warren + Barry Marshall

172
Q

What disease does Helicobacter pylori cause in humans?

A

gastritis + gastric ulcers

173
Q

Chronic Gastritis caused by H. pylori leads to Gastric _________ and Gastric __________.

A

Lymphoma
Adenocarcinoma

174
Q

In addition to humans, dogs, cats, ferrets, monkeys, and rabbits can all become infected with Helicobacter. Give the species that infects them.

A

dogs: H. canis
cats & dogs: H. felis
Ferrets: H. mustelae
Dogs, cats, monkeys, rabbits, humans: H, heilmannii

175
Q

(T/F) Helicobacter is present worldwide, but higher incidence in developing countries.

A

True

176
Q

Avian Chlamydiosis, Parrot Fever, and Ornithosis are all other disease names for:

A

Psittacosis

177
Q

Give the etiology of Psittacosis.

A

Chlamydia psittaci

178
Q

Chlamydia psittaci is (facultative/obligate) (intracellular/extracellular) bacteria.

A

obligate intracellular

179
Q

Psittacosis exists in 2 forms:

A
  1. elementary body
  2. reticulate body
180
Q

Regarding the forms of Chlamydia psittaci, _________ body is non-infectious and replicating while ________ body is infectious and NON-replicating.

A

reticulate
elementary

181
Q

List 3 routes of transmission of Chlamydia psittaci to humans.

A
  1. inhalation (droppings, feather secretions)
  2. direct contact (plumage, tissue handling)
  3. person-to-person (rare)
182
Q

Psittacosis in humans varies from inapparent to system infections with __________.

A

pneumonia

183
Q

(T/F) Psittacosis in humans appears with an abrupt onset of fever, chills, headache, cough, splenomegaly, and rash.

A

True

184
Q

Psittacine birds such as _________ and ________, in addition to turkeys, ducks, and rarely chickens become infected with Psittacosis.

A

parakeets
cockatiels

185
Q

List a few signs of Psittacosis seen in animals.

A

anorexia, weight loss, diarrhea, yellow droppings, sinusitis, nervous signs

186
Q

(Young/Old) bird carriers for Psittacosis undergo intermittent shedding which is activated by stress.

A

young

187
Q

(T/F) With treatment, Psittacosis is NOT highly fatal.

A

True (1-5%)

188
Q

(T/F) Without treatment, Psittacosis has nearly 100% mortality.

A

False (may resolve on its own, 10-40% mortality)

189
Q

(T/F) There is NO vaccination for Chlamydia psittaci.

A

True

190
Q

Looking at the history of Psittacosis outbreaks in the US, the majority of cases are with known source of exposure to _________ birds.

A

caged

191
Q

Give the etiology for Catch Scratch Disease.

A

Bartonella henselae

192
Q

Bartonella henselae is a gram (positive/negative) (obligate/facultative) intracellular _________.

A

negative
facultative
coccobacillus

193
Q

Bartonella henselae is __________ or silver staining.

A

argyrophilic

194
Q

Catch Scratch Disease is a _______-_______ illness.

A

self-limiting

195
Q

Cats with Cat Scratch Disease are:

A

asymptomatic

196
Q

There is a higher incidence of (domestic/feral) cats with Cat Scratch Disease.

A

feral

197
Q

(T/F) Cat Scratch Disease incidence is higher in cats with FeLV or FIV.

A

False

198
Q

Catch Scratch Disease often infects children and adults that are younger than ____.

A

21

199
Q

Cat Scratch Disease is the most common cause of _________ in children.

A

chronic lymph node swelling

200
Q

(T/F) Lymphadenopathy or lymph node swelling due to Cat Scratch Disease can spontaneously regress.

A

True

201
Q

List the 3 criteria for “Classical” Cat Scratch Disease.

A
  1. cat contact history
  2. positive skin test
  3. negative lab investigation
202
Q

6% of humans that develop Cat Scratch Disease develop _________ _________ Syndrome, characterized by conjunctivitis, preauricular adenopathy, and granulomatous lesion in conjunctiva.

A

Parinaud Oculoglandular Syndrome

203
Q

1-2% of humans with atypical Cat Scratch Disease develop:

A

Idiopathic Stellate Neuroretinitis

204
Q

Idiopathic Stellate Neuroretinitis caused by Cat Scratch Disease is characterized by a loss of visual acuity with lipid exudates called:

A

macular star

205
Q

Immunocompromised humans infected with CSD develop __________-like lesions in the skin & bone or liver & spleen.

A

hemangioma

206
Q

How is CSD transmitted to humans?

A

bite/scratch from cat

207
Q

(T/F) Bartonella henselae can penetrate intact skin.

A

False

208
Q

What is the vector for CSD?

A

Ctenocephalides felis (cat flea)

209
Q

The exact route of spread of Cat Scratch Disease between ______ is unknown.

A

cats

210
Q

Cats transmit CSD to humans by contact with infected ________ ________.

A

flea feces

211
Q

Are the majority of CSD cases without treatment fatal or resolve?

A

resolve (1-6 months)

212
Q

2 ways to prevent CSD.

A
  1. cat flea control
  2. avoid adopting kittens of unknown origin (immunocompromised individuals)
213
Q

Rat Bite Fever is caused by:

A

Streptobacillus moniliformis

214
Q

Streptobacillus moniliformis is a gram (positive/negative) (motile/non-motile) ________.

A

negative
non-motile
rod

215
Q

What is the oxygen requirement for Streptobacillus moniliformis?

A

microaerophilic

216
Q

While Streptobacillus moniliformis causes Streptobacillary Rat Bite Fever, this another organism, _______ ________, which cause Spirillary Rat Bite Fever in Africa & Asia.

A

Spirillum minus

217
Q

(T/F) Spirillum minus is a short, thick, motile spirochete.

A

True

218
Q

(T/F) Both Spirillum minus and Streptobacillus moniliformis are in NORMAL rat gastrointestinal flora.

A

False (normal RESPIRATORY flora)

219
Q

How is Rat Bite Fever transmitted?

A

rat contact with humans (scratch, handling)

220
Q

In addition to rat contact, Rat Bite Fever (Streptobacillary) can potentially be transmitted via:

A

contaminated milk

221
Q

(T/F) There has been NO reported human-to-human contact spread of Streptobacillary Rat Bite Fever.

A

True

222
Q

Rat Bite Fever outbreak in Massachusetts and England in 1983 due to raw milk contamination was termed:

A

Haverhill Fever

223
Q

In 2013, a child died from Rat Bite Fever after adopting a rat from ________.

A

Petco

224
Q

Majority of Rat Bite Fever cases in the US occur in (urban/rural) areas.

A

urban

225
Q

Initially RBF causes non-specific signs including ________ pain.

A

joint

226
Q

Untreated Rat Bite Fever causes a variety of systemic sequelae and mortality in ___ to ___%.

A

7-10

227
Q

What are 2 main differences of Spirillary RBF compared to Streptobacillary RBF?

A

Spirillary is more generalized with NO joint signs

228
Q

(T/F) Streptobacillus moniliformis DOES NOT grow on artificial media.

A

False (Spirillum minus doesn’t)

229
Q

(T/F) Antimicrobials are ineffective at reducing disease severity of RBF.

A

False (shorten and decrease severity)

230
Q

(T/F) There are serious, possible fatal complications if Streptobacillary RBF is NOT treated.

A

True

231
Q

Brucella is a gram (positive/negative) (obligate/facultative) intracellular bacteria.

A

negative
facultative

232
Q

Brucella causes ________, ________, or ________ Fever in humans.

A

Undulant, Malta, Gibraltar

233
Q

Brucella is primarily known for causing ________ in cattle.

A

abortion

234
Q

Human Brucellosis causes what kind of signs for <8 weeks?

A

flu-like

235
Q

After <1 year of Brucellosis, humans develop undulant fever, arthritis, and __________.

A

orchiepidimyitis

236
Q

3 ways to diagnose Brucellosis in humans.

A
  1. culture
  2. agglutination titer (4x increase)
  3. immunofluorescence
237
Q

3 route of Brucella transmission in humans.

A
  1. ingestion (unpasteurized milk/dairy)
  2. inhalation (aerosols)
  3. wound contamination
238
Q

Which route of transmission for Brucella in humans is most common?

A

ingestion

239
Q

Which route of Human Brucellosis transmission has bioterrorism potential?

A

inhalation

240
Q

(T/F) Brucellosis is nearly eradicated in the US.

A

True

241
Q

The majority of US cases of Brucellosis are caused by Brucella __________, associated with imported _______.

A

melitensis
cheese

242
Q

Raw milk in Texas in 2017 and raw milk at a Biodiversity Farm in PA in 2019 were both associated with Brucella outbreaks related to:

A

vaccine strain (RB51)

243
Q

________ vaccine for brucella was licensed in 2003.

A

RB51

244
Q

RB51 vaccine for Brucellosis (does/does not) induce a measurable antibody response.

A

does not (NO O-antigens)

245
Q

Mycobacterium tuberculosis infects ONLY _______ animals.

A

captive

246
Q

Which 3 captive species can transmit Mycobacterium tuberculosis to humans?

A
  1. non-human primates
  2. Asian elephants
  3. Psittacine birds
246
Q

Match the Mycobacterium tuberculosis antibiotic treatment its mechanism:

  1. inhibits lipid & nucleic acid synthesis
  2. inhibits RNA synthesis (x2)
  3. inhibits transfer of mycolic acids into cell wall
  4. may inhibit fatty acid synthesis
A
  1. Isoniazid
  2. Rifampin, Rifapentine
  3. Ethambutol
  4. Pyrazinamide
247
Q

Multidrug Resistant TB is resistant to ________ and ________.

A

isoniazid
rifampin

248
Q

Extensively Drug-Resistant TB is resistant to ________, in addition to rifampin and isoniazid (at least 1/3 of injectable second-line anti-TB drugs).

A

fluoroquinolone

249
Q

How is Mycobacterium tuberculosis transmitted to humans?

A

pet transfer

250
Q

Bison, black bears, bobcats, coyotes, racoons, red foxes, and deer are all _________ hosts of Mycobacterium bovis.

A

maintenance

251
Q

Recent Mycobacterium bovis outbreaks in the US have been associated with _______ and _______.

A

deer hunters
tattoos

252
Q

Worldwide cases of Mycobacterium bovis continue to rise in developing countries due to what source?

A

milk

253
Q

What clinical sign is seen with Mycobacterium bovis?

A

caseous necrosis (lymph nodes)

254
Q

There are several syndromes caused by Mycobacterium avium complex (MAC) in humans caused by Mycobacterium _________ or __________.

A

avium
intracellulare

255
Q

Mycobacterium avium complex causes _________ infections that are more mild than tuberculosis and disseminated infections associated with _______.

A

pulmonary
HIV

256
Q

Which species of Mycobacterium prefers colder temperatures and does not invade well into tissues?

A

Mycobacterium marinum

257
Q

M. marinum causes what disease?

A

Swimming Pool Granuloma

258
Q

(T/F) Mycobacterium marinum usually resolves spontaneously but is worse for immunocompromised individuals.

A

True

259
Q

Mycobacterium marinum has developed some antibiotic resistance to __________ and ________.

A

isoniazid
pyrazinamide

260
Q

Which pathogen causes Leprosy?

A

Mycobacterium leprae

261
Q

Leprosy is also known as:

A

Hansen’s Disease

262
Q

Leprosy is a chronic infection of ________ and _________.

A

skin & peripheral nerves

263
Q

(T/F) Leprosy is highly contagious.

A

False (contagious but not high)

264
Q

How is Mycobacterium leprae transmitted?

A

nasal secretions

265
Q

(T/F) Mycobacterium leprae cannot be cultured.

A

True

266
Q

(T/F) Mycobacterium leprae is common worldwide, even in the US.

A

False (not in US)

267
Q

In the US, what animal serves as a host for Mycobacterium leprae?

A

nine-banded armadillo

268
Q

Which Mycobacterium species has primary multidrug-resistance and therefore needs long-term treatment with multiple antibiotics?

A

Mycobacterium leprae

269
Q

In addition to armadillos in the US, what new reservoir for Mycobacterium leprae is appearing in Ireland and Britain?

A

Eurasian Red Squirrels

270
Q

(T/F) Non-human primates can become infected with a variety of Mycobacterium species.

A

True

271
Q

The MOST susceptible non-human primate to Mycobacterium are (young/old) ___________, also known as the “old world monkey”.

A

young macaques

272
Q

The LEAST susceptible non-human primates to Mycobacterium infection are the “new world monkeys” such as ________ or ________.

A

squirrel monkey
owl monkey

273
Q

Influenza virus is part of ___________ family.

A

Orthomyxoviridae

274
Q

List the 4 main types of Influenza Virus.

A

Type A
Type B
Type C
Type D

275
Q

Match which influenza virus types infect which species:

  1. humans & swine (x2)
  2. cattle & swine
  3. multiple species
A

Type B & C: humans + swine
Type D: cattle + swine
Type A: multiple species

276
Q

Which influenza type is the most virulent?

A

Type A

277
Q

Birds and mammals can be infected by Influenza A viruses. ________ and _______ are reservoirs.

A

waterfowl
shorebirds

278
Q

Influenza B viruses are (more/less) severe than A.

A

less

279
Q

Influenza B viruses mostly infect:

A

humans

280
Q

Which influenza virus results in seasonal epidemics and pandemics in humans?

A

Influenza A

281
Q

Which influenza virus causes mild to no symptoms in humans and swine, often infants and younger kids?

A

Influenza C

282
Q

Most humans have _______ for influenza C virus at 15 years old.

A

antibodies

283
Q

Influenza C & D viruses all have a ____ gene segmented genome but differ by what protein?

A

7
hemagglutinin-esterase fusion protein

284
Q

(T/F) Influenza D viruses infect cattle, swine, and humans.

A

False (NOT known to cause disease in humans)

285
Q

Which influenza virus type contributes to respiratory disease complex?

A

Influenza D

286
Q

Which 2 surface antigens and proteins make influenza viruses unique?

A

hemagglutinin (HA)
neuraminidase (NA)

287
Q

What is the function of Hemagglutinin in influenza viruses?

A

attachment sites, penetration of host cells

288
Q

What is the function of Neuraminidase?

A

remove neuraminic acid from mucin for viral release from cells

289
Q

Match the influenza protein to its function:

  1. viral genome assembly
  2. replication (x3)
  3. assembly
  4. penetration
  5. RNA transport, replication
A
  1. NS2 (NEP)
  2. PB1, PB2, PA
  3. M1
  4. M2
  5. NP (nucleocapsid)
290
Q

The human seasonal flu vaccine uses 2 strains of Type _____ and 1 or 2 strains of Type ____.

A

A
B

291
Q

Why are influenza outbreaks and pandemics difficult to predict?

A

affect multiple amino acids in multiple genes

292
Q

Match the influenza evolutionary mechanism to its description:

  1. large mutations of virus surface proteins lead to emergence of new subtypes
  2. gradual alteration of surface proteins
A
  1. antigenic shift
  2. antigenic drift
293
Q

Antigenic ________ causes pandemics of Type A influenza virus where there is little to no immunity yet.

A

shift

294
Q

Type A influenza pandemics cause a higher mortality in (old/young) adults.

A

young

295
Q

List 3 specific influenza pandemics that occurred within the last decade due to antigenic shift.

A
  1. Asian Flu
  2. Hong Kong Flu
  3. Swine Flu
296
Q

Antigenic drift causes ________ mutations in HA & NA genes, which is why vaccines are updated yearly.

A

point

297
Q

______ classifies pandemic strains of influenza in phases 1-6.

A

WHO (world health organization)

298
Q

An influenza virus classifies as WHO Status Phase ___ if there is human-to-human spread in 2+ countries and there is a strong signal that pandemic is imminent.

A

5

299
Q

WHO Status Phase ___ is the pandemic phase where outbreaks have occurred in at least 1 more country than Phase 5 and a global pandemic is occurring.

A

6

300
Q

Which two vaccine types are available for influenza virus?

A
  1. inactivated vaccine (killed)
  2. quadrivalent vaccines
301
Q

In Avian Influenza, _________ determines disease severity in poultry.

A

pathogenicity

302
Q

Low pathogenic (LPAI) Avian Influenza includes _____ or _____ subtypes.

A

H1 or H16

303
Q

Highly Pathogenic Avian Influenza (HPAI) includes some ____ or ____ subtypes.

A

H5 or H7

304
Q

(T/F) LPAI H5 or H7 subtypes can mutate to HPAI.

A

True

305
Q

(T/F) The human flu vaccine also protects against Avian Influenza.

A

False

306
Q

What animals are asymptomatic carriers of HPAI (Highly Pathogenic Avian Influenza)?

A

waterfowl

307
Q

Waterfowl can transmit HPAI to ______ and ______ which develop disease.

A

chickens & turkeys

308
Q

In the US in 2022-2023, there was an Avian Influenza outbreak detected in _______.

A

mammals (fox, skunk, raccoon)

309
Q

Human cases of Avian Influenza are associated with _______ farms and live bird markets.

A

poultry

310
Q

(T/F) Avian Influenza is rarely transmitted from human to human.

A

True

311
Q

Possible subtypes of Avian Influenza which infect humans include ________ and ________.

A

H5N1
H7N9

312
Q

Match the Avian Influenza subtype which can infect to humans to its description:

  1. high viral loads, intense inflammation, high mortality, LOW poultry-to-human or human-to-human transmission
  2. 615 Chinese deaths, NO evidence of human-human transmission, closure of live poultry markets and began poultry vaccine campaign
A
  1. H5N1
  2. H7N9
313
Q

(T/F) Foot and Mouth Disease is a virus which causes blister-like eruptions in the mouth and a skin rash in infants & children.

A

FALSE (Hand, Foot, and Mouth Disease)

314
Q

_________ is a Coxsackievirus, an enterovirus in the Picornaviridae family.

A

Hand, Foot, and Mouth Disease

315
Q

Foot & Mouth Disease is in the ___________ family, more specifically, an _________.

A

Picornaviridae
Aphthovirus

316
Q

There are _____ serotypes of Foot & Mouth Disease.

A

7

317
Q

(T/F) Antibodies of FMD between serotypes are NOT cross-protective.

A

True

318
Q

Which animals are affected by Foot & Mouth Disease?

A

cloven-hoofed animals

319
Q

FMD is (resistant/sensitive) to the environment.

A

resistant

320
Q

FMD has a (low/high) infectious dose.

A

low

321
Q

FMD survives in ________, _______, and _______.

A

milk
bone marrow
lymph nodes

322
Q

FMD survives longer in the environment when protected by:

A

mucous/feces

323
Q

FMD can be spread great distances by:

A

wind

324
Q

Sheep and goats are __________ hosts of FMD and carry the virus in their pharyngeal tissues for 4-6 months.

A

maintenance

325
Q

(T/F) Pigs are carriers for FMD.

A

False

326
Q

Pigs are __________ of FMD.

A

amplifiers

327
Q

Cattle are ________ of FMD, where the virus is present in pharyngeal tissues for 6-24 months.

A

indicators

328
Q

Give 2 routes of transmission of FMD.

A
  1. direct contact (ingestion, fomites, artificial insemination)
  2. respiratory
329
Q

The lase US case of FMD was in what year?

A

1929

330
Q

What are 2 impacts of FMD (not health related)?

A
  1. economic
  2. tourism
331
Q
A
332
Q

FMD disease in animals has _____% morbidity and 1-5% mortality in (young/adults) or 20% in (young/adults).

A

100%
adults
young

333
Q

(T/F) Humans rarely develop disease due to FMD or only develope mild signs.

A

True

334
Q

How do humans get infected with FMD?

A

ingestion of unprocessed milk/dairy

335
Q

Foot & Mouth Disease is a zoonosis OR _______ zoonosis.

A

reverse

336
Q

FMD can be a reverse zoonosis via _________ tract or contaminated __________.

A

respiratory
clothing

337
Q

_______ _______ has strict regulations on import of livestock from countries affected with FMD and biosecurity regulations for livestock facilities.

A

USDA APHIS

338
Q

What 2 clinical signs are seen in animals with FMD?

A
  1. fever
  2. vesicles –> erosions (feet, mouth, nares, teats)
339
Q

(T/F) FMD can cause abortion and death in young animals.

A

True

340
Q

Most animals recover from FMD within ________ without secondary infections.

A

2 weeks

341
Q

List 3 lesions of cattle with FMD.

A
  1. oral vesicles
  2. decreased milk
  3. lameness
342
Q

In swine with FMD, oral vesicles are less common, but instead they have lesions on their ______ and vesicles on the _______.

A

hoof
snout

343
Q

_______ & _______ have mild or asymptomatic signs from FMD.

A

sheep & goats

344
Q

(T/F) Despite being asymptomatic or having mild signs from FMD, sheep & goats shed the virus but it is difficult to diagnose and prevent the disease in them.

A

True

345
Q

(T/F) You cannot clinically differentiate between FMD and other vesicular diseases.

A

True

346
Q

If you suspect FMD, you need to contact the state __________ and __________.

A

veterinarian
quarantine

347
Q

(T/F) There is NO treatment or vaccination for FMD.

A

False (NO treatment, but vaccination helps control outbreak)

348
Q

(T/F) There is NO need to vaccinate for FMD in the US since it is eradicated.

A

True

349
Q
A

Public Health (3 decks)

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