SPECIAL CHAPTER: BIOTERRORISM

Question 1

involves the release of toxic biological agents

Answer 1

bioterrorism

Question 2

intentional release of viruses, bacteria or fungi that can sicken or kill people

Answer 2

biological attack

Question 3

characteristics of bioterrorism

Answer 3

more insidious
more potential casualties
harder to detect and trace to origin
easier to disperse

Question 4

characteristic of chemical terrorism

Answer 4

agents are readily available
limited success
treatment options is limited and must be administered in the field

Question 5

characteristic of nuclear terrorism

Answer 5

easy to detect

Question 6

key features of biologic agents used as bioweapons

Answer 6

high morbidity and mortality rates
potential for person to person spread
low infective dose
highly infectious by aerosol
lack of rapid diagnostic capability
lack of universally available effective vaccine
potential to cause anxiety
availability of pathogen and feasibility of production
environmental stability

Question 7

examples of category A CDC agents

Answer 7

anthrax-bacillus anthracis
botulism- clostridium botulinum toxin
plague-yersnia pestis
small pox- variola major
tularemia-francisella tularensis
viral hemorrhagic fever
arenaviruses
bunyaviridae

Question 8

examples of category B CDC agents

Answer 8

brucellosis
epsilon toxin of clostridium perfringes
food safety threats such as ecoli salmonella and shigella
glanders
meliodosis
pssitaciosis
q fever
ricin toxin
staph enterotoxin
typhus fever
viral encephalitis
water safety threats such as vibrio cholerae and cryptosporidium parvum

Question 9

examples of CDC category C agents

Answer 9

emerging infectious diseases threats such as Nipah, hantavirus, SARS or MERS coronavirus and pandemic influenza, COVID 19 virus

Question 10

anthrax is caused by?

Answer 10

bacillus anthracis

Question 11

bacillus anthracis is what type of bacteria

Answer 11

gram positive
non motile
spore forming
found in soil
causes disease in herbivores

Question 12

incubation period of B. anthracis

Answer 12

2 to 43 days

Question 13

death occurred in what day

Answer 13

1-4 days following the onset of symptoms

Question 14

what are the 4 forms of bacillus anthracis

Answer 14

gastrointestinal
cutaneous
inhalational
injection

Question 14

what are the 4 forms of bacillus anthracis

Answer 14

gastrointestinal
cutaneous
inhalational
injection

Question 15

clinical syndrome of bacillus anthracis

Answer 15

cutaneous lesions: papule to eschar
inhalational disease: fever, malaise, chest and abdominal discomfort
pleural effusion: widened mediastinum in xray

Question 16

how to diagnose bacillus anthracis

Answer 16

culture
gram stain
PCR
wright stain of peripheral smear

Question 17

treatment for Bacillus anthracis post-exposure

Answer 17

ciprofloxacin 500mg PO bid for 60 days
doxycyline 100 mg PO bid for 60 days
amoxicillin 500 mg po q8H for 60 days (effective if strain is penicillin sensitive)

Question 18

treatment for active disease of bacillus anthracis

Answer 18

ciprofloxacin 400 mg IV q12h or doxycyline 100 mg IV q12h plus
clindamycin

Question 19

ntitoxin for treatment of anthracis bacillus

Answer 19

raxibacumab
diphenhydramine to reduce reaction
obiltoxaximab to premedicate

Question 20

prophylaxis for anthrax bacillus

Answer 20

recombinant protective antigen vaccines

raxibacumab or obiltoxaximab

Question 21

causative agent of pneumonic plaque

Answer 21

yersinia pestis

Question 22

clinical syndrome of yersinia pestis

Answer 22

fever cough dyspnea and hemoptysis

infiltrates and consolidation on chest xray

Question 23

incubation period of yersinia pestis

Answer 23

1- 6 days

Question 24

diagnosis of yersinia pestis

Answer 24

culture gram stain direct fluorescent antibody PCR

Question 25

treatment for yersinia pestis

Answer 25

gentamicin streptomycin alternatives include: docycyline and chloramphenicol

Question 26

prophylaxis of yersinia pestis

Answer 26

doxycyline and levofloxacin and formalin fixed vaccine

Question 27

causative agent of small pox

Answer 27

variola major

Question 28

clinical syndrome of small pox

Answer 28

``` fever malaise headache backache emesis maculopapular to vesicular to pustular skin lesions ```

Question 29

incubation period of small pox

Answer 29

7-17 days

Question 30

diagnosis of small pox

Answer 30

culture PCR electron microscopy

Question 31

treatment for small pox

Answer 31

supportive measures consideration for cidofovir, recovirimat, immunoglobulin

Question 32

prophylaxis for small pox

Answer 32

vaccination and immunization

Question 33

causative agent for tularemia

Answer 33

francisella tularensis

Question 34

clinical syndrome of tularemia

Answer 34

``` fever chills malaise chest discomfort dyspnea headache skin rash pharyngitis conjunctivitis hilar adenopathy on chest xray ```

Question 35

incubation period for francisella tularensis

Answer 35

1-14 days

Question 36

diagnosis for tularemia

Answer 36

gram stain culture PCR immunochemistry

Question 37

treatment for tularemia

Answer 37

``` streptomycin gentamicin doxycyline chloramphenicol ciprofloxacin ```

Question 38

prophylaxis for tularemia

Answer 38

doxycycline and ciprofloxacin

Question 39

clinical syndrome for viral hemorrhagic fever

Answer 39

``` fever myalgia rash encephalitis prostration ```

Question 40

incubation period of viral hemorrhagic syndrome

Answer 40

2-21 days

Question 41

diagnosis for viral hemorrhagic fever

Answer 41

RT-PCR serologic testing for antigen or antibody | viral isolation

Question 42

treatment for viral hemorrhagic fever

Answer 42

supportive measure for ebola: slow IV infusion | for lassa: ribavarin

Question 43

prophylaxis for viral hemorrhagic fever

Answer 43

no known chemoprophylaxis | experimental vaccines

Question 44

causative agent for botulinum toxin

Answer 44

clostridium botulinum

Question 45

clinical syndrome

Answer 45

``` dry mouth blurred vision ptosis weakness dysphagua dizziness respiratory failure progressive paralysis dilated pupils ```

Question 46

incubation period of botulinum toxin

Answer 46

12-72 hours

Question 47

diagnosis for clostridium botulinum

Answer 47

mouse bioassay | toxin immunoassay

Question 48

treatment for clostridium botulinim

Answer 48

supportive measures HPAT

Question 49

prophylaxis for clostridium botulinum

Answer 49

administration of antitoxin