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Microbio -3- Bioterrorism

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Question
Answer
What are the A list biologic agents   Anthrax (bacillus anthracis), Smallpox (variola major), Tularemia (francisella tularensis), Plague (yersinia pestis), Botulism (clostridium botulinum toxin), Viral hemorrhagic agents  
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Requirements to be an A list agents   easily transmitted or spread from person to person, has high mortality rates, might cause public panic and require special action for public health preparedness  
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Requirements of a B list agents   moderately easy to disseminate, moderate morbidity, low mortality rates, require enhancement of CDC's diagnositc capacity and enhanced disease surveillance  
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Requirements of a C list agents   emerging pathogens that could be engineered later to be disseminated, potential for high morbidity and mortality  
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has two forms pulmonary and cutaneous is spore forming   anthrax  
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what is the mortality rate for a full blown case of anthrax   100%  
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what are the starting s/sx like for anthrax   flu like  
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What does the spore forming ability of anthrax allow it to do   survive for long periods and resist drying and sunlight,  
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HOw is anthrax diagnosed   routine blood culture, sputum culture, direct fluorescent stain, chest x-ray with widened mediastinum.  
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do you need to quarantine for anthrax   no, no patient to patient spread  
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Treatment of anthrax   doxycycline, cipro or anthrax vaccine  
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what form must anthrax be in to infect target   aerosolized  
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what is the treatment for a person who opens an envelope with powder   prophylatic course of antibiotics  
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what is the less deadly but uglier form of anthrax and what are its s/sx   cutaneous anthrax which starts with edema develops into pruritic macule or papule enlarges and ulcerates  
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When was small pox eradicated   1970  
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what is the incubation rate for small pox   21 days allows health department to indentify and vaccinate and isolate contacts  
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Where is the pustular/vesicular rash of small pox most prominant why is this important   face and extremities, allows for differentiation from chicken pox  
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Do the lesions of small pox develop and heal in stages or all at once   all at once, chicken pox develops and heals in stages this is another way to differentiate between chicken pox and small pox  
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How do you diagnose small pox and what course do you take with a patient you think is infected   requires specialty testing and put patient in quarantine no treatment on symptomatic care  
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What is tularemia what types are there   gram negative coccobacillus jellison type A (highly virulent) Type B (mild disease)  
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Who is the most common group infected with tularemia   people who work with rabbits  
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How does tularemia normally infect us   passing through broken skin causing febrile condition with skin ulcers and tender lymphadenopathy  
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What is the incubation for tularemia   1-21 days  
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What way would tularemia need to enter to infect people as an effective bioagent   via the lungs as a aerosol which causes acute onset  
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what are the s/sx of acute onset tularemia via inhalation   non productive cough substernal burning chest x-ray may show patchy ill defined infiltrates may develop toxicity shock is common  
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what are the major problems with inhaled tularemia   febrile condition, develop multiple necrotizing granulomata that destroy alveolar septa. can develop bronchopneumonia, bronchitis or tracheaitis. can also develop bacteremia  
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How do you diagnose tularemia   sed rate and c reactive protein is elevated smears of aspirates from lymph nodes have organism pneumotic form harder to diagnose  
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What is the treatment for tularemia   streptomycin  
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what are the fatality rates for untreated tularemia skin and lung   skin 5% pneumonic 30%  
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What is the type of plauge found in the US   Yersenia pestis  
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what is the initial s/sx of plague yersenia pestis   non specific viral syndrome, progresses to severe pneumonia, cough w/ muco-purulant sputum, hemoptysis, and chest pain  
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How do you diagnose plague   gram's stain of blood or sputum culture direct fluoroscopy assay serology chest x ray with bronchopneumonia  
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Treatment for plague   contagious need strict isolation, treat with streptomycin, gentamycin, doxycyline, chloramphenicol,  
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What is botulism   a toxin produced by an organism  
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what is the lethal concentration of botulism   extremely lethal in parts per billion 1ng/kg  
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how do you get infected with botulism   direct ingestion or inhalation of the toxin  
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How is botulism toxic and lethal   is a choinergic blocker, which causes muscle paralysis. Death usually from respiratory failure.  
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What is treatment for botulism   intubation with respirator  
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How do you diagnose Botulism poisoning   look for the D's dysarthia, diplopia, descending paralysis, dysphonia.  
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WHat is the treatment of botulism   antitoxin most effective if used in first 48-72 hours if this doesn't work ventilator  
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What is the incubation time for hemorrhagic fevers   5-10 days  
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what is the characteristic s/sx of onset of hemorrhagic fever   abrupt onset of fever myalgia and headache, w/ nausea and vomiting, abdominal pain, diarrhea, chest pain and cough.  
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what occurs five days after infection with hemorrhagic fever   develop macular papular rash which in prominent on the trunk  
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What are the last s/sx of hemorrhagic fever   petechiae, ecchymoses and hemorrhages occur as the disease progresses  
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what type of virus are all the hemorrhagic fevers   RNA viruses  
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all hemorrhagic fevers but dengue can be transmitted via what   aerosol or fomites  
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what is the only hemorrhagic fever with a vaccine   yellow fever  
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