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Emergency Medicine > Bioterrorism > Flashcards

Flashcards in Bioterrorism Deck (27)
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1
Q

CBRNE mnemomic

A

chemical, biological, radiological, nuclear, energetic (explosives and incendiary)

2
Q

chemical has __ onset of sx

A

rapid

3
Q

biological agents create __ onset of sx

A

gradual

4
Q

describe anthrax bacteria

A
bacillus anthracis 
encapsulated 
aerobi 
gram + 
spore former 
Rod shaped
5
Q

what are the two toxins anthrax creates?

A

edema toxin ET and lethal toxin LT

6
Q

sx of cutaneous anthrax exposure

A

painless skin lesions over 1-7 days
papules to vesicle to depressed black eschar with local edema

80% recover w/o tx

7
Q

onset of inhalation anthrax exposure

A

onset 1 wk but up to 2 mo

Prodrome - viral resp illness
hypoxia, dyspnea with mediastinal widening, or pleural effusion on CXR

88% fatal event even with aggressive tx

8
Q

sx inhalation anthrax exposure

A

fever, chills, chest discomfort, SOB, cough, N/V, dizzy, HA sweats, myalgias

9
Q

signs of anthrax meningitis from inhalation exposure

A

AMS, fever, HA, N/V, sz, nuchal rigidity

krnig/brudzinski sign

10
Q

gastrointestinal sx

A

severe abdominal distress s/s of septicemia

fever, chills, cervical lymphadenopathy, pharyngitis, dysphagia, hoarseness, N/V/D, hematemesis, HA, flushing, red eyes, abdominal pain/swelling etc

11
Q

anthrax abx tx

A

1 bacteriocidal agent
(Cipro, levo, moxi, meropenem, impipenem, doripenem, vancomycin)

AND 1 protein synthesis inhibitor: clindamycin, linezolid, doxy, rifampin

12
Q

anthrax tx if PCN susceptible

A

for bacteriocidal agent use one of following: Pen G or ampicillin

13
Q

anthrax additional tx with abx

A

need good CNS penetration for anthrax meningitis: fluoro + b lactam + protein synthesis inhibitor

14
Q

anthrax PEP

A

doxy and Cipro are first line

Sensitive: amoxicillin, Pen VK, clndaymycin

Dose for 60 days

15
Q

what drug would you consider for anthrax exposure with pregnancy?

A

> .?

16
Q

describe plague bacteria

A

Yersinia pestis: bacterium gram - rod

17
Q

plague clinical sx

A

fever and leukocytosis plus 1 or more of the following:

bubonic, septicemic, pna, pharyngeal sx

18
Q

bubonic plague sx

A

regional lymphadenitits

19
Q

septicemic plague

A

septicemia without evident bubo

20
Q

pharyngeal plague

A

pharyngitis and cervical lymphadenitis

21
Q

plague pna sx

A

onset 1-6 days PE

fever, HA, weakness, hemoptysis, SOB, cough, CP

22
Q

first line plague tx

A

streptomycin
gentamicin
ciprofloxacin, levofloxacin
treat 10-14 days

23
Q

second line plague tx

A

moxifloxacin, doxycycline and chloramphenicol

24
Q

pediatrics plague tx

A

streptomycin, gentamicin
levofloxacin, ciprofloxacin
doxycycline
chloramphenicol for kids 2+

25
Q

pregnancy plague tx

A

gentamicin, doxycycline, ciprofloxacin

26
Q

smallpox caused by__

A

variola virus - no animal, environmental or vectors

27
Q

classic smallpox presentation

A

acute onset fever 101+, HA, myalgia

small spot on mouth and tongue

rash 1-4 days later
(firm deep seated vesicles or pustules in same stage of development)