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IOS 11 Exam 2
Rabies/Tetanus
| Question | Answer |
|---|---|
| Pathogenesis of Rabies virus | HUman is bites and virus travels with saliva enters into mucles and replicates travels into neurons then via spinal cord, into the CNS |
| Species of rabies virus | Rabdoviridae, ss RNA |
| Reservoir of rabies virus | Dogs, Bats, Racoons |
| Clinical manifestations | Incubation (30-90days), Prodrome (2-10 days)-HA, Flu symptoms Acute neurological- Furious rabies or Paralytic rabies |
| Diagnosis of Rabies | Hydrophobia, bite wound, cerebralspinal fluid abnormalitis, CT, MRI |
| Mortality of rabies occurs in ___ days | 18 days |
| Who is a candidate for pre-vaccination of rabies vaccination | Vet, Lab worker, Cat &dogs, Cattle, traveler to high exposure area |
| Pre-exposure vaccines are | Imovax, Rabavert(1mL IM Booster 2-3 years), Imovax ID(0.1mL SQ- booster 2 years) 0,7,21 or 28 |
| Rapid animal bite post exposure | IMIG (1 dose) + vaccine (5 doses) |
| Rabid bite and preveious vaccination | If have adequate titer only 2 doses of vaccine |
| Pathogenesis of tetanus | Enters the body via wound, replicates and produces toxins, these enter the CNS, brain stem and block neurotransmitter release from presynaptic membrane or can suppress the ANS (increase CCA's) |
| Lifecycle of the tetanus bacteria | Incubation- 7-10 days, Onset of symptoms- 2 weeks (Paralysis), Recovery period 1 month |
| Clinical manifestations (4) | Generalized (most common), Localized, cephalic, neonatal |
| Generalized presentation of tetanus | Trismus, Risus sardonicus, abdominal rigidity, generalized spasm |
| Localized presentation of tetanus | Rigidity of site of spore infection |
| Cephalic presentation of tetanus | Affects the cranial nerves and musculature, extraocular muscle involvement |
| Neonatal presentation of tetanus | Post infection on umbilical stump, due to poor aseptic technique=90% mortality |
| Clinical Observations | Clostridium tetani cannot be cultures. Diagnosis by presentation |
| Tetanus release two exotoxins thery are | tetanospasmin and tetanolysin |
| Treatment of infected patient with symptoms | Supportaive care (airway), Benzodiazipine, Neuromuscular blocker, Magnesium (inhibit Ca), alpha and beta blockers, HTIG, Metronadizole |
| Tetanus Prophylaxis for adults | Td- Primary 3 doses, 0,1-2 months, 6-12 months later |
| Children <7 DTaP prophylaxis | Months 2,4,6, 15-18 months |
| If patient has a clean wound and no vaccination or < 3 doses | Vaccinate only |
| If patient has dirty wound and no vaccination or <3 doses | IMIG + vaccination |
| If patient has dirty wound + no active immunization w/in 5 years give | IMIG + vaccination |
| Clostridium tetanus is a gram | + anaerobe |
Created by:
liza001
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