CMN 577 Unit 3 Bioterroism McPhee
What are the 3 forms of naturally occurring Botulism? - CORRECT ANSWER-1.
food borne
2. Infant (ingested honey)
3. Wound (injection drug use)
What are the s/s of ingested Botulism? (4) - CORRECT ANSWER--12-36 hours
after ingestion, *visual disturbances (diplopia and loss of accomodation)*
-*Ptosis*
-*Cranial nerve palsies with impairment of ocular muscles, fixed dilated pupils*
-Sensory exam is normal
-dry mouth, dysphagia, dysphonia
-N/V Type E toxin
-Sensorium clear, temperature normal
-*Paralysis progresses to respiratory failure*
What is the treatment for Botulism? (1) When is this ideally administered? Do you
delay treatment until lab confirmation? - CORRECT ANSWER--Contact state
health or CDC for advice
-Equine Serum heptavalent botulism antitoxin
-Ideally within 24 hours of onset of s/s to arrest progression
-DO NOT delay administration for lab confirmation
-may remove unabsorbed toxin from gut, assay for toxin
How do you catch Anthrax? (6) - CORRECT ANSWER--exposure to animals or
animal hides (sheep, cattle, horses, goats, swine)
-through soil by inoculation of broken skin or mm
-inhalation of aerosolized spores
-ingestion resulting in cutaneous, inhalational or GI forms of anthrax
-act of bioterrorism
-has been sent through the mail
What are the s/s of cutaneous Anthrax? (5) - CORRECT ANSWER-*-occurs
within 2 weeks after exposure to spores
-no latency period
, -initial lesion is erythematous papule that vesiculates then ulcerates and
undergoes necrosis, progressing to purple to black eschar
-eschar is painless, but pain indicates secondary step or strep infection*
-surrounding area is edematous and vesicular but not purulent
-regional adenopathy,fever, malaise H/A, , N/V
-*usually self limiting, but can spread to sepsis or meningitis*
What are the s/s of inhalational anthrax? (7) - CORRECT ANSWER--occurs in 2
stages
-beginning on avg. 10 days after exposure
- latent onset 6 weeks after exposure.
-First Stage: Nonspecific viral like symptoms
-Anterior chest pain is early symptom of mediastinitis
-Stage 2: within hours to a few days progresses to fulminant stage
-fulminant stage with overwhelming sepsis, delirium, obtundation or meningeal
irritation suggest hemorrhagic meningitis
What are the s/s of GI anthrax? (6) - CORRECT ANSWER--*fever, abdominal
signs 2-5 days after ingestion*diffuse abdominal pain, rebound, abdominal
tenderness, vomiting, constipation, diarrhea occur 2-5 days after ingestion of
meat contaminated with anthrax spores
-primary lesion is ulcerative producing *emesis that is blood tinged or coffee
grounds, stool may be blood tinged or melenic.*
-*oropharyngeal form has local lymphadenopathy*, cervical edema, dysphagia,
and UR obstruction
How is diagnosis established of anthrax? (1) - CORRECT ANSWER-isolation of
anthrax of skin lesion culture or csf
What is hallmark feature of anthrax on CXR? - CORRECT ANSWER-Mediastinal
widening
What is the treatment for anthrax? (4) - CORRECT ANSWER-first line is
Ciprofloxacin
Alternative first line is Doxycycline
-Inhalational or disseminated or cutaneous infection involving face, head, neck or
local edema or systemic signs should be treated with combination therapy
What are the 3 forms of naturally occurring Botulism? - CORRECT ANSWER-1.
food borne
2. Infant (ingested honey)
3. Wound (injection drug use)
What are the s/s of ingested Botulism? (4) - CORRECT ANSWER--12-36 hours
after ingestion, *visual disturbances (diplopia and loss of accomodation)*
-*Ptosis*
-*Cranial nerve palsies with impairment of ocular muscles, fixed dilated pupils*
-Sensory exam is normal
-dry mouth, dysphagia, dysphonia
-N/V Type E toxin
-Sensorium clear, temperature normal
-*Paralysis progresses to respiratory failure*
What is the treatment for Botulism? (1) When is this ideally administered? Do you
delay treatment until lab confirmation? - CORRECT ANSWER--Contact state
health or CDC for advice
-Equine Serum heptavalent botulism antitoxin
-Ideally within 24 hours of onset of s/s to arrest progression
-DO NOT delay administration for lab confirmation
-may remove unabsorbed toxin from gut, assay for toxin
How do you catch Anthrax? (6) - CORRECT ANSWER--exposure to animals or
animal hides (sheep, cattle, horses, goats, swine)
-through soil by inoculation of broken skin or mm
-inhalation of aerosolized spores
-ingestion resulting in cutaneous, inhalational or GI forms of anthrax
-act of bioterrorism
-has been sent through the mail
What are the s/s of cutaneous Anthrax? (5) - CORRECT ANSWER-*-occurs
within 2 weeks after exposure to spores
-no latency period
, -initial lesion is erythematous papule that vesiculates then ulcerates and
undergoes necrosis, progressing to purple to black eschar
-eschar is painless, but pain indicates secondary step or strep infection*
-surrounding area is edematous and vesicular but not purulent
-regional adenopathy,fever, malaise H/A, , N/V
-*usually self limiting, but can spread to sepsis or meningitis*
What are the s/s of inhalational anthrax? (7) - CORRECT ANSWER--occurs in 2
stages
-beginning on avg. 10 days after exposure
- latent onset 6 weeks after exposure.
-First Stage: Nonspecific viral like symptoms
-Anterior chest pain is early symptom of mediastinitis
-Stage 2: within hours to a few days progresses to fulminant stage
-fulminant stage with overwhelming sepsis, delirium, obtundation or meningeal
irritation suggest hemorrhagic meningitis
What are the s/s of GI anthrax? (6) - CORRECT ANSWER--*fever, abdominal
signs 2-5 days after ingestion*diffuse abdominal pain, rebound, abdominal
tenderness, vomiting, constipation, diarrhea occur 2-5 days after ingestion of
meat contaminated with anthrax spores
-primary lesion is ulcerative producing *emesis that is blood tinged or coffee
grounds, stool may be blood tinged or melenic.*
-*oropharyngeal form has local lymphadenopathy*, cervical edema, dysphagia,
and UR obstruction
How is diagnosis established of anthrax? (1) - CORRECT ANSWER-isolation of
anthrax of skin lesion culture or csf
What is hallmark feature of anthrax on CXR? - CORRECT ANSWER-Mediastinal
widening
What is the treatment for anthrax? (4) - CORRECT ANSWER-first line is
Ciprofloxacin
Alternative first line is Doxycycline
-Inhalational or disseminated or cutaneous infection involving face, head, neck or
local edema or systemic signs should be treated with combination therapy
