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Questions and Answers
Unclotted blood from nasal, buccal or anal orifice may be collected from a carcass that is ______ days old.
Unclotted blood from nasal, buccal or anal orifice may be collected from a carcass that is ______ days old.
1 to 2
For old putrefying carcasses, selection of ______ or any blood stained material may be collected.
For old putrefying carcasses, selection of ______ or any blood stained material may be collected.
tissues
Soil or other material from ______ site may be collected if the specimen is buried.
Soil or other material from ______ site may be collected if the specimen is buried.
burial
Routine blood culture methods are sufficient for ______ specimens.
Routine blood culture methods are sufficient for ______ specimens.
Bacillus anthracis appears as short chains of ______ cells which are encapsulated.
Bacillus anthracis appears as short chains of ______ cells which are encapsulated.
Cultures should be incubated at ______° C under ambient conditions.
Cultures should be incubated at ______° C under ambient conditions.
100% mortality within 24 hours in mice indicates the presence of ______.
100% mortality within 24 hours in mice indicates the presence of ______.
PCR is one of the ______ methods used for confirming the presence of Bacillus anthracis.
PCR is one of the ______ methods used for confirming the presence of Bacillus anthracis.
Brucellosis is a disease widely prevalent in all countries of the world and is a serious problem facing the Veterinary and Medical professions, especially in ______.
Brucellosis is a disease widely prevalent in all countries of the world and is a serious problem facing the Veterinary and Medical professions, especially in ______.
The natural reservoirs for the Brucella bacteria include cattle (Brucella abortus), goats (Brucella melitensis), and ______ (Brucella suis).
The natural reservoirs for the Brucella bacteria include cattle (Brucella abortus), goats (Brucella melitensis), and ______ (Brucella suis).
Each year about a half million cases of brucellosis occur around the world, according to the ______ reference.
Each year about a half million cases of brucellosis occur around the world, according to the ______ reference.
The US biological warfare program focused on three agents of the Brucella group: Porcine Brucellosis (agent US), Bovine Brucellosis (agent AB), and ______ Brucellosis (agent AM).
The US biological warfare program focused on three agents of the Brucella group: Porcine Brucellosis (agent US), Bovine Brucellosis (agent AB), and ______ Brucellosis (agent AM).
Serious losses in animals due to brucellosis can include abortions, stillbirths, premature birth of weaklings, infertility, and loss of ______ and milk.
Serious losses in animals due to brucellosis can include abortions, stillbirths, premature birth of weaklings, infertility, and loss of ______ and milk.
The modes of transmission of brucellosis to humans include ingestion, contact, ______, and accidental inoculation.
The modes of transmission of brucellosis to humans include ingestion, contact, ______, and accidental inoculation.
Infection by ingestion of brucellosis may occur via the gastrointestinal tract or by penetration through the mucous membrane of the ______.
Infection by ingestion of brucellosis may occur via the gastrointestinal tract or by penetration through the mucous membrane of the ______.
Brucellosis can lead to permanent sterility in ______, among other socio-economic impacts.
Brucellosis can lead to permanent sterility in ______, among other socio-economic impacts.
Brucellae have occasionally been isolated from ______, placenta, mother’s milk, and vaginal discharges.
Brucellae have occasionally been isolated from ______, placenta, mother’s milk, and vaginal discharges.
A high or rising agglutination titre is presumptive evidence of ______ infection.
A high or rising agglutination titre is presumptive evidence of ______ infection.
Low titres are quite significant when the 2-mercaptoethanol tests show the presence of ______ immunoglobulin.
Low titres are quite significant when the 2-mercaptoethanol tests show the presence of ______ immunoglobulin.
The ______ test should be used in the diagnosis of both acute and chronic brucellosis.
The ______ test should be used in the diagnosis of both acute and chronic brucellosis.
The Coombs’ test is important for the detection of ______ cases.
The Coombs’ test is important for the detection of ______ cases.
The passive (indirect) haemagglutination test can be used to diagnose ______.
The passive (indirect) haemagglutination test can be used to diagnose ______.
Cholera induced agglutinins for brucella can be differentiated by the agglutinin-______ test.
Cholera induced agglutinins for brucella can be differentiated by the agglutinin-______ test.
When antibiotics are freely used in febrile conditions, positive diagnosis by blood culture is less frequently ______.
When antibiotics are freely used in febrile conditions, positive diagnosis by blood culture is less frequently ______.
The South-east Asia region countries carry ______% of the global burden of tuberculosis.
The South-east Asia region countries carry ______% of the global burden of tuberculosis.
The DOTS strategy stands for Directly Observed Treatment, ______-course.
The DOTS strategy stands for Directly Observed Treatment, ______-course.
India globally ranks first in ______.
India globally ranks first in ______.
The emergence of ______-drug resistant strains of TB poses an additional threat.
The emergence of ______-drug resistant strains of TB poses an additional threat.
Factors influencing the incidence of TB include poor healthcare, ______, and malnutrition.
Factors influencing the incidence of TB include poor healthcare, ______, and malnutrition.
India falls under the ______-TB zone.
India falls under the ______-TB zone.
It is estimated that ______% of the current global population is infected asymptomatically with tuberculosis.
It is estimated that ______% of the current global population is infected asymptomatically with tuberculosis.
A lack of ______ and awareness can contribute to the spread of tuberculosis.
A lack of ______ and awareness can contribute to the spread of tuberculosis.
The indirect immunofluorescence test is a specific, rapid, and sensitive method of detecting antibodies in human ______.
The indirect immunofluorescence test is a specific, rapid, and sensitive method of detecting antibodies in human ______.
A positive intradermal test normally indicates a state of specific allergy for ______.
A positive intradermal test normally indicates a state of specific allergy for ______.
A positive intradermal test can result in a rise in ______ when certain skin-test allergens are used.
A positive intradermal test can result in a rise in ______ when certain skin-test allergens are used.
In chronic brucellosis, a positive intradermal test may be the only objective indicator of ______.
In chronic brucellosis, a positive intradermal test may be the only objective indicator of ______.
In areas with a low incidence of endemic brucellosis, a positive reaction may have important ______.
In areas with a low incidence of endemic brucellosis, a positive reaction may have important ______.
In the treatment of brucellosis, the acute and subacute forms must be considered separately from the ______ form of the disease.
In the treatment of brucellosis, the acute and subacute forms must be considered separately from the ______ form of the disease.
Therapy of chronic brucellosis may include treatment with ______ and even surgical intervention.
Therapy of chronic brucellosis may include treatment with ______ and even surgical intervention.
Physiotherapy may be a useful ______ to treatment for brucellosis.
Physiotherapy may be a useful ______ to treatment for brucellosis.
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Study Notes
Bacillus anthracis Sample Collection and Isolation
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Carcass samples (1-2 days old): Collect unclotted blood from nasal, buccal, or anal orifices; if opened, collect body fluids, spleen, and/or unclotted blood.
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Older carcasses: Collect tissues or blood-stained material; if opened, collect body fluids and spleen.
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Buried carcasses: Collect soil or material from the burial site.
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Sputum specimens: Inoculate onto SBA, MacConkey agar, and broth enrichment media.
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Blood specimens: Use routine blood culture methods. Gram stain may reveal short chains (2-4 cells) of encapsulated, gram-positive rods, strongly suggestive of B. anthracis. Positive blood cultures should be Gram stained and subcultured to SBA and MacConkey agar.
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Swab specimens: Inoculate one swab onto SBA, MacConkey agar, or broth enrichment; prepare a Gram stain from a second swab.
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Stool specimens: Use routine stool culture methods (SBA, MacConkey agar, or PEA plates); avoid CVA or hectone agar.
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CSF specimens: Centrifuge at 1500 x g for 15 minutes, Gram stain the sediment, and inoculate the remaining sediment onto SBA and broth enrichment media.
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Incubate cultures at 35-37°C; examine within 18-24 hours (growth may appear as early as 8 hours).
Bacillus anthracis Confirmation
- Animal pathogenicity: Inject 5-10 mice intraperitoneally with a culture suspension. 100% mortality within 24 hours is indicative of B. anthracis. If no mortality occurs, observe for 10 days. Process spleens from dead mice to detect B. anthracis.
- Molecular methods: Direct PCR.
Brucellosis: Epidemiology and Socioeconomic Impact
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Globally prevalent; a serious veterinary and medical problem.
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High prevalence in India.
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Human brucellosis from B. canis (dogs) is uncommon, often from contact with aborting bitches.
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Approximately half a million cases worldwide annually (WHO, 1975).
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Eradicated from several countries including Finland, Norway, Sweden, Denmark, the Netherlands, Belgium, Switzerland, Germany, Australia, Hungary, the former Czechoslovakia, Rumania, and Bulgaria.
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Swine brucellosis is less prevalent in Muslim countries due to religious restrictions on pig farming.
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Natural reservoirs: cattle (Brucella abortus), goats (Brucella melitensis), and swine (Brucella suis).
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Socioeconomic impact: Biological warfare potential (U.S. program used porcine, bovine, and caprine strains); permanent male sterility; monetary losses; reduced international trade; loss of man-hours/days; abortions in animals and humans.
Brucellosis: Transmission and Serological Tests
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Transmission: Ingestion, contact, inhalation, accidental inoculation. Brucellae may be found in lymph nodes, CSF, urine, abscesses, sputum, placenta, mother's milk, vaginal discharges, and seminal fluid.
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Serological tests: Should be repeated if initial results are suspicious or negative.
- Serum agglutination test: Positive results indicate active infection; high titres usually indicate infection, but low titres do not exclude it. Low titres are significant with presence of 7S immunoglobulin. Cross-reactivity with cholera and tularaemia, but distinguishable via agglutinin-absorption test and 2-mercaptoethanol treatment.
- Complement fixation test: Used for acute and chronic brucellosis diagnosis.
- Coombs’ test: Detects chronic cases; useful for epidemiological surveys and when serum agglutination is negative.
- Passive (indirect) haemagglutination test: Specific and more sensitive than agglutination.
- Indirect immunofluorescence test: Specific, rapid, sensitive; used in qualified labs.
- Buffered Brucella antigen test (card, Rose Bengal): Shows potential value, needs further evaluation.
- Intradermal test: Indicates specific allergy; useful in chronic brucellosis when other tests are negative, in low-incidence areas, and in epidemiological surveys (consider vaccination status).
Brucellosis: Treatment
- Acute and subacute brucellosis: Clinical improvement within a week, absence of Brucella from blood/tissues, reduced complications/relapses, and antibody titre drop indicate effective therapy.
- Chronic brucellosis: Antibiotics, surgical intervention, and desensitization may be necessary; physiotherapy may be helpful.
Tuberculosis: Epidemiology and Control
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Higher incidence in low-income countries.
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South-east Asia carries 38% of the global burden, with 3 million new cases and 0.6 million deaths annually.
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Rising HIV infection and multidrug-resistant TB (MDR-TB) pose threats.
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Influencing factors: Inadequate healthcare; low socioeconomic status; malnutrition; high population density; occupational exposure; poor hygiene; lack of education/awareness; other diseases (HIV/AIDS, diabetes); close confinement.
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DOTS (Directly Observed Treatment, Short-course) strategy: Cost-effective approach to control TB; ensures cure.
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DOTS categorization of countries: 0 (no WHO reporting); 1 (no DOTS, case rate >10/100,000); 2 (pilot phase, DOTS implementation, 10% population coverage); 3 (expansion phase, 10-90% coverage); 4 (routine implementation, >90% coverage); 5 (low incidence, no DOTS, <10 cases/100,000).
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As of 2002: 180 countries implemented DOTS (69% of the world's population).
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India: Globally ranks first in tuberculosis; one-third of the global population is asymptomatically infected; falls under MDR-TB zone; significant public health problem.
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