0 The following information is taken DIRECTLY FROM (http://www.cdc.gov/rabies/sp

Question

0 The following information is taken DIRECTLY FROM (http://www.cdc.gov/rabies/specific,groups/doctors/index.html) Patient history, duration and progression of illness, and laboratory tests for other commo etiologies of encepha for a patient. Patient history is important to identify a possible exposure to the virus and other encephalitides; however, rabies should never be ruled out based solely on the absence of dehnite exposure history litis will help determine if rabies should be on the differential diagnosis list Rabies should be considered in patients with signs or symptoms of ence including autonomic instability, dysphagia, hydrophobia, paresis, and paresthesia, particularly if a nonspecific prodrome preceded the onset of these signs by three to four days. Progressi worsening of neurologic signs is characteristic of rabies and should be considered as a positive indicator for rabies. encephalitis or myelitis Laboratory tests to rule out common encephalitides (herpes, enteroviruses, arboviruses) should be performed. Negative results of these tests would increase the likelihood of rabies as the diagnosis. If a patient presents with symptoms similar to the ones described above, but the neurologic status does not change and the illness continues for longer than three weeks, rabies is unlikely as the diagnosis." Part 1: A person thinks they have rabies but have not been bitten by any animals in the last year. Their primary physician states "Since you have not been bitten, it is IMPOSSIBLE that you have rabies" Based on the information above, would you agree with the doctor? Why or why not? (1 pt) Part 2: What other viruses have similar symptoms as that of the rabies virus? (1 pt) Part 3: Does the onset and progression of neurological signs/symptoms help clinicians diagnose rabies? Why or why not? (1 pt) s causes an acute encephalitis in all warm-blooded hosts and the outcome is almost always fatal. The first symptoms of rabies may be nonspecific and include lethargy, fever vomiting, and anorexia. Signs progress within days to cerebral dysfunction, cranial nerve

Explanation / Answer

Page #1:

Part #1: If a person has not been bitten by a rabid animal it is very unlikely (Not Possible) that he will have rabies. Transmission of rabies virus occurs when saliva of a rabid animal containing the rabies virus is introduced in the skin of a person through a bite because for the virus to infect it needs to penetrate deeply into the skin. Just a superficial contact of animal's saliva with skin breaks or cuts does not cause rabies.

Part #2: The three viruses antigenically similar to rabies virus are: Mokola Virus (isolated from shrews in Nigeria), Lagos bat virus (from fruit bats in Nigeria), Duvenhage virus (from the brain of a man bitten by a bat in South Africa). Others include European bat lyssavirus (EBLV1 & 2), Australian bat lyssavirus (ABLV).

Part #3: Yes, the onset and progression of neurological symptoms help clinicians diagnose rabies. If the neurological symptoms do not change, diagnosis of rabies is ruled out. Similarly, if the neurological symptoms are progressively worsening, it is a clear indication of rabies diagnosis.

Page #2

Question #10: Statements that describe skeletal muscle physiology:

- Actin and myosin interact by sliding filament theory.

- The trigger of contraction is the rise of intracellular calcium.

- ATP energizes the sliding process.

- Tropomyosin is the site of calcium regulation in the contraction.

(All options except option 4 are correct regarding skeletal muscle physiology)

Question #11: The levator ani muscle of pelvic diaphragm is made up of three muscles: Puborectalis muscle, Pubococcygeus muscle and Iliococcygeus muscle.

So the answer is "coccygeus".

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