Microbiology 26: Fever In Returning Traveller

Question 1

List the 5 types of plasmodium that cause malaria ?

Answer 1

P.falciparum
P.vivax
P.ovale
P.Malariae
P.knowlesi

Question 2

What is the initial treatment for non-falciparum malaria ?

Answer 2

Chloroquine

Question 3

How is malaria diagnosed ?

Answer 3

Rapid diagnostic test

Thick and thin blood film

Question 4

What does the thick blood film tell you ?

Answer 4

allows you to see if there are parasites

Question 5

What does a thin blood film tell you ?

Answer 5

Gives you a closer look at what type of parasite/species

Allows you to quantify the parasitaemia

Question 6

List 3 side effects of quinine ?

Answer 6

Cinchonism- dizzy, nauesues, vomiting
Arrhythmias
Hyperinsulinaemia

Question 7

List 2 features on blood film suggestive of falciparum malaria ?

Answer 7

Headphone shaped parasites in red cells

Red cells with more than 1 parasite in it

Question 8

What is the treatment of severe malaria ?

Answer 8

IV artusanate
(If not available then IV quinine)
followed by artemisinin + lumefantrine

Question 9

Which disease presents with arthralgia, myalgia, retro-orbital headache, fever and rash ?

Answer 9

Dengue

Question 10

Sphygmothermic dissociation is associated with which disease ? (When your Heart rate is relatively bradycardic for the high temperature)

Answer 10

Typhoid fever

Question 11

Rose spots are pathognomonic of which disease ?

Answer 11

Typhoid fever

Question 12

Which mosquito causes Dengue ?

Answer 12

AIDES

Question 13

list diseases mosquitoes can cause

Answer 13

malaria 
encephalitis 
dengue 
yellow fever 
west nile virus 
zika virus

Question 14

features of severe malaria

Answer 14

high parasitaeima 
altered consciousness with/ without seizures 
ARDS 
circulatory collapse
metabolic acidosis 
renal failure, haemoglobinuria 
hepatic failure 
coagulopathy +/- DIC 
severe anaemia 
hypoglycaemia

Question 15

treatment for mild falciparum malaria

Answer 15

oral malarone (atovaquone + proguanil)
artermisinin combination therapy (artemesin + lumefantrine)
oral quinine (with doxy/clindamycin)

Question 16

hwta is the treatment of choice for severe malaria

Answer 16

IV artesunate

Question 17

list clinical features of dengue fever

Answer 17

fever
headache
myalgia 
erythrodermic rash 
bleeidng 
hepatitis 
if severe - encephalitis, myocarditis 
can progress to dengue haemorrhagic fever/ dengue shock 
inv = serology, PCR
treatment: supportive

Question 18

features of typhoid fever

Answer 18

gram negative rod
vaccine only partially effective against S typhi, so protection against S paratyphi
high fever, headache, rose spots, constipation, dry cough
complications: GI bleeding, perforation, encephalopathy

Question 19

treatment for typhoid fever

Answer 19

empirical ceftriaxone

azithromycin

Question 20

features of infectious mononucleosis

Answer 20

EBV/CMV 
tonsillar enlargement with exudates 
atypical lymphocytosis 
inv: monospot, igM + EBV/CMV 
always consider HIV