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SBOMs > Global Health > Flashcards

Global Health Flashcards

1
Q

Name 4 potentially life threatening acute tropical infections

A

P. Falciparum malaria
Typhoid fever
Paratyphoid fever
Leptospirosis

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2
Q

Where is travellers diarrhoea most common? %?

A

India (1 week risk 54%)

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3
Q

What is the ABCD of malaria advice?

A 
Aware of risk (fever up to 6 months after return)
Bite avoidance (DEET insect repellant, nets, long sleeves dawn till dusk)
Chemoprophylaxis compliance (duration, SE, cost)
Diagnose early
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4
Q

Name the 3 most commonly used malaria prophylaxis treatments

A

Malarone (proguanil +atovaquone)
Doxycycline
Mefloquine

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5
Q

How many vaccinations are covered by the green book?

A

27

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6
Q

What vaccinations are often legally required?

A

Yellow fever, meningococcus ACWY, Polio

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7
Q

List 5 common travel vaccines

A 
Hep A
Typhoid
Yellow fever
Rabies
Meningococcal ACWY
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8
Q

What vaccines are legally required for the Hajj pilgrimage?

A

Meningococcal ACWY

Polio & yellow fever if from a country at risk

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9
Q

What is Ebola?

A

A viral haemorrhagic fever

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10
Q

Name the 6 most affected countries by Ebola

A

Guinea, Sierra Leone, Liberia, Senegal, Nigeria, Mali

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11
Q

Signs and symptoms of Ebola

A 
Fever
Headache
Weakness (more fatal)
Dizziness (more fatal)
Diarrhoea (more fatal)
Abdo pain
Sore throat
Vomiting
Conjunctivitis
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12
Q

Treatment of Ebola

A 
No cure
Supportive care
IV fluids
Antimalarials
Antibiotics
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13
Q

What was the likely viral reservoir for Ebola?

A

Fruit bats

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14
Q

Peak incidence of infection (age) for Ebola?

A

15-18yrs, 26-40yrs

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15
Q

Incubation period? Death? (Ebola, %)

A

6-12 days

8-9 days

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16
Q

Fatality? (%, Ebola)

A

74%

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17
Q

How was it transmitted? (Ebola)

A

Through contact with bodily fluids

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18
Q

What made the outbreak worse? (Ebola)

A

Delayed recognition and response
Fear & distrust of authorities
Limited sanitation and overcrowding
Long incubation, no vaccine and no treatment
Fluid borders
Poor infrastructure and healthcare resources

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19
Q

What are emerging infections driven by?

A

Increased global travel
Environmental and climate change (deforestation, flooding, drought, urbanisation)
Political instability and breakdown of public health measures
Widespread antibiotic use
Decline in immunisation
Better diagnostics

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20
Q

What is MERS?

A 
Middle eastern respiratory sydrome
Coronavirus
Camels likely host
Mainly in Saudi Arabia
36% mortality
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21
Q

Name the last 3 influenza pandemics

A

2006 novel H1N1 swine flu
H5N1 avian flu, Hong Kong
H7N9 avian flu, Far East

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22
Q

What species of mosquito spreads malaria?

A

Anopheles mosquito

23
Q

How many types of malaria are there?

A

5

24
Q

What type of malaria is the most deadly? Deaths a year?

A

P. Falciparum, 0.5mill deaths a year

25
Q

Where are most deaths from P. Falciparum located?

A

Sub Saharan Africa:

Kenya, Angola, Zambia, Tanzania, Sierra Leone

26
Q

What stage of plasmodium parasite is inoculated into the blood stream by the mosquito?

A

Sporozoite

27
Q

What stage of the plasmodium is found in liver cells?

A

Hypnozoites

28
Q

How long is the liver multiplication stage?

A

5-12 days

29
Q

What stage of the plasmodium enters the bloodstream from the liver?

A

Merozoites

30
Q

What stage of the plasmodium is found when it invades RBCs?

A

Trophozoite

31
Q

What stage of the plasmodium is sucked up into the mosquito?

A

Gametocyte

32
Q

Signs and symptoms of P. Falciparum malaria

A 
Fever (continuous/tertian)
Rigors
Vomiting
Headache
Arthrlagia
Malaise
33
Q

When does P. Falciparum commonly present?

A

4 weeks after returning from an endemic area

34
Q

When is malaria classed as sever?

A 
Parasitaemia>2% or complications:
Cerebral malaria
AKI
Pulmonary oedema (ARDS)
Metabolic acidosis
Hypoglycaemia
35
Q

How do you diagnose malaria?

A

Blood film
Antigen testing
PCR (used as research tool)
Low platelets, raised bilirubin is suggestive

36
Q

Non severe treatment of P/ Falciparum malaria?

A

Oral quinine + second agent
Malarone (atovaquone + proguanil)
Co-artem (artesunate +halofantine)

37
Q

Treatment of severe P/ falciparum malaria?

A

IV Quinine or IV Artesunate

38
Q

Where is P. Vivax endemic?

A

Pakistan, India, SE Asia, Oceania, S America, Mediterranean

39
Q

Treatment of P. Vivax

A

Multiple relapses if untreated

oral chloroquine or oral primaquine

40
Q

What needs to be checked before giving primaquine?

A

G6PD deficiency

41
Q

How many cases of malaria are imported to the UK each year?

A

1500 cases a year

42
Q

What type of malaria is imported to the UK?

A

P. Faliparum (74%) (Africa, Nigeria)

P. Vivax (14%) (India)

43
Q

What is the efficacy of chemprophylaxis in sub saharan Africa?

A

95%

44
Q

What reason for travel is the most likely to get malaria infection and import to UK? Why?

A

Visiting friends and family
Stay longer in rural/semi urban areas that tourists
Do not take prophylaxis
DO not perceive themselves to be at risk

45
Q

What continents are you most likely to acquire an illness?

A 
Asia (32.6%)
Subsaharan Africa (26.7 %)
46
Q

Where are you most likely to acquire GI disease? What % of total illness?

A

34% of all illnesses

SC Asia, C America

47
Q

Where are you most likely to acquire a febrile illness?What % of total?

A

Africa, SE Asia

23.3%

48
Q

Where are you most likely to acquire a dermatologic illness? What % of total?

A

Caribbean, S America

19.5%

49
Q

What is the most common cause of GI illness?

A

Parasitic (Giardia) except in SE Asia where Campylobacter is most common

50
Q

Most common causes of febrile illness and area

A

Malaria (Subsaharan Africa)
Dengue fever (SE Asia and Caribbean)
Mononucleosis (EBV, CMV, acute HIV) (Caribbean, C America)
Enteric fever/typhi (SC Asia)

51
Q

Most common causes of dermatological disease and area

A

Insect bites (C America)
Cutaneous larava migrans (Caribbean)
Allergy (everywhere esp Caribbean)
Skin abscess (SC Asia & Sub Saharan Africa)

52
Q

What reason for travel are least likely to become ill? Most common disease type in that group?

A

Business

Respiratory

53
Q

What % of travel related legionella, measles and HIV is acquired in Europe?

A

1/3 legionella
20% measles
15% acute HIV

54
Q

Causes of death abroad

A

Trauma
Chronic disease
Suicide/homicide
Infectious cause (malaria)

SBOMs (18 decks)

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