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Pretravel - Special Populations Flashcards

(46 cards)

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1
Q

What is the estimated proportion of travellers for business/occupational reasons?

A

15-35%

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2
Q

What are 3 additional considerations related to immunizations for business travellers?

A
  1. Consider cumulative risks
  2. Consider financial consequences of lost productivity
  3. Offer maximum protection.
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3
Q

How do health risks in business travelers compare to other international travelers

A

Historically considered low but recent studies demonstrate similar risk

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4
Q

What are 6 common health risks identified in frequent business travellers?

A
  1. Higher BMI
  2. Increased cholesterol
  3. High BP
  4. Higher levels of stress
  5. Sleep disorders
  6. Disrupted circadian rhythm
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5
Q

Approximately what proportion of international business trips of 2 weeks duration will develop infectious illness?

A

Approximately 1/3

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6
Q

What are important considerations of international travel timing and influenza vaccine?

A

Hemisphere-specific influenza vaccine may need to be obtained on arrival

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7
Q

What’s the approximate incidence of travelers diarrhea among travelers?

A

10-40%

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8
Q

Approximately what proportion of business travelers are vaccinated for hepatitis B?

A

~60%

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9
Q

When is exercise advised when travelling to areas with high levels of outdoor air pollution?

A

In the morning

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10
Q

What should be done with jewelry during travel?

A

Left in a safe due to risk of theft

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11
Q

In what country is kidnapping of business travelers most common?

A

Mexico

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12
Q

What proportion of Zika virus cases are symptomatic?

A

20%

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13
Q

Which direction of flights are easier for jet lag adjustment?

A

Eastbound

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14
Q

How many days per time zone are required for adjustment?

A

One day per time zone

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15
Q

When is JE vaccine recommended or considered?

A

Recommended
* When spending 1 month or longer in endemic areas during the JE transmission season

Considered:
* For certain activities (camping, hiking, trekking, biking, fishing, hunting, or farming)

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16
Q

List 4 reasons when an obstetrician should be consulted about travel for a pregnant woman

A
  1. Any history of pregnancy issues
  2. Bleeding
  3. Preterm labour
  4. Chronic illness
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17
Q

Which trimester is the safest for pregnant women to travel

A

2nd trimester

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18
Q

What should be done prior to all travel for a pregnant woman in her first trimester?

A

Confirm intrauterine pregnancy

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19
Q

List 4 physiological changes of pregnancy may affect travel?

Study These Flashcards
A
  1. Reduced exercise tolerance
  2. Reduced heat tolerance
  3. Elevated heart rate
  4. Physiological anemia
20
Q

What is the most common cause of fetal death during travel?

Study These Flashcards
A

Maternal trauma due to motor vehicle accidents

21
Q

Can Yellow Fever Vaccine be given to pregnant women?

Study These Flashcards
A

Recommended to be avoided, but may be given if travel to a high-risk area is unavoidable

22
Q

List 7 absolute contraindications to travel for pregnant women

Study These Flashcards
A
  1. Placental abruption
  2. Active labour
  3. Incompetent cervix
  4. Premature rupture of membranes
  5. Suspected ectopic pregnancy
  6. Threatened abortion in pregnancy
  7. Toxemia
23
Q

When in pregnancy is a physician letter required for air travel (domestic and international)? For multiple pregnancy

Study These Flashcards
A
  • Domestic travel - beyond the 36th week
  • International travel - beyond the 35th week
24
Q

Up to what week should a woman with a multiple pregnancy fly?

Study These Flashcards
A

Should only fly up to 32 weeks

25
Does the reduced oxygen pressure in aircrafts affect maternal or fetal oxygenation more?
Maternal Fetal hemoglobin binds oxygen more strongly
26
When would supplemental oxygen during flying be recommended for a pregnant woman?
If hemoglobin is <8.5 g/dL
27
What is the total recommended radiation exposure recommended during pregnancy? Monthly limit? Which weeks of pregnancy are most radiation sensitive?
1 milliSievert total pregnancy 0.5 milliSievert monthly limit Weeks 8-14 are most radiation sensitive
28
Do magnetometers at airports pose a risk to pregnancy? Full body scanners?
No
29
What 2 medications should be first line for pregnant women for motion sickness?
1. Dimenhydrinate 2. Diphenhydramine
30
What common antibiotics given for travel-related infections/prophylaxis should be avoided in pregnancy?
1. Ciprofloxacin 2. Doxycycline 3. Sulfisoxazole (in 3rd trimester due to kernicterus)
31
What antimalarials should be avoided in pregnancy?
1. Malarone (Atovaquone/proguanil) - avoid in 1st trimester 2. Doxycycline 3. Primaquine 4. Quinine
32
At what stage of pregnancy is scuba diving considered safe?
Not considered safe at any stage
33
Can Yellow Fever Vaccine be given to breastfeeding women?
Should be avoided Transmission of vaccine strain YF has been documented in breastfeeding infants of mothers who received YFV
34
How long should couples wait to conceive after traveling to an area with known ZIKV?
6 months The virus can persist for up to 6 months in semen
35
What are recommended malaria chemoprophylaxis for pregnant women?
1. Chloroquine in chloroquine-sensitive areas 2. Mefloquine Both safe in all stages of pregnancy
36
What stage of pregnancy has highest risk of toxoplasmosis infection transmission to the fetus? Stage with greatest severity of infection?
Most likely in third trimester Most severe in first
37
What's the recommended iodine intake per day for pregnant women?
200 ug/day Can use for water purification for short-term but there is risk of fetal goiter and hypothyroidism
37
What is the maternal mortality rate due to hepatitis E?
2% in first trimester 20-30% in third trimester
38
What is the treatment of choice for travelers diarrhea in pregnancy?
Azithromycin
39
How long after receiving MMR or Varicella vaccines should couples wait to try to conceive?
1 month
40
When should metronidazole be avoided in pregnancy?
Avoid in 1st trimester
41
Are those aged >50 years more or less susceptible to motion sickness?
Less susceptible
42
Is Zolpidem or Melatonin more effective for jet lag?
Zolpidem
43
How does age affect susceptibility to acute mountain sickness?
Unclear and likely no effect
44
How does malaria mortality change with age?
Malaria mortality increases with age
45
What is the effect of age on toxicity from DEET?
No effect

Travel Medicine (18 decks)

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