the returning traveller Flashcards
1
Q
what causes MERS
A
coronavirus
2
Q
clinical features of mers
A
severe acute resp tract infection
- fever
- short of breath
- cough
- pneumonia
- gi upset
3
Q
what is pertussis
A
whooping cough
4
Q
cause of pertussis
A
bordella pertussis gram negative fastidious bacteria
5
Q
pathogenesis of pertussis
A
-toxin
attaches to and paralyses respiratory cilia that if followed by inflammation of the resp tract
6
Q
3 stages of pertussis
A
catarrahl
paroxysmal
convalescent
7
Q
catarrhal stage
A
mild fever, coryza and cough 1 week
8
Q
paroxysmal stage
A
intermittent cough becomes paroxysmal and ends in an inspiratory “whoop”
-2-6 weeks
9
Q
convalescent stage
A
non-paroxysmal cough 2-6 weeks
10
Q
complication pertussis
A
apnoea
pneum
seizures
11
Q
management of pertussis
A
- vaccine 5 in 1
- antibiotics clarithromycin
12
Q
viruses that cause hepatomegaly
A
malaria
typhoid
hepatitis
13
Q
viruses that cause splenomegaly
A
- malaria
- relapsing fever
- typhoid
14
Q
viruses that cause lymphadenopathy
A
- HIV
- rickettsial
- brucellosis
15
Q
viruses that cause haemorrahge
A
viral haemorrhagic fever
dengue fever
yellow fever
meningococcal sepiteciaemia
16
Q
2 main mosquitoes that carry viruses
A
aedes aegypti
aedes albopictus
17
Q
risk if person bites you and treatment
A
-risk of bacterial infection
give phx co-amoxicalv
low risk of tetanus
18
Q
dogs bites treatment
A
- bacterial infection
- tetanus
- rabies
treatment: co-amoxiclav
19
Q
risk of infection from bat bite
A
rabies
20
Q
money risk of infection and treamtnet
A
- bacterial
- rabies
- tetanus
- hep b prophylaxis aciclovir
- bacterial co-amoxiclav
21
Q
main causes of fever in the returning traveller
A
- malaria
- enteric fever
- dengue
- HIV seroconversion
- Rickettsia
22
Q
what causes malaria
A
- parasite
- plasmodium falciparum (main one)
- vivax
- malariae
- ovale (west africa)
- knowlesi
23
Q
where is plasmodium knowlesi found
A
in long tailed and pig tailed macques in SE asia
24
Q
which malaria parasite has the highest parasitaemia and merozoites produced
A
falciparum then vivax ovale malariae
25
where does malaria replicate and what is produced
replicates in liver and produces merozoites that invade mostly rbc
26
dx of malaria
```
is a blood film
-thick film for sensitivity
-thin film for
quantification
- do it 3 times
```
27
what is the rapid diagnostic test for malaria
- parasite lactate dehydrogenase
| - plasmodium histidine rich protein 2 in falciparum only
28
presentation of malaria
- prodromal episodes of tiredness, aching
| - non specific fever, -myalgia, headache, gi upset and cough
29
how does the fever present in malaria
-cyclical occurrence of sudden coldness followed by rigor then fever then sweating lasting 4-6 hours occurring every 2 days -or every 36-48 hrs for falciparum or even an almost continuous fever
30
lab findings for malaria
decreased platelets
| increased bilirubin
31
severe malaria presentation
- cerebral malaria
- ards
- anaemia
- aki
- hypo
- shock (algid malaria)
- gi
- secondary infections gnb
32
what is complicated falciparum malaria
- impaired consciousness or seizures
- renal impairment
- acidosis and elevated lactate
- hypo
- pulmonary oedema or ARDS
- haemoglobin <80
- spontaneous bleeding/ disseminated IV coagulation
- shock algid malaria BP <90/60
33
treatment of malaria falciparum
-IV therapy artesunate
| or quinine
34
treament for non-falciparum malaria
- chloroquine
| - primarquine
35
what causes enteric fever
-bacteraemia with salmonella enterica serotype
| typhi or paratyphi
36
treatment of enteric fever
ceftriaxone 3rd generation for gram negative cover
37
clinical features of enteric fever
- abdo-> non specific-> fever
- abdominal pain
- constipation
- diarrhoea
- chills
- headache
- cough
- myalgia
- sore throat
38
complication after week 3 enteric fever 3
- intestinal perforation and haemorrhage
- endocarditis
- hepatic and splenic abscess
39
exam findings for enteric fever
- fever
- abdo tenderness
- hepato and splenomegaly
- rose spots
- chest signs
40
enteric fever labs
increase ALT
| decrease eosionphilics
41
another name for enteric fever
typhoid
42
what family member are dengue viruses
flaviviridae viruses
43
how is enteric fever transmitted
faecal oral
44
how is dengue fever transmitted
aedes aegypti and albopictus viruses
45
clinical features of dengue
- asymptomatic
- fever and rash
- retro-orbital headache
- msk pain
- leukopenia
- thrombocytopenia
46
dx of dengue
-serology or PCR
47
complications of dengue
- dengue haemorrhagic fever
- dengue shock syndrome
- severe plasma leakagen and organ impairment
48
what is dengue haemorrhagic fever and how is it tested
-fever
-positive tournique test
platelets <100 haemoconcentration
49
what is dengue shock syndrome
dhf plus shock
50
what family is chikungunya from
genus alphavirus
51
transmission of chikungunya
aedes mosquitoes
52
clinical features of chikungunya
- fever
- arthralgia
- joint swelling
- rash
- headache
- muscle pain
- nausea
- fatigue
53
persistent symptoms of chikungunya
- persistent arthritis and arthralgia
- oedematous polyarthritis
- severe tenosynovitis
- new onset raynaud phenomena
54
zika virus transmission
- aedes mosquito
| - sexual transmssion
55
what monkey was zika originaly from
rhesus
56
manifestation of chikungunya
- maculopapular rash
- arthralgia
- conjunctivitis
- myalgia, headache, retro-orbital pain
- low grade fever
57
complications zika virus
-pregnancy causes congenital microcephaly, fetal loses and guillain barre syndrome
58
what is schistosomiasis
worms
59
treatment schistosomiasis
steroids and then praziquantel
60
what is rickettsial
The rickettsiae are a diverse collection of obligately intracellular Gram-negative bacteria found in ticks,
61
triad of rickettsial
- fever, headache and malaise within 1-2 weeks of infection
| - rash or an eschar at site of tick infection
62
types of rickettsial 3
- african tick bite fever
- mediterrranean spotted fever
- scrub typhus: mites in asia: splenomegaly, cough, hearing difficulties, and encephalitis
63
dx of rickettsial
serology
64
treamtent of rickettsial
doxycycline
65
4 viral haemorrhagic fevers
- Arenaviridae
- Bunyaviridae
- Flivoridae
- Flaviridae eg dengue
66
when does HIV seroconversion take place
2-3 weeks after exposure
67
how does hiv seroconversion present
```
like mononucleosis
-fever
adenopathy
pharyngitis
rash
myalgia
diarrhoea
headache
```
68
what is hiv seroconversion
when hiv antibodies start to develop
69
what is the commonest identified cause of traveller diarrhoea
giardia
70
pathophysiology of giardai
cyst are passed in stools with motile trophozoites in duodenal aspirates
71
presentation of giardia
-foul smelling malabsorptive diarrhoea, floating stool, post prandial bloating
72
treatment of giardia
with metronidazole
73
where is cutaneous larva migrans found
jamaica
74
presentation of cutaneous larva migrans
- feet and buttock
- pruritic serpiginous eruption
- rash
75
treatment larva migrans
ivermectin
| albendazole
76
what is myasis
maggots of african tumbu fly that burrow larvae into skin
77
presentation of myasis
-boils which exude serous fluid
78
what is tungiasis
parasite flea in indies eggs put by flea into broken skin
