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301 > Travel > Flashcards

Travel Flashcards

1
Q

What is another name for travel health?

A

Emporiatrics

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2
Q

List some health-related risks for travellers

A

Medical related:
• malaria
• influenza
• traveler’s diarrhoea
• hep A

• drowning
• driving on opposite side
• taking risks
• alcohol/drugs use
• STIs
• heart disease

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3
Q

What are the 3 main trends - in international travel

A

• change is the amount of people travelling - more people are travelling
• change in destination of travel
• change in the type of travellers

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4
Q

Change in the amount of people travelling?

A

More people are travelling to developing countries

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5
Q

Change in destination of travel

A

• More people are travelling to hight risk places
• travelling on shorter notices
• little to no planning
• require greater healthcare needs during and after the trip

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6
Q

Change in the type of travellers

A

Reasons for travels (order of most to least)
1. Leisure
2. Religious (VFR)
3. Business
*all there purposes are increasing to developing countries)

Types of traveler’s -
• older people
• those with pre existing, co-morbidities
• those using chronic medications

More people are travelling who aren’t always young and healthy

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7
Q

Religious travellers - VRF

A

• there people are in close proximity with local people
• don’t really comply with professional advise
• believe to have immunity again country specific diseases

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8
Q

Travel health - what do they want to cover?

A

• pre-assessment risks
• medication/prescriptions for managing/prophylaxis treatment of disease
• vaccinations.
• managing health issues over retiring travellers

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9
Q

A pre-travel assessment consists of?

A

• assessment of general heath
• discussion of the possible risks in that destination
• vaccinations
• education and disease prevention

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10
Q

Educational interventions?

A

Inset precautions
Malaria prophylaxis
Food and water precautions
Diarrhea and self-management
Current disease breakouts at destination
Vector-bone disease
Climate and jetlag
Routine meds
Sextual activity
First aid kits
Local medical care destinations
Crime and safety at destination

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11
Q

Define travellers diarrhoea

A

3+ loose stools within 24 hours

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12
Q

Sign and symptoms of TD

A

• n+v
• abdominal pain
• blood or mucus in stool
• fever

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13
Q

Pathogens which can cause TD?

A

Bacteria - E.coli
Virus - norovirus
Parasite

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14
Q

Risk factoids of TD

A

• consuming unclean water and food
• season
• length of stay
• medication: PPIs & H2 antagonist

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15
Q

Prevention of TD

A

Food hygiene
Water hygiene
• boil water (2-3mins) boil for longer at higher altitudes
• use chlorine or iodine (iodine-not in women)
• vaccination
• chemoporphylaxis - pepto-bismol

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16
Q

Treatment of TD

A

•hydration & diet
• Oral rehydration
• loperamide - not in young people, fever or blood/mucus in stool
• antibiotic - 3days
+ fluroquinolones
+ azithromycin or nor

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17
Q

Reasons for Malaria worldwide spread?

A

• global warming
• resistance to plasmodium
• insecticide resistance to vector

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18
Q

Types of malaria? 4 (5)

A

• p. Falciparum
• p. Ovale
• p. Vivax
• p. Malaria
• p. Knowlessi

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19
Q

Which agents is P.falciparum resistant to?

A

Chloroquine

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20
Q

Do people who live in endemic areas have semi-immunity to p.falciparum?

A

Yes
- life-threatening cases of malaria to these healthy people is rare

21
Q

Risk of malaria is lower in which areas?

A

• Urban
• coastal
• above 2000m

22
Q

Malaria - life cycle

A
  1. Bite of mosquito injects sporozoite into blood stream, enters liver an multiplies
  2. Merozoites enter blood steam and invade red blood cells (erythrocytes)
23
Q

Early signs of p.falciparum

A

Fever:
• cold
• hot and flushed
• intense sweating

24
Q

What can happen if p.falciparum is left untreated

A

Coma and death within 24 hours

25
Q

P.falciparum symptoms

A

• fever
• n+v
• headache
• diarrhoea

26
Q

High risk issue with p.falciparum in non-immune traveler’s

A

• carebral malaria - due to change in RBC
• renal issues
• thrombopenia

27
Q

First line for plasmodium falciparum

A

Artemeter & Lumefantrine

28
Q

3 chemoprophylaxis/treatment antimalarial agents

A

• chloroquine
• doxycycline
• mefloquine

MOA: suppressors blood parasite

29
Q

Chloroquine?

A

• safe in pregnancy + breastfeeding

30
Q

Doxycycline

A

Not safe in:
• pregnancy
• oral contraceptives
• <8
• virginal thrush
• oesophagitis

Start: 2 days before trip

31
Q

Mefloquine

A

Not safe in those with neurological issues
Avoid in pregnancy

Start: 2-3 weeks before trip

32
Q

Best agent for stand by treatment?

A

Artemether & Lumefeantrine

33
Q

Non-pharmacological management of malaria- Bite avoidance

A

• cover arms and sleeves.
• wear light colour clothes and thicker material
• apply inset repelant
• apply insecticide to clothing
• avoid perfume
• avoid daytime exposure to Anopheles mosquitoes
• avoid nighttime exposure to Aedes mosquitoes
• cautious in wet weather

34
Q

What causes Rabies?

A

rhabdovirus of the genus Lyssavirus

35
Q

How is Rabia transmitted?

A

Virus is in the saliva of the infected animal and is transmitted to humans through bites and scratches

36
Q

If rabies is untreated is it fatal?

A

Yes

37
Q

Which countries is their a higher risk of Rabies

A

In the Rural areas of:
• Asia
• Africa
• south and North Africa

38
Q

Which types of travellers are at a risk risk of developing rabies?

A

• small children
• travelling on bicycles
• adventures behaviour
• working with animals

39
Q

Clincal features of rabies?

A

• fever
• hallucinations
• sensory changes around animals
• aerophobia
• hydrophobia

40
Q

Whats is Economy Class syndrome - DVT/VTE caused by

A

Lack of mobility and cramp conditions

DVT = blood clots in the deep veins

41
Q

What beverages contribute to dehydration and sluggish circulation?

A

Caffeine & Alcohol

42
Q

What is jet lag?

A

A psychological + physiological desynchronising of sever different time zones

43
Q

Which factories can aggregate jet lag?

A

• age
• dehydration
• poor diet
• snaps
• lack of sleep
• coffee + alcohol
• direction of travel

44
Q

Melatonin can be used to reduce effects of get lag, but who should not take it?

A

Epileptics and those taking warfarin

45
Q

Measures to take BEFORE flight

A

• adequate sleep
• don’t book tasks which need to be done immediately after landing

46
Q

Measures to take During flight

A

• drink plenty of fluids
• avoid alcohol + caffeine
• avoids sleep deprivation

*hypnotics - temazepam (but can increase DVT)

47
Q

Measures to take AFTER flight

A

• adapt to the counties sleeping and eating times
• But avoid sleep deprivation

48
Q

Which health risks are associated with cruise ships?

A

• being in close proximity with diverse people
• risk of foodbourn + waterbourn diseases

49
Q

Illnesses on board include:

A

• GI - norovirus
• respiratory - influenza
• slips and falls
• death - CV disease

301 (27 decks)

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