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446- ID and transplant > Travel Health > Flashcards

Travel Health Flashcards

(67 cards)

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1
Q

personal travel risk factors include

A

medical conditions, medications, allergies, vax hx, travel experience, risk perception and tolerance, financial

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2
Q

destination travel risk factors include

A

Where: not just the country but the specific location within the country- urban or rural?
When: date of departure and duration (must plan around timeline)
Why: business, holiday, visiting family, volunteer, medical tourism
How: transportation, accommodation
What: types of activities

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3
Q

T or F: pharmacists can carry out a care plan for travel without need for MD intervention

A

T

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4
Q

traveler’s diarrhea is primarily caused by

A

bacteria, less often virus or protozoa

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5
Q

TD is often ________ to _______ days

A

self limiting
3-4 days

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6
Q

which of the following is considered a “riskier choice” for traveler’s diarrhea
1. boiling water involved in cooking cabbage
2. apples
3. hibachi grills
4. bananas

A

2- not peelable or cooked

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7
Q

Dukoral vaccine is originally a _______ vaccine

A

cholera

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8
Q

dukoral offers some protection against ________ which protects against TD

A

ETEC, enterotoxigenic E coli

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9
Q

which of the following is the best description of the dukoral vaccine
1. benefits are limited, risks are significant
2. benefits are limited, risks are limited
3. benefits are significant, risks are significant
4. benefits are significant, risks are limited

A

2

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10
Q

the use of a dukoral vaccine is primarily based on
1. location of travel
2. hx of GI issues
3. patient’s willingness to get it (ex- $$, other med issues, risk tolerance)
4. none of the above

A

3

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11
Q

what 2 OTCs can be used for TD

A

bismuth subsalicylate
loperamide

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12
Q

what is the first choice abx for TD tx

A

azithromycin

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13
Q

what is the main AE of azithromycin

A

QT interval prolongation

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14
Q

what are options for TD for pts who can not take azithromycin

A

ciprofloxacin and rifaximin

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15
Q

ciprofloxacin is
1. limited in effectiveness in asia due to resistance
2. not used in children
3. only used in adults who can’t tolerate azithro
4. has risk of tendon injury
5. all of the above

A

5

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16
Q

hepatitis A is transmitted through

A

fecal oral, contaminated food and water

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17
Q

T or F: hep A vaccines are not part of routine childhood immunizations in Canada

A

T

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18
Q

what is the Hep A schedule? how many doses are needed for trip protection?

A

2 doses: 0 and min 180 days apart
1 dose needed for trip protection, get FU dose in 180+ days

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19
Q

what is the twinrix schedule and accelerated schedule? how many doses are needed for protection?

A

Schedule: 0, 30d, 180d
2 doses needed to provide sufficient immunity

Accel sch: 0, 7, 21, 365d
3 doses needed to provide sufficient immunity
Difference of 7 days

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20
Q

what is the Twinrix Jr schedule

A

0, 30, 180 days

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21
Q

what is the alternative peds twinrix schedule

A

use adult twinrix at 0 and 180 days

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22
Q

how many doses of hep A offers trip protection?

A

1

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23
Q

hep B is transmitted by

A

contaminated blood or body fluids

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24
Q

those born before ____ are not hep B vaxxed as part of childhood vaccines

A

1982

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25
typhoid fever is a ______ infection spread by ____________
bacterial contaminated food and water
26
sx of typhoid fever
fever, rash, stomach pain
27
how to tx typhoid fever
antibiotics
28
highest risk of typhoid fever is in
south asia
29
the oral typhoid vaccine _________vaccine PO schedule: day ___________ Protected ~_____days after last dose + lasts _____ yrs For ________yrs old
Live vaccine PO schedule: day 1, 3, 5, 7 Protected ~7 days after last dose + lasts 5-7yrs For =>5yrs old
30
Injectable typhoid vaccine ________ vaccine ________ dose _____ days for protection which lasts ___ yrs For ____ yrs old
Inactivated vaccine IM single dose ~14 days for protection which lasts 2-3yrs For =>2yrs old
31
yellow fever is _________ infection spread by ______
viral mosquitos
32
highest risk of yellow fever is in _______ and ________
sub Saharan Africa and South America
33
the yellow fever vaccine is a ____ given ________ as a ____ dose
live SC single dose
34
the yellow fever vaccine takes ____ to take effect
10 days
35
what is the age limit for yellow fever vaccine
=>9mths
36
japanese encephalitis is a _____ infection spread by ____
viral mosquitos
37
japanese encephalitis is a risk throughout
Asia- primarily rural/ agricultural areas
38
the japanese encephalitis vaccine is an __________ vaccine, administered IM on days __________. it provides protection for _______ or ______ if a booster is given at 1-2rys
inactivated 0, 7-28 protection for 1-2yrs 10yrs
39
the pt must be > _____ to receive the japanese encephalitis vaccine
2 months
40
rabies is a _____ infection spread through __________
viral saliva of ifnected animal
41
If infected with rabies + no post exposure prophylaxis =
99.99% fatal and horrible way to die
42
what is the #1 animal for rabies transmission
dogs (others include monkeys, bats, other mammals)
43
the rabies vaccine is an _________ vaccine given IM on adys _____________
inactivated IM on days 0, 7, 21-28
44
duration of rabies protection is determined by
titres
45
factors to consider when offering rabies vaccine
Activities on trip- related to animals? Spending a lot of time in caves? Remote travel- access to medical care and post exposure prophylaxis Future travel Risk tolerance Price (~$700 if no coverage)
46
meningococcal vaccine ________ vaccine Protects against _______ ______ dose Protection for _________yrs ____________ vaccine given as part of G9 vax in AB
Inactive vaccine Protects against 4 serotypes IM single dose Protection for 3-5yrs Quadrivalent ACWY vaccine given as part of G9 vax in AB
47
what is the meningitis bell in africa
high risk travel area esp in dry season (Nov-May) when outbreaks can occur
48
meningitis is a __________ infection spread by __________
viral coughing, sneezing
49
polio is a ______ infection spread by ________
viral fecal oral route
50
polio is endemic in
afghanistan and pakistan
51
adults can get a booster dose of polio as a single ______ dose
SQ
52
polio is a(n) ___________ vaccine
inactivated
53
4 antimalarial options
chloroquine mefloquine doxyxycline atovaquone/ proguanil
54
pros for chloroquine
weekly dosing cheap
55
cons for chloroquine
Resistance in most of the world except Central America and Caribbean Have to take at least 2 wks before + 4 wks after leaving risk area Tablets not commercially available in Canada rn
56
pros of mefloquine
Weekly dosing Inexpensive
57
cons of mefloquine
AEs include psych SEs (avoid in those w/ FHx mental illnesses even if it is mild or well controlled) Have to take at least 2 wks prior + 4 wks after leaving risk area
58
doxycycline pros
Inexpensive Typically 1st or 2nd choice
59
cons of doxycycline
Daily dosing SEs: GI irritation, ↑ sun sensitivity, vaginal yeast infxns Have to take 28 days after leaving area
60
pros of atovaquone/ proguanil
Mostly well tolerated- possible GI upset Need to take only 7 days after leaving risk area
61
cons of atovaquone/ proguanil
Daily dosing Expensive May be 1st choice if cost not a concern
62
dangue fever is a virus transmitted by the
aedes mosquito
63
dengue fever has 1. a risk anywhere tropical 2. severe sx can result in hemorrhagic fever 3. tx only with supportive and sx tx 4. 4 serotypes 5. all of the above
5
64
preventative measures for dengue fever include
bite protection, clothing, bug sprays
65
T or F: there are currently no vaccines available in Canada for Dengue fever
T- dengvaxia and qdenga in progress
66
which country requires yellow fever vaccine
kenya south africa and mozambique require proof of vax if traveling through coutnry with risk of yellow fever transmission
67
If pt has been to malaria country + develop a fever =
treat like pt has malaria until proven otherwise

446- ID and transplant (18 decks)

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