Travel Related Infection

Question 1

9Why are travellers at increased risk of infection?

Answer 1

Temptation to take risk e.g. food, water, animals, sex
Different epidemiology of some diseases
Incomplete understanding of health hazards
Stress of travel

Question 2

Why are refugees more prone to infection?

Answer 2

Deprivation
Malnutrition
Disease
Injury

Question 3

List some climate/environment related health problems.

Answer 3

Sunburn
Heat exhaustion and heatstroke
Fungal infections
Bacterial skin injuries
Cold injury
Altitude sickness

Question 4

Infections can be controlled by public health measures. Which kind of measures can be made to reduce risks?

Answer 4

Sanitation
Immunization
Education

Question 5

List some water related infections.

Answer 5

Schistosomiasis
Leptospirosis
Liver flukes
Strongyloidiasis
Hookworms
Guinea worms

Question 6

What insect transmits malaria?

Just to say, I made these flashcards ahead of the in person lecture and the lecturer said that knowing the insects which transmit the following conditions isn’t really undergraduate knowledge. Might be wroth remembering a few though, especially malaria etc.

Answer 6

Mosquitos

Question 7

What insect transmits dengue fever?

Answer 7

Mosquitos

Question 8

What insect transmits Rickettsia infections, like typhus?

Answer 8

Ticks

Question 9

What insect transmits Lesihmaniasis?

Answer 9

Sand flies

Question 10

What insect transmits trypanosomiasis?

Answer 10

Tsetse fly

Question 11

What insect transmits filariasis?

Answer 11

Mosquitos

Question 12

What insect transmits onchocerciasis?

Answer 12

Black flies

Question 13

What is malaira?

Answer 13

A parasitic infection of the red blood cells

Question 14

Where is malaria most prevalent?

Answer 14

Africa, particularly Sub-Saharan Africa
India
Botswana
Brazil
Southeast Asia

Question 15

What is the vector of malaira?

Answer 15

Female Anopheles mosquito

Question 16

Briefly describe the malaria life cycle.

More because I find it interesting tbh

Answer 16

Mosquito bites a human
Mosquito injects sporozoites
Sporozoites go to liver and replicate to form merozoites
Merozoites rupture into bloodstream
Patient is infected
Next mosquito comes along and takes some infected RBC’s
Then carries it onto the next person

Question 17

There are five forms of malaria. Which is the only one which is potentially severe?

Answer 17

Plasmodium falciparum

Question 18

What are the symptoms of malaria?

Answer 18

Fever
Rigors
Aching bones
Abdominal pain
Headache
Dysuria
Frequency
Sore throat cough

Question 19

What are the signs of malaria?

Answer 19

Often none
Splenomegaly
Hepatomegaly
Mild jaundice

Question 20

What are some complications of malaria?

Answer 20

Cerebral malaria
Blackwater fever
Pulmonary oedema
Jaundice
Severe anaemia
Algid malaria

Question 21

How is a diagnosis of malaria made?

Answer 21

Thick and thin blood films
Quantitative buffy coat
Rapid antigen tests
PCR

-> lecturer said this a common exam question

Question 22

List some of the potential complications which would promote the malaria to complicated malaria.

Answer 22

Imapired consciousness or seizures
Hypoglycaemia
Parasite count >2%
Spontaneous bleeding
Haemoglobinuria
Renal impairment or pH <7.3
Pulmonary oedema
Shock

Question 23

Which two drugs are mainly used in the treatment of malaria?

Answer 23

Quinine
Artemisinin

Question 24

What are the treatment options for uncomplicated malaria?

Answer 24

Riamet for three days- most common
Quinine as mentioned previously

->if quinine, oral doxycycline or clindamycin is required in addition for possibility of resistance

Question 25

What are the treatment options for complicated malaria?

Answer 25

IV artesunate IV quinine ->if quinine, oral doxycycline or clindamycin is required in addition for possibility of resistance

Question 26

Give some examples of malaria control programmes which are in place.

Answer 26

Drainage of standing water as mosquito breeding sites Mosquito killing sprays Bed nets and mesh windows

Question 27

What type of infection is typhoid?

Answer 27

A type of salmonella infection

Question 28

Why is typhoid fever widespread?

Answer 28

Poor sanitation, unclean drinking water

Question 29

How long is the incubation period of typhoid fever?

Answer 29

7 days - 4 weeks

Question 30

What happens in the first week of symptoms in a patient with typhoid fever?

Answer 30

Fever, headache, abdominal discomfort, constipation, relative bradycardia, neutrophilia, confusion

Question 31

What happens in the second week of symptoms in a patient with typhoid fever?

Answer 31

Fever peaks at 7-10 days Rose spots Diarrhoea Tachycardia Neutropenia

Question 32

If untreated, which complications can occur in the third week of symptoms in a patient with typhoid fever?

Answer 32

Intestinal bleeding Perforation Peritonism Metastatic infections

Question 33

What % of typhoid fever patients get a relapse?

Answer 33

10-15%

Question 34

How is a diagnosis of typhoid fever made?

Answer 34

Not very easily... Based on the evolution of features and labs of blood culture and bone marrow culture

Question 35

What is the treatment of typhoid fever?

Answer 35

Oral Azithroymycin IV Ceftriaxone (if patient cannot or will not have oral meds)

Question 36

In which countries is Dengue fever more prevalent?

Answer 36

South America, Africa, Southeast Asia

Question 37

RECAP- how is Dengue transmitted?

Answer 37

Aedes aegypi tiger mosquito

Question 38

What are the clinical signs of Dengue fever?

Answer 38

Sudden fever Sudden headache, retro-orbital pain Severe myalgia and arthralgia (muscle and joint pain) Macular rash Haemorrhagic signs

Question 39

How is a diagnosis of Dengue fever made?

Answer 39

Based on history, rash, blood testing Lab confirmation made using PCR or serology

Question 40

What is the management of Dengue fever?

Answer 40

No specific therapeutic agents

Question 41

What are some of the complications of Dengue fever?

Answer 41

Dengue haemorrhagic fever Dengue shock syndrome ->managed with IV fluids, fresh frozen plasma and platelets

Question 42

Prevention of Dengue fever is better than cure. What can be used to in attempt to prevent?

Answer 42

Avoiding bites New vaccine in 2016, limited use yet

Question 43

What is the intermediate host for Schistomiasis?

Answer 43

Freshwater snails

Question 44

Briefly discus the Schistomiasis lifecycle.

Answer 44

Human infected passing faeces into water Eggs from faeces hatch and parasite goes into freshwater snails Replication occurs and sporozoites form Sporozoites hatch into water Enter the skin

Question 45

What is the first sign of Schistomiasis?

Answer 45

Swimmers itch within first few hours

Question 46

What are the symptoms during the invasive phase of Schistomiasis?

Answer 46

Cough Abdominal discomfort Splenomegaly Eosinophilia

Question 47

15-20 days after exposure to Schistomiasis, Katayama fever may develop. What are the symptoms of this?

Answer 47

Fever Urticaria (hives) Lymphadenopathy Splenomegaly Diarrhoea

Question 48

In the acute Schistomiasis, what sign occurs when the eggs are deposited in the bowel/bladder?

Answer 48

Bowel- dysentery Bladder- haematuria

Question 49

How is a diagnosis of Schistomiasis made?

Answer 49

History Antibody test Ova is stool or urine Rectal snip

Question 50

What is the treatment of Schistomiasis?

Answer 50

Praziquantel ->prednisolone if severe

Question 51

What causes typhus/Rickettsiosis?

Answer 51

Tick bite- leaves a pink maculopapular rash

Question 52

What are some of the types of Rickettsiosis?

Answer 52

Tick typhus Rocky Mountain Spotted Fever Epidemic Typhus Murine or endemic typhus Scrub typhus

Question 53

What type of Rickettsiosis is the most common type imported to the UK?

Answer 53

Tick typhus

Question 54

What are the clinical features of Rickettsiosis?

Answer 54

Abrupt onset of swinging fever, headache, confusion, endovasculitis, rash, bleeding

Question 55

How is a diagnosis of Rickettsiosis made?

Answer 55

History Serology

Question 56

What is the management of Rickettsiosis?

Answer 56

Tetracycline

Question 57

List some viral haemorrhagic fevers which are serious but rare in the UK.

Answer 57

Ebola Congo-Crimea haemorrhagic fever Lassa fever Marburg disease

Question 58

If someone has a viral haemorrhagic fever, what needs to be done?

Answer 58

Patient needs to be on a high security infection unit

Question 59

If a patient gets Zika virus in pregnancy, what can happen?

Answer 59

Microcephaly and other neurological problems in the child

Question 60

Which syndrome can be caused by Zika virus?

Answer 60

Guillain-Barre syndrome

Question 61

What transmits Zika virus?

Answer 61

Mosquitos Sexual contact Blood transfusion

Question 62

What are the symptoms of Zika virus?

Answer 62

Sometimes no or mild symptoms Headache Rash Fever Malaise Conjunctivitis Joint pain

Question 63

Lol, symptoms of Covid-19? xxx

Answer 63

Fever Dry cough Tiredness Aches and pains Nasal congestion Loss of taste or smell

Question 64

In which travel related conditions maybe there be a rash?

Answer 64

Typhoid Typhus Dengue Fever

Question 65

In which travel related conditions maybe there be jaundice?

Answer 65

Hepatitis Malaria Yellow Fever- remember this by yellow and yellow ig

Question 66

In which travel related conditions maybe there be hepatomegaly?

Answer 66

Malaria Typhoid Amoebic abscess

Question 67

In which travel related conditions maybe there be splenomegaly?

Answer 67

Malaria Typhoid Visceral leishmaniasis