Travel related infection

Question 1

What are some climate or environment related health problems?

Answer 1

Sunburn
Heat exhaustion and heat stroke
Fungal infections
Bacterial skin infections
Cold injury
Altitude sickness

Question 2

How are infections controllable by public health measures?

Answer 2

Sanitation
Immunisation
Education

Question 3

What are some example of infections controllable by sanitation?

Answer 3

Travellers’ diarrhoea
Food poisoning
Cholera

Question 4

What are some water related infections?

Answer 4

Schistosomiasis
Leptospirosis
Liver flukes

Question 5

What are some arthropod borne infections?

Answer 5

Malaria
Dengue fever
Leishmaniasis

Question 6

What are the emerging infectious diseases?

Answer 6

Zika
Ebola
Swine flu
Avian flu
SARS
West Nile virus
MERS-CoV

Question 7

What is the vector for malaria?

Answer 7

Female anopheles mosquito

Question 8

What is the life cycle of malaria?

Answer 8

Malaria parasite enters body and sporozoites injected into bloodstream and travel to liver
There, they produce merozoites which replicate in RBCs and destroy them
The damaged RBCs are then drunk by a mosquito, where the parasite can form a zygote and replicate, ready to infect another patient

Question 9

What are the species of malaria?

Answer 9

Plasmodium falciparum
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae
Plasmodium knowlesi

Question 10

What is the potentially severe form of malaria?

Answer 10

Plasmodium falciparum

Question 11

What are he clinical features of malaria?

Answer 11

Fever, riggers, aches and pains
Abdo pain
Headache
Dysuria and frequency
Sore throat, cough

Question 12

What signs can be present with malaria?

Answer 12

Splenomegaly
Hepatpmegaly
Mild jaundice

Question 13

How is malaria diagnosed?

Answer 13

Thick and thin blood films
Quantative buffy coat
Rapid antigen tests

Question 14

What is complicated malaria diagnosed by?

Answer 14

One or more of:
Impaired conciousness/seizures
Hypoglycaemia 
Parasite count >2%
Haemoglobin <8
Spontaneous bleeding
Haemoglobinuria
Renal impairment or pH <7.3
Pulmonary oedema
Shock

Question 15

What is the management of uncomplicated p. falciparum malaria?

Answer 15

3 days Riamet, Eurartesm or Malarone OR

7 days Quinine with oral doxycycline

Question 16

What is the management of complicated p. falciparum malaria?

Answer 16

IV artesunate OR IV quinine with oral doxycycline

Question 17

What is the treatment of p. vivax and p. ovale malaria?

Answer 17

3 days chloroquine or Riamer

AND primaquine 14 days

Question 18

What is the treatment of p. malariae and p. knowlesi malaria?

Answer 18

3 days chloroquine or Riamer

Question 19

What are the possible complications of malaria?

Answer 19

Cerebral malaria
Blackwater fever
Pulmonary oedema
Jaundice
Sever anaemia
Algid malaria

Question 20

What does cerebral malaria cause?

Answer 20

Drowsiness, seizures, coma and death

Question 21

What does blackwater fever cause?

Answer 21

Haemoglobulinuria and acute renal failure

Question 22

What is typhoid due to?

Answer 22

Salmonella typhi or salmonella paratyphi

Question 23

How is typed spread?

Answer 23

Via poor sanitation or unclean drinking water

Question 24

What are the week 1 clinical features of typhoid?

Answer 24

Fever
Headache
Abdo discomfort
Constipation
Dry cough
Bradycardia

Question 25

What are th week 2 clinical features of typhoid?

Answer 25

Fever peaks at 7-10 days Rose spots Diarrhoea Tachycardia

Question 26

What are the possible week 3 complications of typhoid?

Answer 26

Intestinal bleeding Perforation Peritonism

Question 27

What is the typical week 4 progression of typhoid?

Answer 27

Recovery | 10-15% relapse rate

Question 28

How is typhoid diagnosed?

Answer 28

Clinical Lab- Culture blood, urine, stool and bone marrow Rule out malaria

Question 29

What is the treatment of typhoid?

Answer 29

Oral azithromycin or IV ceftriaxone

Question 30

How is dengue transmitted?

Answer 30

Via aedes aegypti

Question 31

What is the classical presentation of dengue?

Answer 31

``` Sudden fever Severe headache or retro-orbital pain Severe myalgia and arthralgia Macular/maculopapular rash Haemorrhagic signs ```

Question 32

How is dengue diagnosed?

Answer 32

Positive tourniquet test Thrombocytopenia, leucopenia, elevated transaminases PCR and serology

Question 33

What is the management of dengue?

Answer 33

No specific therapeutic management | Prevention

Question 34

What are the possible complications of dengue?

Answer 34

Dengie haemorrhage fever | Dengue shock syndrome

Question 35

How is schistosomiasis transmitted?

Answer 35

Fresh water snails

Question 36

What are the bacteria involved in schistosomiasis?

Answer 36

s. haemotobium s. mansion s. japonicum

Question 37

What is the life cycle of schistosomiasis?

Answer 37

Infected snails release cercariae into water These penetrate skin of the human and become schistosomulae by losing tails These are in circulation and migrate to portal circulation;ation where they mature

Question 38

What are the immediate features of schistosomiasis?

Answer 38

Swimmers' itch in few hours

Question 39

What are the phases of schistosomiasis?

Answer 39

Invasive stage Katayama fever Acute disease Chronic disease

Question 40

What are the clinical features of the invasive stage of schistosomiasis?

Answer 40

After 24 hours | Cough, abdominal discomfort, splenomegaly, eosinophilia

Question 41

What are the clinical features of the Katayama fever phase of schistosomiasis?

Answer 41

15-20 days | Fever, lymphadenopathy, splenomegaly, diarrhoea, eosinophilia, urticaria

Question 42

What are the 2 types f acute disease in schistosomiasis?

Answer 42

Eggs deposited in bowel- dysentery | Eggs deposited in bladder- haematuria

Question 43

When does the acute disease in schistosomiasis happen?

Answer 43

6-8 weeks

Question 44

How is schistosomiasis diagnosed?

Answer 44

CLinical Antibody tests Ova in stool/urine Rectal snip

Question 45

What is the treatment of schistosomiasis?

Answer 45

Praziquantel- 2 doses 6 hours apart | Prednisolone if severe

Question 46

What is the commonest cause of rickettsiosis imported to the UK?

Answer 46

Tick typhus, caused by r. conorii or r. africae

Question 47

What are the clinical features of rickettosis?

Answer 47

Abrupt onset swinging fever | Headache, confusion, endovasculitis, rash, bleeding

Question 48

How is rickettosis diagnosed?

Answer 48

Clinical | Serology

Question 49

What is the management of rickettosis?

Answer 49

Tetracycline

Question 50

What are the viral haemorrhage fevers we are concerned about?

Answer 50

Ebola | Congo-Crimea haemorrhage fever

Question 51

What is the incubation period of viral haemorrhage fevers?

Answer 51

Max 3 weeks

Question 52

What is the treatment of viral haemorrhage fevers?

Answer 52

Isolation | Supportive

Question 53

How is the zika virus transmitted?

Answer 53

Via aedes aegypti mosquito, sexual contact or blood transfusion

Question 54

What are the clinical features of zika?

Answer 54

No or mild symptoms- headache, rash, fever, malaise, conjunctivitis, joint pain Can cause Guillain Barre

Question 55

What can zika during pregnancy cause?

Answer 55

Microcephaly and other neurological problems