Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Infection > Travel related infections > Flashcards

Travel related infections Flashcards

(64 cards)

Start Studying
1
Q

What makes travelers more vulnerable to infection? [5]

A
  • Temptation to take risks away from home (sex, food)
  • Different epidemiology of some diseases
  • Incomplete understanding of health hazards
  • Stress of travel
  • Refugees: deprivation, malnutrition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some climate/environmental related health problems? [4]
(Include in your list of differentials for the returning traveller)

A
  • Sunburn, Heat exhaustion
  • Fungal infections
  • Bacterial skin infections
  • Cold injury
  • Altitude sickness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are infections controlled by public health measures? [3] Eg sanitation immunization education

A

Sanitation
-Travellers diarrhoea, viral gastroenteritis, food poisoning, cholera, shigella dysentery, hep A or E

Immunisation
-Poliomyelitis, diphtheria

Education
-HIV, STDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some water-related infections? [5]

A
  • Schistosomiasis
  • Leptospirosis
  • Liver flukes
  • Strongyloidiasis
  • Hookworms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some arthropod borne infections? [5]

A
  • Malaria (mosquitoes)
  • Dengue fever (mosquitoes)
  • Rickettsial infections (ticks)
  • Leishmaniasis (sand flies)
  • Filariasis (mosquitoes)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some important tropical diseases?

A
  • Malaria
  • Typhoid
  • Dengue fever
  • Schistosomiasis
  • Rickettsiosis
  • Viral haemorrhagic fevers
  • Zika fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name malarial vector

What is the life cycle of malaria? [5]

A

Vector: female Anopheles mosquito

  • Mosquito infects human
  • Human carries malaria in blood
  • Female mosquito bites human and now carries malaria parasite
  • Reproduces and offspring also has malaria parasite
  • Goes off to infect other humans
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 5 species of malaria parasite?

Protective factors [4]

A

Potentially severe
- Plasmodium falciparum

Benign

  • Plasmodium vivax
  • Plasmodium ovale
  • Plasmodium malariae
  • Plasmodium knowlesi

Protective factors:

  • Sickle cell trait
  • HLA-B53
  • G6PD deficiency
  • Absence of Duffy antigens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are symptoms of malaria? [7]

A
  • Fever (alternating days), rigors
  • Aching bones
  • Abdo pain
  • Headache
  • Dysuria, frequency
  • Cough, sore throat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are signs of malaria? [4]

A
  • Can be none: asymptomatic
  • Splenomegaly
  • Hepatomegaly
  • Mild jaundice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are 6 complications of malaria?

A
  • Cerebral malaria (encephalopathy)
  • Blackwater fever
  • Pulm. oedema or ARDS
  • Jaundice
  • Severe anaemia
  • Algid malaria (gram -ve septicaemia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What blood work is required? [5]

A

-FBC (thrombocytosis without leucocytosis)
- U&E, LFT
-Thick and thin blood films (Giemsa, Field’s stain)
> Schizonts seen in severe malaria and parasitemia 2%
-Quantitative buffy coat (centrifugation, UV microscopy)
-Rapid antigen tests (OptiMal, ParaSight-F)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

There is a severity assessment for malaria. Having ‘complicated P. Falciparum malaria’ = one or more of what? [7]

A
  • Impaired consciousness/seizures
  • Hypoglycaemia
  • Parasite count at least 2%
  • Haemoglobin 8mg/dL or less
  • Renal impairment/pH <7.3
  • Pul oedema or ARDS
  • Shock (algid malaria)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are treatment options for uncomplicated P. falciparum malaria?

A

artemisinin based combination therapies e.g. oral ARTESUNATE + MEFLOQUINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are treatment options for complicated/severe P. falciparum malaria? [3]
If patient is in shock what does this indicate? [2]

A

Parasite count >2%
-IV artesunate (unlicensed in UK)
-IV quinine plus oral doxycycline (or clindamycin)
Parasite count >10%: exchange transfusion

Shock may indicate co-existent gram -ve bacterial sepsis (algid malaria) as malaria rarely causes shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment of P. vivax/ovale/malariae/knowlesi malaria? [3]

A
  • ACT (Artemisin based combination therapy) or
  • Chloroquine
  • Add primaquine (14d) in vivax and ovale to eradicate liver hypnozoites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some malaria control programmes? [4]

A
  • Mosquito breeding sites (draining standing water)
  • Larvacides
  • Mosquito killing sprays
  • Human behaviour (bed nets, mesh windows)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Typhoid fever
2 causes
What organisms cause this? [2]
Incubation period

A

Typhoid fever is widespread and happens due to poor sanitation and unclean drinking water.

  • Salmonella typhi
  • Salmonella paratyphi
  • 1-4 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What clinical features are seen in the first week of disease onset?
5 generalized flu-like symptoms
3 signs

A

Generalised flu-like symptoms

  • Fever
  • Headache
  • Abdo discomfort
  • Constipation
  • Dry cough
  • Relative bradycardia
  • Neutrophilia
  • Confusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What clinical features are seen in the second week of disease onset? [5]

A
  • Fever
  • Rose spots
  • Diarrhoea
  • Tachycardia
  • Neutropenia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What clinical features are seen in the third week of disease onset? (complications arise) [4]

A
  • Intestinal bleeding
  • Perforation
  • Peritonism
  • Metastatic infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Typhoid fever
What clinical features are seen in the fourth week of disease onset?
Rate of relapse

A

Usually recovery begins in 4th week of disease onset

10-15% relapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do you diagnose typhoid fever? [3]

A

Clinical dx
Lab
Cultures: blood, stool, urine, bone marrow (Looking for Salmonella typhi/paratyphi)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do you treat typhoid fever? [3]

A
  • Notifiable disease
  • Oral azithromycin 1g
  • IV Ceftriaxone (esp if complicated)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Dengue fever is the commonest human arbovirus infection. Ax and transmission? [2]
``` Dengue arbovirus spread by Aedes aegypti (type of mosquito) ```
26
What are the symptoms and signs of classical dengue fever? [5] Includes one clinical test What are features of severe dengue? [3]
- Sudden fever - Sudden headache, retro-orbital pain - Severe myalgia and arthralgia - Macular/maculopapular rash - Haemorrhagic signs: petechiae, purpura, positive tourniquet test Severe dengue: severe plasma leakage, severe bleeding, organ failure
27
How is dengue fever diagnosed? [6] | What is the tourniquet test
- Positive tourniquet test - PCR - Serology - FBC (leukopenia, thrombocytopenia) - LFT (elevated AST and ALT) - clotting (DIC = prolonged APTT and INR, increased D-dimer, reduced fibrinogen) Tourniquet test - This test is performed by inflating a blood pressure cuff on the upper arm to midway between diastolic and systolic blood pressures for 5 minutes. The results are considered to be positive if more than 20 petechiae per square inch are observed on the skin in the area that was under pressure
28
What is the management of Dengue fever? [3] | What are 2 complications?
Supportive -Mx: IV fluids, fresh frozen plasma, platelets Complications - Dengue haemorrhagic fever - Dengue shock syndrome
29
Schistosomiasis is spread via freshwater snails. What are the 3 water born parasites that cause this?
- Schistosomiasis haematobium - Schistosomiasis mansoni - Schistosomiasis japonicum
30
What is the schistosomiasis life cycle? [5]
- Infected snails penetrate human skin while swimming etc - Circulate in body, lose tails to become schistosomulae in body upon penetration - Migrate to portal blood in liver/mesenteric venules of bowel/rectum/venous plexus of bladder - Released in urine/faeces into sea - Parasite infects snail and cycle continues
31
The first clinical feature of schistosomiasis is Swimmers Itch, which presents after a few hours and stops after a day or two. What clinical features occur in the invasive stage? [4]
- Cough - Abdo discomfort - Splenomegaly after 24h - Eosinophilia
32
What clinical features are seen in the Katayama fever seen in schistosomiasis? [4] Onset?
- Fever - Urticaria - Lymphadenopathy - Splenomegaly - After 15-20 days
33
What happens in acute disease of schistosomiasis? [2] (also get chronic disease)
* S. haematobium: frequency, haematuria and urinary calcification after 6-8w * S mansoni and S. japonicum: dysentery after 6-8w
34
How is schistosomiasis diagnosed? [4]
- Clinical diagnosis - Antibody tests - Ova in stools and urine - Rectal snip
35
What is the treatment for schistosomiasis? [2]
- Praziquantel (2 doses 6hr apart) | - Prednisolone if severe
36
What are the different types of rickettsiosis diseases and what organism causes them?
- Tick typhus (rickettsia conorii/africae) - Rocky mountain spotted fever (rickettsia rickettsii) - Epidemic typhus (rickettsia prowazekii) - Scrub typhus (rickettsia tsutsugamushi)
37
What is the most common rickettsiosis disease imported to UK?
Tick typhus (from S Africa, Mediterranean, Arabian Gulf)
38
What are the clinical features of rickettsiosis? [8]
- Abrupt onset swinging fever - Headache - Confusion - Endovasculitis - Rash (macular, petechiae) - Bleeding - Reactive arthritis, neck myalgia - Tick bite eschar
39
What are the investigations for rickettsiosis? [3] | What is the treatment for rickettsiosis?
Ix: serology (IgM or IgG), FBC (leukopenia, thrombocytopenia), U&E and electrolytes (hyponatraemia) Doxycycline
40
How is Zika virus transmitted? [3]
- Aedes mosquitoes - Sexual contact - Blood transfusion
41
What are the clinical features of Zika virus? [8]
- none/mild symptoms - Headache - Rash - Fever, malaise - Conjunctivitis - Joint pains - Fetal problems: microcephaly and other neuro problems - Can cause GBS
42
What treatment is there for Zika virus? [3]
- No antiviral therapy - Mosquito control measures - Vaccines in development
43
What should be focused on in a patient history in a returning traveller with symptom onset? [6]
``` o Geographical location: urban/rural, geographical/travelled through o Risk activities: swimming, game park o Trip purpose o Accommodation Sexual hx o Contacts o Vaccines and malaria prophylaxis ```
44
Upon examination, what diseases does rash point to? [3]
- Typhoid (salmonella) - Tick Typhus - Dengue
45
Upon examination, what diseases does jaundice point to? [3]
- Hepatitis - Malaria - Yellow fever
46
Upon examination, what diseases does lymphadenopathy point to? [2]
- Leishmania | - Trypanosomiasis
47
Upon examination, what diseases does liver symptoms point to? [3]
- Malaria - Typhoid - Amoebic abscess
48
Upon examination, what diseases does splenomegaly point to? [3]
- Visceral leishmaniasis - Typhoid - Malaria
49
What general investigations should be done for travel acquired infections? (as well as specific investigations)
- FBC - Malaria films - LFTs - Stool microscopy and culture - Urine analysis and culture - Blood culture - CXR
50
General treatment for travel acquired infections? [4]
- Isolation: (PPE, single rooms) - Supportive measures - Empirical treatment - Specific treatment once diagnosis established
51
Name 3 features of cerebral malaria | Name 4 features of blackwater fever
-Cerebral malaria (encephalopathy): convulsions hypoxia hypoglycemia ``` -Blackwater fever: severe haemolysis high parasitaemia acute renal failure haemoglobinuria - black urine ```
52
Anti-malaria prophylaxis [4]
Malarone Chloroquine Doxycycline Mefloquine
53
Anti-malaria prophylaxis: Malarone and Chloroquine | Describe timing, SE, CI
Malarone - take 1-2d before travel - SE: GI upset - CI: pregnancy unless folate supplementation Chloroquine - Take 1w before travel - Retake weekly - SE: headache - CI: epilepsy - suitable in pregnancy
54
Anti-malaria prophylaxis: Doxycycline and Mefloquine | Describe timing, SE, CI
o DOXYCYCLINE: take 1-2d before travel (SE: photosensitivity, oesophagitis; CI: pregnancy, children) o MEFLOQUINE: taken 1w before and re-taken weekly (CI: hx depression)
55
What is dengue shock syndrome [4]
- poor peripheral perfusion - narrow pulse pressure - reduced cerebral perfusion - shock early in disease
56
Viral hemorrhagic fever Ax [4] Pathophysiology [3]
- Ax: yellow fever, dengue, Ebola (2-21d incubation peroid), Lassa fever Px: - viremia attacks vascular system - leading to increased vascular permeability - causing haemorrhage, hypotension and shock
57
Viral hemorrhagic fever Describe early signs [4], initial signs [6] What are florid signs of this syndrome? [3]
- early signs: non-specific w/ pyrexia, headache, myalgia and N&V - initial signs: high fever, oedema conjunctival injection, maculopapular or petechial rash, jaundice and altered mental state - florid signs are coagulopathy and haemorrhagic cx and multi-system organ failure
58
Viral hemorrhagic fever - describe what are complications of hemorrhage [3] Mx [2]
hepatic damage, myocarditis, encephalopathy - High security infection unit - Supportive treatment
59
Yellow fever Ep [2] Ax [2] Incubation period
Ep: Africa and South America Ax: flavivirus spread by Aedes mosquito Px: 2-4d incubation period
60
Yellow fever Presentation [5] Ix [3]
- sudden onset high fever, rigors - N&V - bradycardia - brief remission - followed by jaundice, hematemesis and oliguria Ix: serology, ELISA, PCR
61
Yellow fever Describe what you would see on FBC, LFT, U&E, Cr Mx [2] Complication
FBC (leukopenia, thrombocytopenia if coagulopathy) LFT (elevated AST and ALT) U&E and creatinine (AKI) Mx: rehydration therapy, notifiable disease Cx: viral hemorrhagic fever
62
``` Lassa fever Ep Vector Causative organism Describe a mild presentation [2] Describe neurological sequelae [3] ```
Endemic in West Africa Vector: multimammate rat Lassavirus Presentation - 1-3w - Mild symptoms: slight fever, malaise, headache - neuro: hearing loss, tremors, encephalitis
63
Describe serious symptoms of Lassa fever [6] | Risk factor [3]
Serious (20%): - hemorrhage: mucosal bleeding - conjunctivitis - respiratory distress - vomiting - facial swelling - chest pain, back, abdomen - shock Risk factors: - Endemic areas - HCW - Butchering or eating rodent meat
64
Lassa fever investigations [4] | Treatment
- RT-PCR - Serology - rapid diagnostic lateral flow assay - Check for typhoid & malaria (usually co-endemic and as differential) Mx: - Ribavirin IV

Infection (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions