Travel Related Infections Flashcards

1
Q

What are the possible symptoms of traveller’s diarrhoea?

A
Anorexia
Malaise
Abdominal cramps
Watery (non-bloody) diarrhoea
Fever
Nausea and vomiting
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2
Q

How can mosquito bites be physically avoided?

A

Air conditioning
Screens
Permethrin impregnated meeting
Clothing to cover the arms, legs, ankles and feet

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3
Q

What is the most common cause of fever in travellers from sub saharan Africa?

A

Malaria

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4
Q

What techniques are used to diagnose malaria?

A

Antigen testing
Blood films
PCR

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5
Q

What are the clinical features of malaria?

A
Fever
Malaise
Headache
Myalgia
Diarrhoea
Anaemia
Jaundice
Renal impairment
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6
Q

In severe malaria there is parasitaemia. What are the other clinical features of severe malaria?

A
Cerebral malaria
Severe anaemia
Renal failure
Shock
DIC
Acidosis
Pulmonary oedema
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7
Q

What drugs can be used for chemoprophylaxis for malaria?

A

Mefloquine
Doxycycline
Malarone

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8
Q

Which chemoprophylactic agent for malaria has the side effect of photosensitisation?

A

Doxycycline

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9
Q

Which organisms cause enteric fever?

A

S.thyphi

S.parathyphi

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10
Q

S.typhi and s.parathyphi have an animal reservoir. T/F?

A

False - it only exists in humans

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11
Q

What is the incubation period for enteric fever?

A

5 to 21 days depending on age, gastric acidity, immune status and infectious load

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12
Q

What are the symptoms of enteric fever?

A
Fever
Myalgia
Headache
Cough
Abdominal pain
Constipation
Diarrhoea
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13
Q

Diarrhoea or constipation can occur in enteric fever. Which is more likely in children?

A

Diarrhoea

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14
Q

What is the diagnosis of enteric fever based upon?

A

Travel history
Blood culture
Stool culture
Serology

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15
Q

What antibiotic class is the most effective agents against enteric fever?

A

Quinolones

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16
Q

If there is resistance to quinolones in enteric fever what agent is used?

A

Cephalosporins

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17
Q

What is the incubation period of dengue fever?

A

5-14 days

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18
Q

What are the clinical. features of dengue fever?

A
Headache
Fever
Retro-orbital pain
Arthralgia/myalgia
rash
cough
sore throat
nausea
diarrhoea
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19
Q

What laboratory findings are seen with dengue fever?

A

Lecuopaenia
Thrombocytopaenia
Transaminitis

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20
Q

How is dengue haemorrhage fever defined?

A

Increase in vascular permeability
Thrombocytopenia
Fever
Bleeding

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21
Q

What can cause viral haemorrhagic fever?

A
Lassa
Ebola/marburg
CCHF
SAVHFs
RVF
DHF
Yellow fever
22
Q

Exposure to viral haemorrhagic fever is more common in rural areas. T/F?

A

True

23
Q

Which causes of fever is a returning traveller more at. risk of if they worked in hospitals or refugee camps?

A

TB
HIV
VHF
typhus

24
Q

Which causes of fever is a returning traveller more at. risk of if they had sexual exposure?

A

HIV
Hepatitis B and C
Syphilis
Gonorrhoea

25
Q

Which causes of fever is a returning traveller more at. risk of if they visited an African game park?

A

Tick typhus

26
Q

Which causes of fever is a returning traveller more at. risk of if they had fresh water exposure?

A

Schistosomiasis

Leptospirosis

27
Q

Which causes of fever is a returning traveller more at. risk of if they went caving?

A

Histoplasmosis

Rabies

28
Q

Which causes of fever is a returning traveller more at. risk of if they were exposure to contained food or water?

A
Enteric fever
Shigella
Salmonella
Campylobacter
Amoebiasis
Helminth infections
Hepatitis A and E
29
Q

Which causes of fever is a returning traveller more at. risk of if they ingested. unpasteurised milk?

A

Brucella
Listeria
Salmonella

30
Q

Which causes of fever is a returning traveller more at. risk of if they had animal contact?

A

Brucella

Q fever

31
Q

Which causes of fever is a returning traveller more at. risk of if they used air-con systems or. showers?

A

Legionella

32
Q

How can malaria be diagnosed?

A

Thick or thin blood. film

Rapid diagnostic antigen test

33
Q

What initial investigations should be conducted in a patient with suspected malaria?

A
FBC, LFTs, U&Es
3 malaria. blood films or rapid diagnostic tests over 3 days
Blood. cultures
HIV test
Urine and. stool culture and microscopy
Serology. gro dengue fever
CXR and ultrasound of liver and spleen
34
Q

What is the most severe causative agent of malaria?

A

Falciparum malaria

35
Q

What. is the standard treatment for falciparum malaria?

A

Quinine plus doxycycline. for a week

36
Q

What. are the four plasmodium. species which are. responsible. for human malaria?

A

P.falciparum
P.vivax
P.ovale
P.malariae

37
Q

Which causative agents. of malaria typically show no drug resistance?

A

P.ovale

P.malariae

38
Q

Patients with confirmed non-falciparum malaria may be treated as outpatients with…?

A

Chloroquine

39
Q

What are the clinical features of uncomplicated malaria?

A
Fever
Malaise
Headache
Myalgia
Splenomegaly
Anaemia
Minor GI symptoms
40
Q

What are the clinical features of severe malaria disease. in adults?

A
Impaired consciousness or seizzures
Hypoglycaemia
Haemoglobin <8g
Spontaneous bleeding or. DIC
Haemoglobinuria
Renal impairment
Acidosis
Pulmonary oedema / acute respiratory distress syndrome
Shock
Death
41
Q

Fresh water exposure when travelling can predispose to which infections?

A

Schistosomiasis

Leptospirosis

42
Q

Caving when travelling can predispose to which infections?

A

Histoplasmosis

Rabies

43
Q

Why should malaria blood tests be taken several times over 2-3 days?

A

Malaria parasites may be in the blood at very low concentrations, especially in patients who have taken prophylaxis
Parasites may not be visible in the peripheral blood at different stage of their life cycles.

44
Q

What are the advantages and disadvantages of thin blood film in diagnosing malaria?

A

Good for speciation and estimation of parasitaemia

Low sensitivity

45
Q

What are the advantages and disadvantages of thick blood film in diagnosing malaria?

A

Most sensitive method of detecting parasites

Requires expertise to interpret

46
Q

What are the advantages and disadvantages of rapid diagnostic tests in diagnosing malaria?

A

Less sensitive

Require less expertise to interpret

47
Q

What four parasites can cause malaria?

A

P.ovale
P.vivax
P.malariae
P.falciparum

48
Q

Which causative organisms of malaria exhibit drug resistance?

A

P.falciparum

49
Q

Why do p.vivax and p.ovale require additional treatment to prevent relapse of malaria?

A

These parasites can lie dormant in the liver

50
Q

What additional treatment do p.vivax and p.ovale infections require to prevent relapse of malaria?

A

Primaquine

51
Q

Non-falciparum malaria can be treated as outpatient with what drug?

A

Chlorowuine

52
Q

What clinical features are suggestive of severe disease in adults with malaria?

A
Impaired consciousness or seziures
Hypoglycaemia
Haemoglobin <8g/dl
Spontaneous bleeding or DIC
Haemoglobulinuria
Renal impairment
Acidosis
Pulmonary oedema
Shock
Death