Travel related infections

Question 1

Traveller returning with fever likely cause

Answer 1

malaria
hepatitis
resp inf
UTI
dengue fever
enteric fever
diarrhoeal illness
EBV
TB

Question 2

Presents w rash

Answer 2

typhoid
typhus
dengue

Question 3

Presents w jaundice

Answer 3

hepatitis
malaria
yellow fever

Question 4

Presents w lymph nodes

Answer 4

leismania

trypanosmoiasis

Question 5

Investigations

Answer 5

fbc
malaria film
liver function
stool imcroscopy and culture
urine analysis and culture
blood culture
CXR

Question 6

General treatment

Answer 6

isolation
PPE
supportive mesaures
empirical treatment if unwell- antimicrobial therapy)

Question 7

Malaria species

Answer 7

female anaopheles mosquito
plamodium falciparum (severe potential)
plasmodium vivax
plamodium ovale
plamodium malariae
plasmodium knowlesi

Question 8

Malaria symp

Answer 8

fever
rigors
aching bones
abdo pain
headache
dysuria
inc frequency
sore throat
cough
hepto/splenomegaly
mild jaundice

Question 9

Malaria complications

Answer 9

encephalopathy
blackwater dever
pulm oedema
severe anameia
algid malaria

Question 10

Malaria investigation

Answer 10

thick and tin blood films
quanitiative buffy coat
rapid antigen test

Question 11

Malaria management uncomplicated p. falcipatum

Answer 11

riamet 3 days
eurartesim 3 days
malarone 3 days
quinine 7 days

Question 12

Malaria management complicated p. falcipatum

Answer 12

IV artesunate
IV quinine
oral doxycyclin

Question 13

Malaria management other strains

Answer 13

chloroquinine 3 days
riamet 3 days
add primaquine
check G6PD deficincy (haemolytic anamia cause)

Question 14

Typhoid fever

Answer 14

salmonella typhi or salmonella paratyphi
poor sanitation and unclean water
incubation 7 days to 4 weeks

Question 15

Typhoid fever investigate

Answer 15

blood culture
urine and stool
bone marrow
all for salmonella pathogens

Question 16

Typhoid fever features 1st week

Answer 16

fever
headache
abdo discomofort
constipation
dry cough
relative bradycardia
neutrophilia
confusion

Question 17

Typhoid fever features 2nd week

Answer 17

fever peaks 7-10 days
rose spots
diarrhoea
tachy
neutropenia

Question 18

Typhoid fever features 3rd week

Answer 18

intestinal bleeding
perforation
peritonism
metastatic infection

Question 19

Typhoid fever features 4th week

Answer 19

recovery

some relapse- 10-15%

Question 20

Typhoid fever treatment

Answer 20

oral azithromycin or IV cefriaxone

Question 21

Dengue

Answer 21

mosquitos

Question 22

Dengue symp

Answer 22

sudden fever
severe headache
retro orbital pain
severe myalgia and arthraligia
macular/maculopaular rash
haemorrhagic signs- petechia, purpura, positive tourniquet test

Question 23

Dengue investigate

Answer 23

PCR and serology

Question 24

Dengue complications

Answer 24

dengue haemorrhagic fever
dengue shock syndrome
need IV fluids, fresh frozen plasma, platelets

Question 25

Schistomiasis

Answer 25

in freshwater bodies of water carried by freshwater snails | hepatic/interstinal, urinary or both

Question 26

Schistomiasis organisms

Answer 26

S. haematobium S. mansoni S. japonicum

Question 27

Schistomiasis features first few hours

Answer 27

swimmers itch - clears after day or two

Question 28

Schistomiasis features after 24 hrs

Answer 28

``` invasive stage cough abdo discomfort splenomegaly eosinphilia ```

Question 29

Schistomiasis features 15-20days

Answer 29

``` katayama fever prostrate fever urticuaria lymphadenopathy splenomgaly diarrhoea eosinophilia ```

Question 30

Schistomiasis features 6-8weeks

Answer 30

eggs depsited in bowel (dysentery) or bladder (haematuria)

Question 31

Schistomiasis diagnosis

Answer 31

clinical antib tests ova in stools and urone rectal snip

Question 32

Schistomiasis treatment

Answer 32

praziquantel 20mg/kg 2 doses 6 hrs apart prednisalone if severe

Question 33

Typhus

Answer 33

spread by lice, flees or mites maculopapular rash and tick bite eschar clinical features and serology manage w tetracycline

Question 34

Zika virus

Answer 34

mosquitos dangerous to pregnant women (microcephaly) can cause guillian barre syndrome risk passing through sex/blood tranfusions asymp or mild- headache, fever, rash etc no treatment but there are vaccines