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Travelers Flashcards

(18 cards)

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1
Q
  1. When preparing a patient for travel, what should healthcare professionals consider? (3)
A
  1. diseases spread through food and water
  2. diseases spread through blood and bodily fluids
  3. diseases transmitted by insects
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2
Q

Traveler’s Diarrhea:

  1. If blood is mixed in with stool what is that referred to?
  2. This is often associated with systemic sx’s like?
  3. This is classified as ___
  4. For traveler’s diarrhea, more than 80% of cases are?
  5. Whats the primary pathogen?
A
  1. dysentery
  2. fever
  3. severe
  4. bacterial
  5. e. coli
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3
Q

TD Prevention:

  1. Avoid food thats been ___
  2. Use __ or ___ for approximately 1 minute before drinking or using to brush teeth.
    Avoid __
  3. PPX with ___ reduces incidence of TD by ~50%
  4. Who can you NOT use this drug in?
A
  1. sitting on a buffet
  2. bottled water, boil
    -ice
  3. bismuth subsalicylate
  4. aspirin allergy, pregnancy, renal insufficiency, gout, or anticoags
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4
Q
  1. What should NOT be used by most travelers?
  2. However, if this is indicated, which drug is preferred?

TD TREATMENT:

  1. WHat is essential ?
  2. Whats the preferred method of hydration?
A
  1. ABX PPX
  2. Rifaximin
  3. Hydration w/incr fluid and salt intake
  4. Oral rehydration
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5
Q

TD TREATMENT:

  1. WHats the primary antimotility drug used?
  2. What does this drug do?
  3. Dosing?
  4. This can be used for self treatment for how long?
  5. What else is another tx option? WHat side effects r common with this drug?
A
  1. loperamide (Immodium A-D)
  2. decr the frequency and urgency of bowel movements
  3. 4 mg after first loose stool and 2 mg after each subsequent loose stool up to a max of 16 mg/day by rx or 8 mg/day OTC
  4. up to 2 days
  5. BSS, black tongue/stool
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6
Q

Drugs for Traveler’s Diarrhea:

  1. Prophylaxis (2) Options

Treatment

  1. MILD TD? (2)
  2. Moderate TD?
    -state preferred drug and alt
  3. Severe TD including dysentery?
    -state preferred drug and alt
A
  1. BSS 524-1050 mg PO QID (with meals and at bedtime)

-ABX Rifaximin preferred (only if high risk of complications from TD)

  1. loperamide or BSS
  2. Loperamide +/- ABX
    -azithro or quinolone (if low resistance)
    -Rifaximin is alt
  3. ABX +/- loperamide
    -Azithro preferred
    -Quinolones or rifaximin alts
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7
Q

Typhoid Fever :
1. Which bacterium causes it?

  1. Disease is spread through?
  2. what is recc?
    -although only 50-80% effective… what other guidelines should travelers follow?
  3. what r the 2 typhoid vaccines?
  4. When should the oral vaccine regimen be completed?
  5. WHen should the IM injection be given?
A
  1. Salmonella Typhi
  2. food or water contaminated by the feces of some1 with either an acute infection or from a chronic, asymptomatic carrier
  3. typhoid vaccines
    -safe food and water precuations and wash hands
  4. Vivotif (oral, live attenuated)

Typhim Vi (inactivated IM injection)

  1. > =1 week prior to travel
  2. > =2 weeks before the expected exposure
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8
Q

CHOLERA:

  1. Which bacterium causes it?
  2. most common ae’s?
  3. ina ddition to food and water precautions, whats recc?

POLIO:

  1. What does the CDC reccomend?

HEP A:

  1. Who is at highest risk?
A
  1. vibrio cholerae
  2. rice water stools
  3. Live attenuated vaccine (Vaxchora)
  4. Single lifetime booster dose of inactivated poliovirus vaccine at least 4 wks prior to travel for adults who have previously completed a PV vaccine series
  5. People from developed countries who travel to developing countries
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9
Q

TRAVEL VACCINES:

  1. Which ones are inactivated? (7)
  2. Live? (3)
A
  1. -Hep A (Havrix, VAQTA)
    -Hep B (Engerix B, Heplisav B, Recombivax HB)
    -Hep A/B (twinrix)
    -Jap Enceph (Ixiaro)
    -Meningococcus (Menveo, Menquadfi)
    -Polio (IPOL)
    -Typhoid IM (Typhim VI)
  2. cholera-PO (Vaxchora)
    -typhoid PO (vivotif)
    -Yellow fever SC (YF-VAX)
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10
Q
  1. How is HepB Transmitted?
  2. WHo is the hep b vacc important for?
  3. WHat else can transmit the virus?
  4. 3 dose vaccine series takes how long to complete?
  5. What happens if traveler unable to get all 3 doses?
A
  1. Through contact with contaminated blood or other body fluids
  2. travelers who plan to:
    -receive medical care
    -volunteer to provide medical work
    -have unprotected sexual encounters
  3. piercings and tattoos
  4. 6 months
  5. admin as many doses as possible before departure and complete series upon return
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11
Q

Meningococcal Meningitis:

  1. Which sx’s can a pt show that may require urgent treatment?
  2. Meningitis is spread through?
A
  1. fever
    severe/unrelenting HA
    Nausea
    Stiff neck (nuchal rigidity)
  2. respiratory secretions
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12
Q

Insect Bites:

  1. Insects that transmit disease are called ?
  2. which diseases can mosquitos transmit? (5)
  3. Repelling insects using which products?
  4. What can be used to treat clothing, gear, and bed nets but dont apply this directly to the skin?
  5. Severe dengue can include shock , org failure, and ___
A
  1. vectors
  2. jap enceph, yellow fever, dengue, malaria, zika virus
  3. DEET on exposed skin
  4. Permethrin
  5. Severe bleeding
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13
Q

MALARIA:

  1. It’s transmited by?
  2. Which malaria species causes 50% of malaria cases in india?
  3. Which species is most deadly?
A
  1. Anopheles mosquito
  2. p Vivax
  3. P falciparum
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14
Q

MALARIA PPX:
1. WHen should they be started and continued?

  1. anti malarials can cause ___ so take it with what to decr nausea?
  2. What are the 3 quick start anti malarial regimens?
  3. These are ____ should be avoided in ___ and can cause ___
  4. WHen are these meds initiated?
  5. Doxy regimen can cause ___, not used in (2) ?
  6. Malarone is not used in ? (3)
  7. Primaquine should be stopped when?
  8. Primaquine is not used in ? (1!!)
A
  1. prior to travel and continue after returning
  2. nausea , milk, water or food
  3. Doxycycline (Doryx or Vibramycin) , Malarone Primaquine
  4. daily regimens, pregnancy, nausea
  5. 1-2 days prior to travel
  6. photosensitivity
    -preg, children < 8 yrs old
  7. preg, breastfeeding, severe renal impairment
  8. 1 wk after travel
  9. g6PD deficiency!!
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15
Q

MALARIA PPX: Advance Starts

  1. What are the 3 regimens/meds?
  2. When should the specific regimens be statrted?
  3. Chloroquine:
    A. when is it stopped?
    B. How is it taken?
    C. Side effects?
  4. Mefloquine:
    a. Starts?
    b. Stopped?
    c. How taken?
    d. NOT USED IN? (3)
  5. Tafenoquine: How often is it taken?
  6. All of these regimens are safe in ?
A
  1. Chloroquine, mefloquine, tafenoquine
  2. Chloroquine + Mefloquine started 1-2 weeks before travel
    -Tafenoquine has LD starting 3 days before travel

3a. 4 wks after travel
b. weekly
c. retinal toxicity /visual changes

4a. >= 2 weeks before travel
b. 4 wks after travel
c. weekly
d. Underlying psych conditions, seizures, arrhythmias

  1. weekly
  2. CHildren and pregnancy
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16
Q

YELLOW FEVER:

  1. No specific treatment besides fluids, analgesics, antipyretics… but what can you NOT use and why?
  2. What kind of vaccine avail?
    -After, pt’s are provided with?
    -When is the card valid?
  3. Who is the vaccine contraindicated for?
Study These Flashcards
A
  1. nsaids and ASA due to incr risk of bleeding
  2. Live attenuated (YF-VAX)
    -ICVP (yellow card)
    -10 days after vaccination
  3. Hypersensitivity to eggs, and severely immunocompp
17
Q

Zika Virus:

  1. transmission?
  2. What is the most pressing concern with Zika virus?
  3. vaccine avail? How to prevent?
Study These Flashcards
A
  1. aedes species mosquito, sexual and possible blood transfusion associated transmission also reported
  2. Infants born with microcephaly
  3. no vaccine but avoid mosquito bites and use condoms
18
Q

Altitude Sickness:

  1. primary prophylactic med?
  2. side effects at higher doses?
  3. CI to acetazolamide?
Study These Flashcards
A
  1. acetazolamide (Diamox) 125 mg BID started day before or on the day of ascent
  2. polyuria, photosensitivity

3 sulfa allergy

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