Flashcards in Tropical Gastro Deck (41):
1
What questions should be asked to a returned travellers
Where they have been
When did they go
When did they get back
When did they start to become unwell
Did they have insect bites
What are their symptoms
Is anyone else unwell
What activities did they do when they were away
Any chance of HIV / STI
What precautions did they take?
2
What are common symptoms of a returned traveller
Fever
Rash
Hepatosplenomegaly
Lymphadenopathy
Insect bites
Wounds
3
What can fever be a symptom for?
Respiratory tract infections
Travellers diarrhoea
Malaria
Enteric fever (typhoid / paratyphoid fever)
Arboviruses (dengue or chikungunya)
4
How can we diagnose acute traveller's diarrhoea
3 loose stools within 24 hours
Fever
5
What is the pathogen usually identified>
It usually is not identified
6
What 2 types of viruses are picked up on cruise ships
Norovirus and rotavirus
7
What investigations do we do for acute traveller's diarrhoea
Stool culture
Stool wet prep on recently passed stool for amoebic trophozoites
8
What is the treatment for Acute traveller's diarrhoea
Suportive with fluids
Usually they will get better themselves
9
What symptom would warrant further treatment?
Bloody diarrhoea
10
What drug can stop worsening
Fluoroquinolone (ciprofloxacin) single dose
11
What are the symptoms of enteric fever
Headache
Constipation or diarrhoea
Dry cough
12
Where is enteric fever most common
Indian subcontinent and south east asia
13
What is the incubation period for enteric fever
7-18 days
14
What are 4 complications of enteric fever
GI Bleeding
GI perforation
Encephalopathy
Bone and joint infection
15
What is the causative organism for enteric fever
Salmonella typhi or paratyphi
16
What precautions should be taken for enteric fever
Water, food and hand hygiene
17
What can cause pre-hepatic fever and jaundice
Malaria
18
What can cause hepatic fever and jaundice
Hepatitis A and E
Leptospirosis
Malaria
Enteric fever
Typhus
Viral haemorrhagic fever
19
What investigations do we do for Malaria
Blood film and rapid antigen
20
What other investigations do we do for Traveler's diarrhoea
Blood film for red cell fragmentation
FBC/ UE/ LFT / Coagulation
Blood cultures
USS abdomen
Serological testing for viruses
21
What management and treatment is used for Traveler's diarrhoea
Appropriate isolation and infection control proceudres
Supportive - may need sialysis if acute kidney injury
If acute liver failure - hepatology / transplant unit
Directed to pathogen isolated
Discussion with infectious diseases
22
What are the common presentations of amoebic liver abscess.
When do they develop?
Fever
cough
aching abdominal pain
hepatomegaly
usually male
Usually 2-4 weeks
23
What investigations are appropriate for amoebic liver abscess
CXR raised right hemi-diaphragm
LFTs - abnormal
USS/ CT
Serology
Stool microscopy- often negative
24
Where are helminth infections usually found
In the gut or the tissue
25
What are Helminth infections often associated with
Eosinophilia
26
What is the other name for Roundworms
Nematodes
27
What is the other name for Flukes
Trematodes
28
What is the other name for Tapeworms
Cestodes
29
What is the most common helminthic infection in the world
Intestinal nematodes (round worms)
30
What is the cycle of helminth infections
Eff ingested,
hatched in small intestine,
invade the gut wall
Travel into the venous system
Reaches the liver, heart and lungs
Break into the alveoli
Ascend the tracheobronchial tree
Swallowed in the gut
Develop into adult worm
Adult worm starts to produce eggs
31
Where can we get Taenia solium from?
Pork
32
Where can we get saginatum from?
Beef
33
Where can we get Taenia solium eggs from?
Autpinoculation or from human faeces
34
What can Taenia solium eggs cause
Cystticercosis - tissue cysts in the muscle and brain
35
What are the symptoms of Giardia lamblia
Diarrhoea (chronic), malabsorption and weight loss
36
What type of infection is Giardia lamblia?
Protozoan infection
37
How can we diagnose Giardia lamblia?
Look for cytes or parasites in the stool
38
What is the treatment for Giardia lamblia?
Metranidazole
39
What is the triatome known as?
The kissing bug
40
What does Chagas' Disease cause?
parasympathetic denervation affecting the colon / oesophagus
Megaoesophagus
41