Flashcards in Tropical Gastro Deck (41):
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?
What are common symptoms of a returned traveller
What can fever be a symptom for?
Respiratory tract infections
Enteric fever (typhoid / paratyphoid fever)
Arboviruses (dengue or chikungunya)
How can we diagnose acute traveller's diarrhoea
3 loose stools within 24 hours
What is the pathogen usually identified>
It usually is not identified
What 2 types of viruses are picked up on cruise ships
Norovirus and rotavirus
What investigations do we do for acute traveller's diarrhoea
Stool wet prep on recently passed stool for amoebic trophozoites
What is the treatment for Acute traveller's diarrhoea
Suportive with fluids
Usually they will get better themselves
What symptom would warrant further treatment?
What drug can stop worsening
Fluoroquinolone (ciprofloxacin) single dose
What are the symptoms of enteric fever
Constipation or diarrhoea
Where is enteric fever most common
Indian subcontinent and south east asia
What is the incubation period for enteric fever
What are 4 complications of enteric fever
Bone and joint infection
What is the causative organism for enteric fever
Salmonella typhi or paratyphi
What precautions should be taken for enteric fever
Water, food and hand hygiene
What can cause pre-hepatic fever and jaundice
What can cause hepatic fever and jaundice
Hepatitis A and E
Viral haemorrhagic fever
What investigations do we do for Malaria
Blood film and rapid antigen
What other investigations do we do for Traveler's diarrhoea
Blood film for red cell fragmentation
FBC/ UE/ LFT / Coagulation
Serological testing for viruses
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
What are the common presentations of amoebic liver abscess.
When do they develop?
aching abdominal pain
Usually 2-4 weeks
What investigations are appropriate for amoebic liver abscess
CXR raised right hemi-diaphragm
LFTs - abnormal
Stool microscopy- often negative
Where are helminth infections usually found
In the gut or the tissue
What are Helminth infections often associated with
What is the other name for Roundworms
What is the other name for Flukes
What is the other name for Tapeworms
What is the most common helminthic infection in the world
Intestinal nematodes (round worms)
What is the cycle of helminth infections
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
Where can we get Taenia solium from?
Where can we get saginatum from?
Where can we get Taenia solium eggs from?
Autpinoculation or from human faeces
What can Taenia solium eggs cause
Cystticercosis - tissue cysts in the muscle and brain
What are the symptoms of Giardia lamblia
Diarrhoea (chronic), malabsorption and weight loss
What type of infection is Giardia lamblia?
How can we diagnose Giardia lamblia?
Look for cytes or parasites in the stool
What is the treatment for Giardia lamblia?
What is the triatome known as?
The kissing bug
What does Chagas' Disease cause?
parasympathetic denervation affecting the colon / oesophagus