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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

What parasite causes Chagas' Disease

Trypanasoma cruzi

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