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Year 3 CSP > 1. Fever in the returning traveller > Flashcards

1. Fever in the returning traveller Flashcards

1
Q

Patients presenting with fever - most common cause is?

A

Viral

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2
Q

Patients presenting with fever - second most common cause is?

A

Malaria

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3
Q

Majority of malaria infections are due to which pathogen?

A

P. falciparum

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4
Q

Most second common cause of malarial infections is due to which pathogen?

A

P. vivax

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5
Q

P. falciparum is responsible for what percentage of outpatients travellers presenting with fever?

A

14%

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6
Q

P. vivax is responsible for what percentage of outpatients travellers presenting with fever?

A

6%

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7
Q

Malaria is responsible for what percentage of outpatients travellers presenting with fever?

A

21%

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8
Q

Viral hemorrhagic fever (VHF) will present in a patient up to how many days following the return of a patient from holiday?

A

Fever and their visit must both be within 21 days

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9
Q

TB most commonly seen in what patient type?

A

Those returning home e.g. Bangladesh to visit their family

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10
Q

VHF is common or uncommon?

A

Uncommon

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11
Q

Malaria film is important for patient suspected of having VHF why?

A

Patient most likely to actually have malaria rather than VHF

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12
Q

Fresh water exposure carries risk of what two infections?

A

Acute schistosomiasis

Leptospirosis

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13
Q

Acute schistosomiasis presents when post-exposure?

A

2-12 weeks post-exposure

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14
Q

Leptospirosis presents when post-exposure?

A

<4 weeks post-exposure

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15
Q

Presentation of acute schistosomiasis? x1

A

Eosinophilia

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16
Q

Presentation of leptospirosis? x3

A

Jaundice
Conjunctival suffusion
Liver/renal impairment

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17
Q

Three infections likely to be contracted abroad in game park/safari?

A

Tick typhus
Trypanosomiasis
Anthrax

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18
Q

Four danger signs in the returning traveller

A

Altered mental status
Respiratory distress
Shock
Liver/renal impairment

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19
Q

What is the gold standard investigation for malaria?

A

Malaria film

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20
Q

Malaria - vivax and falciparum - which presents earlier/later than the other?

A

Falciparum presents first

Vivax present later

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21
Q

How does p. falciparum present on a blood film?

A

Rings and dots can be seen

22
Q

Problem with malarial blood film during pregnancy is?

A

Parasites sequester in the placenta and cannot be seen in blood film - should send to speciality lab

23
Q

Severe p.falciparum infection of malaria - what should be considered?

A

IUC admission

24
Q

Treatment for severe/complicated p.falciparum is what? x3

A

IV artensunate or IV quinine
Oral therapy once improved
Check blood film daily

25
Q

Preferred treatment for severe/complicated p.falciparum is what?

A

IV artensunate

26
Q

IV therapy for malaria treatment indicated when? x3

A

Parasitaemia >2% or presence of schizonts
Vomiting
Pregnancy

27
Q

Treatment for uncomplicated p.falciparum is what? x3

A

Oral therapy with wither:
Malarone
Riamet
Quinine and Doxy

28
Q

Treatment for non-p.-falciparum malarial infection is what?

A

Chloroquine followed by primaquine

29
Q

Importance of G6PD in malarial infection is what?

A

G6PD status should be checked prior to treatment with primaquine

30
Q

Incubation period for dengue is?

A

3-14 days

31
Q

Parasite responsible for dengue is?

A

Aedes spp. mosquitos

32
Q

First vs. second contraction of dengue - which is more severe?

A

Second

33
Q

Two presentations of dengue

A

Erythrodermic

Petechial with ‘white islands’

34
Q

Drug that should be avoided when treating dengue is? why?

A

NSAIDs

Risk of renal impairment

35
Q

Main treatment for dengue?

A

Simple analgesia

36
Q

Incubation period for chikungunya is?

A

1-12 days

37
Q

Two presentations of chikungunya is?

A

Fever

Severe arthralgia

38
Q

Two ways to diagnose chikungunya

A

PCR

Serology - IgM

39
Q

Parasite responsible for typhoid and paratyphoid is? x2

A

Salmonella Typhi

Salmonella Paratyphi

40
Q

Incubation period for typhoid/paratyphoid is?

A

1-3 weeks

41
Q

Typhoid/paratyphoid - what percentage is life threatening?

A

3%

42
Q

Is vaccination effective against typhoid?

A

Only partially

43
Q

Is vaccination effective against paratyphoid?

A

No

44
Q

Typhoid/paratyphoid is also known as?

A

Enteric fever

45
Q

Blood count results for enteric fever is?

A

Normal FBC
Decreased WBC
Decreased platelets

46
Q

Treatment for enteric fever is? x2

A

IV ceftriaxone

May be azithromycin in non-complicated disease

47
Q

Enteric fever - patient isolated or not?

A

Yes

48
Q

Specific name for tick typhus is?

A

Rickettsia

49
Q

Incubation period for rickettsia is?

A

5-10 days

50
Q

Classic presentation of rickettsia/typhus is? x3

A

Fever
Headache
Rash and myalgia

51
Q

Treatment for rickettsia is?

A

Doxycycline

Year 3 CSP (21 decks)

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