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Tropical medicine - All clinical images copyright Gorgas course - : Instituto de Medicina Tropical Alexander von Humboldt > Asian Extras > Flashcards

Asian Extras Flashcards

1
Q

Myanmar
1-month cough, fevers, night sweats
Cavitating lesions on CXR
Cavitating pneumonia 3DDx?

A

TANKS CRAMPD
TB / non-TBmycobacteria
Aspergillus
Nocardia
Klebsialla
Staph/strep

Cryptococcus
Rhodococcus
Actinomycosis
Melioidosis/mucor
Paragonimus
Dimorphic fungi

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2
Q

betel nut complication

A

Nasopharyngeal Ca

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3
Q

Nocardia 3 organs
Rx

A

Brain
Skin
Lung

Co-trimox, gent, ceftriaxone

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4
Q

Bipolar staining bacteria

A

BurY PaT

Burkholderia
Yersinia
Pasturella
Tuleraemia

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5
Q

Name 2 ways to get infected with melioidosis.

A

Inhaled,
Direct inoculation

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6
Q

Kid in Asia with parotitis

A

Burkholderia pseudomallei

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7
Q

24M
24hr headache with meningism
2 brothers also the same symptoms
Recently eaten raw snails
dx? ix for dx?

Usually found in?

A

Angiostrongylus cantonensis
CSF PCR
Steroids [maybe albendazole]

Rats pulmonary arteries

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8
Q

New diagnosis HIV
Fever umbilicated skin lesions, hepatosplenomegaly
Night sweats
rx?

A

talaromyces marneffei
The oval shape with line in middle is pathognomonic

Ampho B if severe then
Itraconazole until CD4 >100 for 6 months

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9
Q
A

Talaromyces marneffei

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10
Q

name 5 Infections through broken skin **

A

R prowazekki
R Typhi
L interrograns
B pseudomallei
F Pedrosoi
S Schneckii
B recurrentis
Treponematoses

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11
Q

differentiate podoconiosis and elephantitis

A

bilateral -> podoconiosis
Unilateral -> lymphatic filiariaisis

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12
Q

24F
Pakistan constipation, diarrhoea vomiting,
Mild abdo pain and headache
maculopapular rash and headache
Looks unwell
dx? rx?

A

typhoid
Meropenem (pakistan)

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13
Q

46M farmer india Nil PMH
Fever, headache, myalgia, joint pain
Name 3 ddx?

-> Rapid drop in GCS
-Thrombocytopenic, arranged LFTs, AKI, Raised lactate
-CSF raised protein + lymphocytic
Has groin lesion as pictured
Now Dx? Vector?dx? rx?

A

Dengue
Typhoid
Scrub typhus
Lepto
Malaria

Scrub typhus - Orienta tsutsugamushi
Larval mite
IgG, PCR, [Western blot - often not positive until after 2 weeks]
Doxycycline

[NEJM study new -> Doxy + azithro superior]

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14
Q

52M farmer - T2DM, CKD, TB
2 weeks of right facial pain and swelling
Now decreased vision right eye and unable to open
O/E unable to move eye
Painful necrotic ulceration on hard palate

CT - soft tissue swelling with bony involvement with eye and brain involvement
Biopsy - wide hypahe with 90 degree branching
dx?
name 3 risk factors?

A

Mucor/rhizopus/lichtheimia ssp

Raised glucose, immunocompromised, low pH, iron overload
India - 70x cases than anywhere else

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15
Q

Progressive facial pain, oedema, and proptosis =
name 3 complications

A

Mucorales ssp

Cevernous sinus thrombosis
• Osteomyelitis
• Multiple cranial nerve involvement
• Periorbital destruction
• Palatine ulcers (Painful, black, necrotic ulcerations into the
hard palate)
• Disseminated infection

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16
Q

Mucormycosis rx

A

Do it fast or they’ll be DAID

Debridement - radical
Antifungal - Ampho B + posiconazole/isavuconazole
Immunosuppression control
Diabetic / BM control

17
Q

Date palm sap -> which virus?
Animal implicated?
Ilness?

A

Nipah virus
Fruit bat - Genus pteropus

Acute - non-specific - fever, headache, vomiting
-Or acute neuro

Subacute - late-onset encephalitis

Long term - relapse encephalitis / neuro complications

18
Q

Date palm sap -> which virus?
Animal implicated?
Incubation period?
Illness phases?

A

Nipah virus
Fruit bat - Genus pteropus

May be over months
Incubation 2 weeks - 4 months
Acute - non-specific - fever, headache, vomiting
-Or acute neuro

Subacute - late-onset encephalitis

Long term - relapse encephalitis/neuro complications

19
Q

Eosinophilic CSF causes

A
20
Q

Name 3 things that would make you think eosinophilic meningitis was angiostrongylus? Gnathostoma?

A
21
Q

DDx umbilicated skin lesions - name 3

A
  • Molluscum contagiosum
  • Cryptococcus neoformans
  • Dimorphic fungi: Histoplasmosis/Talaromycosis
  • Trichoepitheliomas
  • Tuberous sclerosis
  • Syphilis
    Mpox
22
Q
A

Talaromyces marneffei

23
Q

Dimorphic fungi Name 5

A
24
Q

Asia umbilicated lesions and this on culture
Key animal implicated
rx severe?

A

Talaromyces marneffei
Bamboo rat

Amphotericin B 0.7mg/kg/day IV for 2 weeks
Then- Itraconazole BD for next 8-10 weeks

25
Q

3 causes of spotted fever?
3 causes of typhus?
Vector for each?

A
26
Q

Shealthless microfilaria tail shapes

A

Tropical medicine - All clinical images copyright Gorgas course - : Instituto de Medicina Tropical Alexander von Humboldt (26 decks)

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