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NAPLEX 2023 > Chapter 21: Travelers > Flashcards

Chapter 21: Travelers Flashcards

1
Q

Travel vaccinations should be listed on what for travelers?

A

International Certificate of Vaccination or Prophylaxis (ICVP) OR yellow card

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2
Q

Travel health information, including travel health insurance recommendations, is available on the CDCs travel website where the ____ is located

A

Yellow Book

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3
Q

Which drugs can be used for traveler’s diarrhea prevention

A

Bismuth subsalicylate

Antibiotics if indicated

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4
Q

If there is bloody stool with traveler’s diarrhea it’s called

A

dysentery (SEVERE)

usualyl accompanied by systemic symptoms

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5
Q

primary causative pathogen in traveler’s diarrhea

A

bacterial
E. coli

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6
Q

prophylaxis for traveler’s diarrhea

A

Bismuth subsalicylate (BSS) in Pepto-Bismol

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7
Q

Bismuth subsalicylate should be avoided in which patients

A 
Aspirin allergy
Pregnancy
renal insufficiency 
gout
anyone taking anticoagulants
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8
Q

If antibiotic ppx is indicated for TD, which antibiotic is preferred

A

Rifaximin

should not be used by most traveler’s though

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9
Q

Traveler’s diarrhea treatment

A

oral rehydration
antimotility (loperamide)
Pepto-Bismol
antibiotics (azith, quinolones, rifaximin)

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10
Q

Which drugs can be used for mild traveler’s diarrhea treatment

A

loperamide or BSS

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11
Q

How does loperamide work for traveler’s diarrhea?

A

Decreases the frequency and urgency of bowel movements

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12
Q

Loperamide dose for Rx and OTC

A

Rx: 4 mg after the first loose stool, then 2 mg after, up to a max dose of 16 mg/day
OTC: 8 mg/day

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13
Q

Loperamide can be used as self-treatment for up to how many days

A

2 days

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14
Q

Which drugs can be used for moderate Traveler’s Diarrhea treatment

A

Loperamide ± antibiotics (quinolones if low resistance, azithromycin or rifaximin)

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15
Q

Which drugs can be used for severe Traveler’s Diarrhea treatment (including dysentery)

A

antibiotics (azithromycin preferred, quinolones or rifaximin as alternatives) ± loperamide

azithromycin is preferred for TD and dysentery

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16
Q

What is the BSS dose for TD ppx

A

524-1050 mg PO QID (with meals and HS)

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17
Q

Which bacterium causes Typhoid Fever

A

Salmonella typhi

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18
Q

How is typhoid fever spread

A

food or water contaminated by the feces of someone with either an acute infection or from a chronic, asymptomatic carrier

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19
Q

What are the names of the Typhoid vaccines and their route of administration

A

Vivotif (oral, live attenuated) - remember this by the word “vivo” which means to live
Typhim Vi (inactivated IM) - remember typhIM

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20
Q

When should the oral typhoid vaccine be completed

A

≥ 1 week prior to travel

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21
Q

When should the IM typhoid vaccine be completed

A

≥ 2 weeks before the expected exposure

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22
Q

Which bacterium causes Cholera

A

Vibrio cholerae

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23
Q

What is the most common symptom of cholera

A

watery diarrhea, which is referred to as “rice-water stools”

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24
Q

What is the name for the cholera vaccine & route of administration

A

Vaxchora; oral solution

Live attenuated vaccine
vaxchORA(L)

25
Q

The CDC recommends ____ booster doses for poliovirus vaccine at least ____ prior to travel for adults who have previously completed a poliovirus vaccine series & who are traveling to regions where poliovirus is circulating

A

1 booster dose
4 weeks

26
Q

HepA high risk individuals

A

people from developed countries traveling to developing countries

27
Q

how is HepB transmitted?

A

through blood or bodily fluids

28
Q

HepB vaccination is most important for those doing high risk activites like ____

A

planning to receive medical care, provide medical work, unprotected sex, piercings and tattoos

29
Q

How long does the Hep B vaccine series take to complete

A

3-dose series takes 6 months to complete

30
Q

What should be done if a traveler is unable to complete the Hep B series before departure

A

Administer as many doses as possible before departure and complete the series upon return

31
Q

What are the symptoms of meningococcal meningitis

A

Fever, severe and unrelenting HA, nausea, stiff neck (nuchal rigidity), and mental status change - all require urgent treatment

32
Q

how is meningitis spread?

A

respiratory secretions

33
Q

Which meningococcal vaccines are quadrivalent

A

Menactra and Menveo

no recommendations for sero B vaccines for travelers

34
Q

Which diseases can mosquitos transmit to travelers

A

Japanese encephalitis, yellow fever, dengue, malaria and zika virus

Those dengue Japanese mosquitos causing yellow male zebras

35
Q

To avoid mosquito bites, proper repellent should contain which active ingredient on exposed skin

A

DEET

36
Q

What should be used to treat clothing, gear and bed nets, but should NOT be applied directly to the skin

A

Permethrin

37
Q

Severe dengue can include

A

severe bleeding

no treatment, only supportive care

38
Q

What is the Japanese encephalitis vaccine called

A

Ixiaro

39
Q

malaria is transmitted via

A

the Anopheles mosquito

40
Q

Which malaria species is the most common

A

P. vivax

41
Q

Which malaria species is the most deadly

A

P. falciparum

42
Q

which mosquito-borne illnesses require prophylaxis?

A

Malaria, yellow fever

43
Q

What is a common side effect of malaria drugs

A

Nausea - taking with sufficient water, food or milk decreases nausea

44
Q

What are the quick start medications for malaria ppx & how long in advance should they be started before travel

How many times a day are they taken

A

Atovaquone/Proguanil
Doxycycline ** (know this one)
Primaquine (avoid in G6PD Deficiency)

1-2 days
Once daily

daily regimens, avoid in pregnancy, all cause nausea

45
Q

Quick start drugs for malaria ppx must be avoided in which population(s)

A

pregnancy

46
Q

What are the advance start medications for malaria ppx & how long in advance do they need to be started?

How often are they taken

A

Chloroquine
Mefloquine
Tafenoquine (avoid in G6PD deficiency)

1-2 weeks prior to travel
once weekly

47
Q

T/F: Advance start medications for malaria ppx are safe in children & pregnancy

A

True

48
Q

Mefloquine should not be used in

A

Underlying psych conditions
Seizures
Arrhythmias

49
Q

When should chloroquine therapy be stopped for malaria ppx

A

4 weeks after travel

50
Q

Side effects of chloroquine

A

Retinal toxicity, visual changes

51
Q

What symptomatic treatments cannot be used for Yellow Fever

A

ASA and other NSAIDs d/t increased risk of bleeding

no specific treatment for acute infectoins except symptomatic relief

52
Q

What is the vaccine for Yellow Fever called

A

YF-VAX

53
Q

When is the Yellow Card valid

A

10 days after vaccination

54
Q

Yellow Fever vaccine is contraindicated with

A

hypersensitivity to eggs

(eggs are yellow)**

55
Q

transmission of Zika

A

mosquitos mostly
some sexual or blood transfusion transmission risk

56
Q

What is the biggest concern with Zika virus

A

infants born with microcephaly

57
Q

What is the primary ppx medication for Acute Mountain Sickness (AMS) & what is the brand name

When should it be used?

A

acetazolamide (Diamox)

Start the day before the day of descent

58
Q

What is the most common SE of acetazolamide

A

polyuri, also photosensitivty risk

59
Q

Acetazolamide is CI with

A

sulfa allergy

NAPLEX 2023 (88 decks)

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