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A - NAPLEX > Chapter 21: Travelers > Flashcards

Chapter 21: Travelers Flashcards

1
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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2
Q

Which drugs can be used for TARDIVE DYSKINESIA (TD) prevention

A

Bismuth subsalicylate

Antibiotics if indicated

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3
Q

Bismuth subsalicylate should be avoided in which patients

A 
Aspirin allergy

Pregnancy

renal insufficiency 

gout

anyone taking anticoagulants
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4
Q

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

A

Rifaximin

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5
Q

Which drugs can be used for mild TD treatment

A

loperamide or BSS

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6
Q

How does loperamide work

A

Decreases the frequency and urgency of bowel movements

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7
Q

Loperamide dose for Rx and OTC

A

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

OTC: 8 mg/day

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8
Q

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

A

2 days

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9
Q

Which drugs can be used for moderate TD treatment

A

Loperamide +/- antibiotics

(quinolones if low resistance)

azithromycin or rifaximin

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10
Q

Which drugs can be used for severe TRAVELERS DIARRHEA (TD) treatment (including dysentery)

A

antibiotics

azithromycin preferred

quinolones

or

rifaximin as alternatives +/- loperamide

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11
Q

What is the BSS dose for TD ppx

A

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

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12
Q

Which bacterium causes Typhoid Fever

A

Salmonella typhi

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13
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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14
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 - vivotif is the only one with an O in its name for oral

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15
Q

When should the oral typhoid vaccine be completed

A

> /= 1 week prior to travel

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16
Q

When should the IM typhoid vaccine be completed

A

> /= 2 weeks before the expected exposure

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17
Q

Which bacterium causes Cholera

A

Vibrio cholerae

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18
Q

What is the most common symptom of cholera

A

watery diarrhea

which is referred to as “rice-water stools”

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19
Q

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

A

Vaxchora

oral solution

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20
Q

The CDC recommends how many booster doses for poliovirus vaccine at least 4 weeks 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

21
Q

Where should vaccination of Poliovirus be documented

A

On an International Certificate of Vaccination or Prophylaxis (ICVP), which also records Yellow Fever vaccine

22
Q

How long does the Hep B vaccine series take to complete

A

3-dose series takes 6 months to complete

23
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

24
Q

What are the symptoms of meningococcal meningitis

A

Fever

severe and unrelenting HA

nausea

stiff neck (nuchal rigidity)

mental status change - all require urgent treatment

25
Q

Which meningococcal vaccines are quadrivalent

A

Menactra
Menveo

26
Q

Which diseases can mosquitos transmit to travelers

A

Japanese encephalitis
yellow fever
dengue
malaria
zika virus

27
Q

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

A

DEET

28
Q

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

A

Permethrin

29
Q

Severe dengue can include

A

severe bleeding

30
Q

What is the Japanese encephalitis vaccine called

A

Ixiaro

31
Q

Which malaria species is the most common

A

P. vivax

32
Q

Which malaria species is the most deadly

A

P. falciparum

33
Q

What is a common side effect of malaria drugs

A

Nausea - taking with sufficient water

food or milk decreases nausea

34
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

35
Q

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

A

pregnancy

36
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

37
Q

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

A

True

38
Q

Mefloquine should not be used in

A

Underlying psych conditions

Seizures

Arrhythmias

39
Q

When should chloroquine therapy be stopped for malaria ppx

A

4 weeks after travel

40
Q

Side effects of chloroquine

A

Retinal toxicity

visual changes

41
Q

What symptomatic treatments cannot be used for Yellow Fever

A

ASA and other NSAIDs d/t increased risk of bleeding

42
Q

What is the vaccine for Yellow Fever called

A

YF-VAX

43
Q

When is the Yellow Card valid

A

if the vaccination is completed at least 10 days before arrival

44
Q

Yellow Fever vaccine is contraindicated with

A

hypersensitivity to eggs

(eggs are yellow)**

45
Q

What is the biggest concern with Zika virus

A

infants born with

microcephaly(A condition that causes a baby’s head to be small and not fully developed)

46
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

47
Q

What is the most common SE of acetazolamide

A

polyuria

48
Q

Acetazolamide is CI with

A

sulfa allergy

A - NAPLEX (83 decks)

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