Clinical Knowledge

Question 1

Name the types of heat illness

Answer 1

Sunburn
Prickly Heat
Heat Stress
Heatstroke

Question 2

Name some preventative measures for heat illness

Answer 2

Acclimatisation
Monitoring of water intake
Appropriate clothing
Salt intake

Question 3

Name the types of cold injury

Answer 3

Frost nip
Frostbite
Immersion foot
Hypothermia

Question 4

Name some preventative measures for cold injury

Answer 4

Appropriate clothing
Diet
Fluid intake
Fitness

Question 5

Name the different types of venomous snakes and their respective venoms

Answer 5

Elapidae - neurotoxic
Viperidae - haemotoxic and proteolytic
Colubridae - haemotoxic

Question 6

How would you treat a snake bite?

Answer 6

Check person has been bitten
Reassure 
Try to retard systemic absorption of venom
No food – especially alcohol
Do NOT interfere with bite wound or apply tourniquet
Treat symptoms as they arise
Analgesia (not aspirin or NSAIDs) 
Move patient to medical care
Try to identify the snake

Question 7

Name some other poisonous organisms

Answer 7

Arthropods (spiders, scorpions, centipedes, bees, wasps)
Aquatic animals (fish, jellyfish, octopi, algae)
Plants (nettles, poison ivy, algae, mushrooms, Cassava)

Question 8

General principles for treating envenomation

Answer 8

Antivenins
Treatment for jellyfish stings (Hot water, Vinegar)
Anti histamines
Allergic reactions – adrenaline
Inappropriate/outmoded treatments

Question 9

How would you best prepare against potential envenomation?

Answer 9

What dangerous animals and plants are present locally?
Location of treatment centres
Local availability of antivenins

Question 10

How would you classify helminth infections?

Answer 10

Cestodes (tapeworms), Nematodes (roundworms), and Trematodes (flukes)

Question 11

Give an example of a Cestode

Answer 11

Taenia solium, Taenia saginata, Echinococcus

Question 12

What is trypanosomiasis caused by?

Answer 12

Trypanosoma brucei

Question 13

What are the subspecies of T. brucei?

Answer 13

T. brucei gambiense - slow onset, West and Central Africa, human reservoir
T. brucei rhodesiense - fast onset, game and livestock reservoir, Southern and Eastern Africa

Question 14

Name some signs and symptoms of Trypanosomiasis

Answer 14

Red Chancre sore
Fever, lymphadenopathy, arthralgia, headache
2nd phase: personality changes, alteration of the biological clock, slurred speech

Question 15

How do you treat Trypanosomiasis?

Answer 15

Phase 1: Pentamidine or suramin

Phase 2: Melarsoprol or elfornithine

Question 16

What is the structure of T. brucei?

Answer 16

A parasitic kinetoplastid belonging to the genus Trypanosoma

Question 17

Management of acute outbreak of diarrhoea

Answer 17

1. Is this the beginning of an outbreak
2. Is the patient suffering from Cholera or Shigella?
3. Inform and ask for help
4. Protect the community
5. Treat the patients

Question 18

Key points regarding community protection

Answer 18

Isolate severe cases
Provide information on the outbreak
Disinfect water sources
Promote water disinfection at home
Avoid gatherings

Question 19

Precautions for funerals

Answer 19

Disinfect corpses with 2% chlorine solution
Fill mouth and anus with cotton wool soaked with chlorine solution
Wash hands with soap
Disinfect clothing and bedding

Question 20

How do you treat Shigella?

Answer 20

500mg ciprofloxacin BD for 3 days

Question 21

How do you treat Cholera?

Answer 21

300mg single dose doxycycline

Question 22

Pathogenesis of Shigella infection

Answer 22

Shigella species enter the basolateral side of M cells in the small intestine. They use a type-III secretion system to translocate toxic effector proteins into the target cells, thus halting protein synthesis.

Question 23

Signs and symptoms of cyanide poisoning?

Answer 23

Headache
Seizures
Tachycardia
Tachypnoea
Cardiac arrest