Fever in the returned traveller

Question 1

what mosquito transmits malaria

Answer 1

anopheles

Question 2

What is the worse malaria type to get

Answer 2

plasmodium falciparum

Question 3

What symptoms occur with severe malaria

Answer 3

FEVER - cyclical or spiking 
Chills, sweats 
altered consciousness, seizures
ARDS 
circulatory collapse 
metabolic acidosis 
Renal failure 
Hepatic failure 
Coagulopathy, DIC 
Severe anaemia 
Hypoglycaemia

Question 4

What ix do you do for malaria

with what kind of stain

Answer 4

THREE thick and thin blood smears

with Field’s or Giemsa staian

Question 5

What. are the thick smears for

Answer 5

find parasites

Question 6

what are the thin smears for

Answer 6

identify species

quantify parasitaemia

Question 7

How do you treat non-falciparum malaria

Answer 7

chloroquine (3 days)

primaquine (14 days)

Question 8

what should you do before prescribing primaquine

Answer 8

screen for G6PD deficiency

as it can cause haemolysis

Question 9

what is treatment for mild falciparum malaria

Answer 9

Oral malarone

Artermisin combination therapy (ART)

Question 10

What is treatment for SEVERE falciparum malaria

Answer 10

IV ARTESUNATE

Question 11

What mosquito carries dengue

Answer 11

Aedes

Question 12

What are clinical fts of dengue

Answer 12

fever 
headache (retroorbital) 
myalgia 
erythrocdermic rash 
bleeding 
gepatitis

Question 13

What are ix for dengue

Answer 13

serology (IgM 5-7 days)

PCR

Question 14

What is tx for dengue

Answer 14

supportive

Question 15

What organisms cause typhoid

Answer 15

Salmonella typhi / paratyphi

Question 16

What are symtoms of typhoid

Answer 16

prolonged fever 
headache 
Rose spots (pink spotson abdo) 
constipation 
dry cough

Question 17

what are tx of typhoid

Answer 17

Ceftriaxone IV > then oral arythromycin

Question 18

What is fever like in brucellosis

Answer 18

UNDULANT - bad in evening, resolves in morning

Question 19

What kind of serology confirms brucellosis

Answer 19

SEROLOGY - anti-O polysaccharide antivody

Question 20

what does biopsy of nervous system reveal in rabies

Answer 20

Negri bodies

Question 21

What pathogen causes the PLAGUE

Answer 21

Yersinia pestis

Question 22

How is yersinia pestis transmitted

Answer 22

IN RATS, then spread by flees

Question 23

Where is yersinia pestis still present?

Answer 23

Some AMerican National Parks e.g. Yosemite

Question 24

What disease is caused by Yersinia Pestis

Answer 24

Bubonic plague - fleas bites humans

Causes swollen lymph nodes (Bubo) and dry gangrene

Question 25

How is leptospirosis transmitted

Answer 25

excreted in dog/rat urine

Pentrates broken skin / swimming in contaminated water

Question 26

What are. presentations of leptospirosis

Answer 26

high spiking temperature
Headache
Conjunctival haemorrhage, 
jaundice
malaise, myalgia

Question 27

What is cutaneous presentation of anthrax

Answer 27

painless round black lesion on back + rim of oedema

Question 28

What organs does anthrax affect

Answer 28

Skin

Pulmonary (woolsorter’s disease) - lymphadenopathy + mediastinal haemorrhage + pleural effusion + resp failure

Question 29

How is Leishmania transmitted

Answer 29

via sand flu

In south/central america + middle east

Question 30

How does cutaneous Leishmania develop

Answer 30

Skin ulcer at site of bite > multiplies ind ermal macrophages > heal after 1 year, leaving a pigmented scar
May be single/multiple painless nodules which grow and ulcerate

Question 31

What are the overall possible Leishmania types that can occur

Answer 31

Cutaneous
Mucocutaneous
Visceral

Question 32

who does visceral leishmania usually present in

Answer 32

young malnourished children