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CSP Week 1 > Fever in the returning traveller > Flashcards

Fever in the returning traveller Flashcards

1
Q

General approach

A 
Travel history
Risk assess for highly infectious/life-threatening
Clinical exam
Danger signs
Malaria film
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2
Q

Risk assessment

A 
A
B
C
Screen for sepsis
Prevent transmissible infection
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3
Q

Risk of transmission

A 
Resp Symptoms
Vom + Diarr
Rash/skin infection/wound
Hospitalisation overseas
Haemorrhage
VHF risk
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4
Q

Sub-Saharan Africa

A 
Malaria
Dengue/Chikungunya
Rickettsiae
Enteric Fever (typhoid)
Acute schistosomiasis
Amoebic liver abscess
Meningococcus
Brucellosis
HIV
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5
Q

Sub Saharan Africa main

A 
Malaria
Dengue
Rickettsiae
Typhoid 
HIV
VHF (lassa, ebola)
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6
Q

Viral haemorrhagic fever risk

A

Consider if- fever AND travel to endemic area <21days

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7
Q

VHF initial management

A 
Malaria film, clotted blood, EDTA blood
Isolation
Discuss with infectious diseases
Virologist
VHF PCR
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8
Q

South + central asia

A 
Dengue
Enteric fever
malaria
chikungunya
TB
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9
Q

South east asia

A 
Dengue 
enteric fever
chikungunya
malaria
leptospirosis
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10
Q

Latin America + caribbean

A

Dengue/chik/zika
enteric fever
malaria

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11
Q

Tick typhus

A

Bite

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12
Q

Trypanosomiasis

A

Painful bite

Chancre

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13
Q

Anthrax

A

Necrotic ulcer

Oedema

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14
Q

Acute schistosomiasis

A

fresh/brackish water
2-12 weeks post exposure
Swimmer’s itch
eosinophilia

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15
Q

Leptospirosis

A 
Swimming/rafting in fresh water
<4wks exposure
Jaundice
conjunctival suffusion
liver/renal impairment
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16
Q

Caves

A

Histoplasmosis
Rabies
Ebola

17
Q

Animal contact/bites

A

Rabies
Brucella
Q fever
VHF

18
Q

Unprotected sex

A 
HIV
Syphilis
Viral hepatitis
Gonococcaemia
STi
19
Q

FBC- Lymphopenia

A

Viral
Dengue
Typhoid
HIV

20
Q

FBC- Low-normal WCC

A

Malaria
Viral
Typhoid
Rickettsial

21
Q

FBC- neutrophilia

A

Bacterial

Amoebic

22
Q

FBC- thrombocytopenia

A

Malaria
Dengue
Typhoid
Sepsis

23
Q

FBC- eosinophilia

A 
Schisto
Fasciola
Filaria
Strongyloides
Allergy/drug reaction
24
Q

Malaria diagnosis

A

Thick and thin blood film

Rapid diagnostic tests detect Plasmodium spp. antigens

25
Q

Malaria + fluid

A

Cautious fluid resuscitation

1-2ml/kg/hr

26
Q

Malaria treatment

A

IV artesunate
IV quinine
Oral therapy
check blood film daily

27
Q

Malaria treatment- uncomplicated P falciparum

A

Malarone
Riamet
Quinine
+ oral therapy

28
Q

Malaria treatment- non falciparum

A

Chloroquine followed by primaquine

Check G6PD status

29
Q

Arbovirus infection

A

Febrile illness, haemorrhagic fever, encephalitis

30
Q

Dengue

A

3-14 incubation period
Aedes spp. mosquitos
Headache, myalgia, arthralgia, rash (initially erthyrodermic, then petechial)

31
Q

Dengue treatment

A

Simple analgesia- avoid NSAIDs

Fluid balance

32
Q

Chikungunya

A

Incubation 1-12
Fever + severe arthralgia
PCR or IgM diagnosis
Symptomatic relief, steroids

33
Q

Typhoid or Paratyphoid

A

Salmonella Typhi or Paratyphi
Fever +++
GI bleeding, intestinal perforation + encephalopathy

CSP Week 1 (2 decks)

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