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Tropical disease > General trop dis > Flashcards

General trop dis Flashcards

1
Q

Parasitic causes of moderate eosinophilia

A 
Fasciola hepatica / gigantica
Paragonimus westermani
Clonorchis
Opisthorchis
Hookworm
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2
Q

Features of chronic paragonimus

A

Chronic cough
Blood- streaked sputum
Unimpaired general condition

Marked eosinophilia

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3
Q

ectoparasites features

A
  • live on or in host skin
  • feed on host blood / keratin
  • go thru entire life cycle or part of it in host
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4
Q

Chagas organism

A

Trypanosoma cruzi

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5
Q

Chagas vector

A

triatomine insect

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6
Q

Typhoid relapse rate

A

5-10% relapse rate

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7
Q

Probs with chloramphenicol in Rx typhoid

A

Does not prevent chronic carriage, transitory carrier state, or relapse rate
Haematologic SEs (anaemia, leukopenia, BM aplasia)
some resistance

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8
Q

Benefits of quinolones in typhoid

A 
Decrease chronic carriage (decrease GB Ca)
Decrease spread
Decrease relapse
Decrease time of Rx
Few SEs, good tolerance
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9
Q

Plague organism

A

Yersinia pestis

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10
Q

Rx plague

A

Streptomycin 10d

tetracyclin, chloramphen, gent, 3rd gen ceph, fluoroquin

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11
Q

Pathognomonic signs of cutaneous anthrax

A

black eschar

malignant oedema

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12
Q

Definition of biological warfare (BW) or biological terrorism (BT)

A

intentional use/attempted of viruses, bacteria, fungi or toxins derived from live orgs to cause death/disease among humans, animals or plants

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13
Q

Examples of BT/BW agents

A 
anthrax
botulism
plague
tularaemia
haemorrhaged fever
smallpox
brucellosis
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14
Q

Causes of haemoptysis

A 
Tropical
- TB
- bronchiectasis
-paragonimiasis
- melioidosis
- leptospirosis
- hydatid disease
- endemic mycosis
General
- Ca
- Chronic bronchitis
- CHF
- blood disease
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15
Q

Tropical pulmonary eosinophilia

A
  • immunologic hyper responsiveness to microfilariae
  • cough, wheeze, fever, LOW
  • CXR diffuse interstitial miliary infiltrates
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16
Q

Pleural effusion common causes

A 
Tropical
- TB
- paragonimiasis
- cryptococcosis 
- histoplasmosis 
- LCa
Other
- CHF
- Ca
- PE
- cirrhosisw
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17
Q

What is the most contagious virus known?

A

Measles

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18
Q

Most common cause of preventable death in refugee/IDP populations

A

Measles

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19
Q

Factors to consider when considering empiric diarrhoea Rx

A 
Clinical syndrome
Most likely etiological agents
Age of pt
Seasonality
Location
Local susceptibility data
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20
Q

Characteristics of an insect vector

A

Anthropophilic (feed on human blood)
Coincides in time and place with infected reservoirs and humans
Found naturally infected with given pathogen
Supports life cycle of pathogen w/i its organism
Carries out transmission event

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21
Q

Parasites of importance to consider before giving CCS Rx

A

strongyloides
entamoeba histolytica
ballantidium coli

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22
Q

Commonest STD worldwide

A

HPV

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23
Q

Commonest symptomatic STD worldwide

A

trichomonis

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24
Q

The two medically important clinical syndromes resulting from spider bites

A

Loxoscelism / Necrotizing arachnoidism (esp by loxosceles spp)
Latrodectism / Neurotoxic arachnidism (esp by lactrodectus spp)

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25
Q

Diseases transmitted by culex mosquitoes

A

Filiarisis

Viral - JE, West Nile

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26
Q

Culex mosquito features

A

Larvae - lie oblique to water surface to get air
- long siphon
Adult - short palps F, wings with uniform scales, rests with body & wings parallel to surface
- diverse larval habitats / polluted water
- active thru night

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27
Q

Anopheles mosquito features

A

Larvae - attached horizontal to water surface
Adult - palps as long as probiscus, spotted wings with dark/pale bands, rests perpendicular to surface
- oviposite in unpolluted water
- malaria vectors
- active sunset-sunrise

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28
Q

Aedes moquito features

A

Larvae - short siphon, otherwise like culex;
Adults - short palps F, wings uniform scales, rest parallel to surface
- active during day (esp morning/evening)
A aegypti - single eggs above waterline on artificial container
A albopticus - natural water containers, tree holes, ground pools etc

29
Q

Diseases transmitted by Aedes aegypti

A

YF
Dengue
(filiarisis - other aedes)

30
Q

RFs for aedes aegypti mosquitos

A 
deficient basic sanitation
lack of drinking water
deficient conditions of water storage
migration from country to city
overcrowding
31
Q

Sand flies (lutzomyia New World, Sergentomyia Old World) features

A

active at night
habitats semi desert, tropical rainforest, highlands
oviposition in humid places rich in plant debris
Peru - lutzomyia verrucarum

32
Q

Vector of African Trypanosomiasis

A

Glossina palpalis (looks like house fly)

  • long morsitans
  • daylight hours
  • one offspring every 10d, laid as mature larva
33
Q

Cause of myasis

A

dermatobia hominis

34
Q

Screw worm name

A

Cochliomyia homnivorax

35
Q

Body lice - name and diseases for which vector

A

Pediculus humanus var corporis
Vectors of typhus (rickettsia prowazeki), trench fever (bartonella quintana), relapsing fever (borrelia recurrentis)
- entire life cycle occurs in close contact with human body

36
Q

Diagnosis of toxocariasis

A

Clinical = fever + HMy + eosinophilia in a child

37
Q

EPI vaccines

A 
Measles
DPT (and TT adult)
Polio
BCG
Hep B
Hib
YF
38
Q

Why isn’t rubella among EPI in many parts of world?

A

In areas with sustained vax coverage <90-95%, addition of rubella vax would cause paradoxical increase in congenital rubella synd.Vax introduction causes increased inter-epidemic period.

39
Q

Dehydration effect on thermoregulation

A

After 2% loss of mass, 0.4 degrees temp increase for each additional 1% mass lost

40
Q

Heat stroke

A

T40-47
CNS dysftn, TC, inc RR, HoT
Residual brain damage 20%

41
Q

Dehydration - 3 critical signs / 3 important signs

A 
3 critical signs:
- thirst
- sensorium: irritable or comatose
- skin turgor: slow, very slow
3 important signs:
- sunken eyes
- dry MMs
- absent tears
42
Q

Diarrhoea incidence per child in limited resource situations

A

3 episodes/child/yr

43
Q

Summary of mgt of diarrhoea in children

A 
Oral rehydration
Continue BF
Early feeding restoration
Zinc supplementation
Most cases viral
Consider ABx for dysentary & WD with fever and faecal leucs (>50)
44
Q

Meliodosis organism

A

Burkholderia pseudomalli

45
Q

Hypothermia cold and wet phases

A
  1. Cold shock (gasp, vasoconstr, TC, asystole)
  2. Rapid cooling of periphery (decreased coordination, strength)
  3. Cooling of core (mental status changes)
    - cannot maintain core temp with muscle activity <25 degrees C
46
Q

Frostbite key features

A
  • duration more important than temperature (can occur > 0 degrees)
  • injury - reward, hyperemia, sequellae
47
Q

Commonest cause of FUO worldwide

A

TB

48
Q

Acute mononucleus-like syndrome + leukopenia

A

HIV

49
Q

Causes of granulomatous amebic encephalitis (GAE)

A

Balamuthia mandrillaris

Acanthamoeba spp

50
Q

Pathogens from unpasteurized milk (EXAM)

A

Tick-borne encephalitis virus
Brucella
Listeria
TB

51
Q

Modes of infection of tick-borne encephalitis virus (?exam)

A 
Ixodes tick
Unpasteurized tick
BF
Blood donation
Lab accidents
52
Q

Causes of biliary obstruction

A
  • rare parasitic disease presentation:
    Nematodes - ascaris
    Trematodes - clonorchis sinensis, opistorchis viverrini, O felinieus, fasciola hepatica
    Cestodes - E granulsosus (v rare)
    Protozoans - cryptosporidium in AIDS
  • cholangiocarcinoma with Asian trematodes
    ,
53
Q

Causes of intrahepatic cholestasis

A 
Rare in bact disease, mostly bacterial:
- lepto**
- brucellosis
- typhoid
- TB (miliary dissemination)
- pyogenic abscess
- amoebic abscess (v rare)
Cholestatic presentation HAV (CMV, EBV)
Drugs - chlorpomazine, others
54
Q

Treatment for fish toxins

A

Heat (hot water)

55
Q

Antivenoms exist for which marine animal injuries?

A

Stonefish and jellyfish stings

56
Q

What treatment for vinegar?

A

vinegar

57
Q

Management coral and sea urchins

A

first aid

58
Q

Management of octopus and cone snail stings

A

Pressure immobilisation

59
Q

Shellfish and ciguatera management

A

supportive

60
Q

Scombroid treatment

A

antihistamines

61
Q

Cardiac glycosides - source, management

A

Oleander (contain compounds similar to dig) - Rx ovine antibodies (digibind/digifab)

62
Q

Cyanide toxicity plant source, Sx, Rx

A

Yuca, sassava, allamanda
Prevent by correct trimming / soaking
Sx tropical ataxic neuropathy, epidemic spastic paraparesis
Rx limited

63
Q

Amanita phalloides - source, sx, Rx

A

Death cap mushroom
Heptarenal failure - 20-30% mortality
Rx benzylpen, N-acetyl cysteine, haemodialysis, liver Tx

64
Q

Causes of intestinal perforation

A

Balantidium coli
Salmonella typhi
Entamoeba histolytica
TB

65
Q

Parasitic causes of massive eosinophilia (>5000)

A

Toxocara
Trichinosis
Lymphatic filariasis - TPE

66
Q

Other parasitic causes of eosinophilia

A 
ascaris (migratory phase)
lymphatic filariasis
non-lymphatic filariasis
schisto
taenia - cysticercosis
echinococcus - cyst rupture
trichuris
aberrant animal helminths
angiostrongylus
gnathostoma
capillaria
trichostrongylus
67
Q

Snakes

A
  1. Vipers
    a) Bothrops - proteolytic + thrombin-like (oedema + bleeding); coast/Andes/jungle
    b) Lachesis - same; Amazon
    (aka mutamuta / shushupe /bushmaster)
    c) Crotalus - neurotoxic + myonecrotic (dark urine, nephrotoxic); Puno
  2. Elapidae
    a) Microcurus (coral snakes) - neurotoxin
    b) Ophiophagus (cobra)
68
Q

Spiders

A
  1. Loxosceles species - violin-shaped marking, 6 eyes in 3 diads, eg L recluse
  2. Lactrodectus (black widow) - neurotoxic

Tropical disease (24 decks)

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