General trop dis Flashcards
1
Q
Parasitic causes of moderate eosinophilia
A
Fasciola hepatica / gigantica Paragonimus westermani Clonorchis Opisthorchis Hookworm
2
Q
Features of chronic paragonimus
A
Chronic cough
Blood- streaked sputum
Unimpaired general condition
Marked eosinophilia
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
4
Q
Chagas organism
A
Trypanosoma cruzi
5
Q
Chagas vector
A
triatomine insect
6
Q
Typhoid relapse rate
A
5-10% relapse rate
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
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
9
Q
Plague organism
A
Yersinia pestis
10
Q
Rx plague
A
Streptomycin 10d
tetracyclin, chloramphen, gent, 3rd gen ceph, fluoroquin
11
Q
Pathognomonic signs of cutaneous anthrax
A
black eschar
malignant oedema
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
13
Q
Examples of BT/BW agents
A
anthrax botulism plague tularaemia haemorrhaged fever smallpox brucellosis
14
Q
Causes of haemoptysis
A
Tropical - TB - bronchiectasis -paragonimiasis - melioidosis - leptospirosis - hydatid disease - endemic mycosis General - Ca - Chronic bronchitis - CHF - blood disease
15
Q
Tropical pulmonary eosinophilia
A
- immunologic hyper responsiveness to microfilariae
- cough, wheeze, fever, LOW
- CXR diffuse interstitial miliary infiltrates
16
Q
Pleural effusion common causes
A
Tropical - TB - paragonimiasis - cryptococcosis - histoplasmosis - LCa Other - CHF - Ca - PE - cirrhosisw
17
Q
What is the most contagious virus known?
A
Measles
18
Q
Most common cause of preventable death in refugee/IDP populations
A
Measles
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
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
21
Q
Parasites of importance to consider before giving CCS Rx
A
strongyloides
entamoeba histolytica
ballantidium coli
22
Q
Commonest STD worldwide
A
HPV
23
Q
Commonest symptomatic STD worldwide
A
trichomonis
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)
25
Diseases transmitted by culex mosquitoes
Filiarisis
| Viral - JE, West Nile
26
Culex mosquito features
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
27
Anopheles mosquito features
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
28
Aedes moquito features
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
Diseases transmitted by Aedes aegypti
YF
Dengue
(filiarisis - other aedes)
30
RFs for aedes aegypti mosquitos
```
deficient basic sanitation
lack of drinking water
deficient conditions of water storage
migration from country to city
overcrowding
```
31
Sand flies (lutzomyia New World, Sergentomyia Old World) features
active at night
habitats semi desert, tropical rainforest, highlands
oviposition in humid places rich in plant debris
Peru - lutzomyia verrucarum
32
Vector of African Trypanosomiasis
Glossina palpalis (looks like house fly)
- long morsitans
- daylight hours
- one offspring every 10d, laid as mature larva
33
Cause of myasis
dermatobia hominis
34
Screw worm name
Cochliomyia homnivorax
35
Body lice - name and diseases for which vector
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
Diagnosis of toxocariasis
Clinical = fever + HMy + eosinophilia in a child
37
EPI vaccines
```
Measles
DPT (and TT adult)
Polio
BCG
Hep B
Hib
YF
```
38
Why isn't rubella among EPI in many parts of world?
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
Dehydration effect on thermoregulation
After 2% loss of mass, 0.4 degrees temp increase for each additional 1% mass lost
40
Heat stroke
T40-47
CNS dysftn, TC, inc RR, HoT
Residual brain damage 20%
41
Dehydration - 3 critical signs / 3 important signs
```
3 critical signs:
- thirst
- sensorium: irritable or comatose
- skin turgor: slow, very slow
3 important signs:
- sunken eyes
- dry MMs
- absent tears
```
42
Diarrhoea incidence per child in limited resource situations
3 episodes/child/yr
43
Summary of mgt of diarrhoea in children
```
Oral rehydration
Continue BF
Early feeding restoration
Zinc supplementation
Most cases viral
Consider ABx for dysentary & WD with fever and faecal leucs (>50)
```
44
Meliodosis organism
Burkholderia pseudomalli
45
Hypothermia cold and wet phases
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
Frostbite key features
- duration more important than temperature (can occur > 0 degrees)
- injury - reward, hyperemia, sequellae
47
Commonest cause of FUO worldwide
TB
48
Acute mononucleus-like syndrome + leukopenia
HIV
49
Causes of granulomatous amebic encephalitis (GAE)
Balamuthia mandrillaris
| Acanthamoeba spp
50
Pathogens from unpasteurized milk (EXAM)
Tick-borne encephalitis virus
Brucella
Listeria
TB
51
Modes of infection of tick-borne encephalitis virus (?exam)
```
Ixodes tick
Unpasteurized tick
BF
Blood donation
Lab accidents
```
52
Causes of biliary obstruction
* 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
Causes of intrahepatic cholestasis
```
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
Treatment for fish toxins
Heat (hot water)
55
Antivenoms exist for which marine animal injuries?
Stonefish and jellyfish stings
56
What treatment for vinegar?
vinegar
57
Management coral and sea urchins
first aid
58
Management of octopus and cone snail stings
Pressure immobilisation
59
Shellfish and ciguatera management
supportive
60
Scombroid treatment
antihistamines
61
Cardiac glycosides - source, management
Oleander (contain compounds similar to dig) - Rx ovine antibodies (digibind/digifab)
62
Cyanide toxicity plant source, Sx, Rx
Yuca, sassava, allamanda
Prevent by correct trimming / soaking
Sx tropical ataxic neuropathy, epidemic spastic paraparesis
Rx limited
63
Amanita phalloides - source, sx, Rx
Death cap mushroom
Heptarenal failure - 20-30% mortality
Rx benzylpen, N-acetyl cysteine, haemodialysis, liver Tx
64
Causes of intestinal perforation
Balantidium coli
Salmonella typhi
Entamoeba histolytica
TB
65
Parasitic causes of massive eosinophilia (>5000)
Toxocara
Trichinosis
Lymphatic filariasis - TPE
66
Other parasitic causes of eosinophilia
```
ascaris (migratory phase)
lymphatic filariasis
non-lymphatic filariasis
schisto
taenia - cysticercosis
echinococcus - cyst rupture
trichuris
aberrant animal helminths
angiostrongylus
gnathostoma
capillaria
trichostrongylus
```
67
Snakes
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
Spiders
1. Loxosceles species - violin-shaped marking, 6 eyes in 3 diads, eg L recluse
2. Lactrodectus (black widow) - neurotoxic
