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SBOMS > Global health, tropical and travel medicine. > Flashcards

Global health, tropical and travel medicine. Flashcards

1
Q

Place with the highest 1 week risk of travellers diarrhoea?

A

India - 54%

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2
Q

Key things to assess when your patient is travelling abroad?

A

When are they going. - how long for vaccinations, is it rainy season?

Where are they going.

What are they doing. - Healthcare? Aid agency? Duration? Access to healthcare?

Past Medical history. Drug interactions, safe to travel?

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3
Q

ABCD of malaria advice?

A

A - Awareness of Risk: Fever for up to 6 months after returning could be malaria.

B - Bite avoidance: DEET, Nets, Dusk till dawn, long sleeved clothing.

C - Chemoprophylaxis - Duration pre, post and during, S/Es and cost

D - Diagnose early

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4
Q

Malaria prophylaxis choices?

A

Malarone (Atovaquone + Proguanil)

  • 1 tablet a day, good S/E profile
  • 1 day before, 1 week afterwards

Doxycycline

  • 1 Tablet a day
  • 20% risk of photosensitivity
  • 1 week before 4 weeks after return. (cheap)

Mefloquine

  • 1 tablet a week
  • Neuropsychiatric S/Es
  • 3 weeks before 4 weeks when returning (cheap)
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5
Q

Legally required vaccine for Saudi Arabia?

A

Meningococcal vaccine

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6
Q

What are the most common types of illness following travel?

A

GI illness - 34%
Systemic febrile illness - 23.3%
Dermatological - 19.5%

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7
Q

Where are systemic febrile illnesses most likely caused from?

A

Sub-saharan africa

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8
Q

Where is acute diarrhoea most likely caused from?

A

SC asia

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9
Q

Pathogenesis of Giardia bacteria?

A

Causes inflammatory process by attaching to enterocytes in the jejunum - acute diarrhoea

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10
Q

Most common bacterial causes of acute diarrhoea?

A

Campylobacter

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11
Q

Whats more common parasitic/viral/bacterial infection causing diarrhoea?

A

Parasitic more common presentation.

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12
Q

Most likely cause of fever presentation?

A

Malaria

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13
Q

Difference in Vivax and falciparum malaria?

A

Falciparum a bit worse generally

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14
Q

What is cutanea larva migrans? Where is it most likely caught from?

A

Infection from hookworms from cats/dogs. Won’t get further than skin as man is not desired host. Most likely caught from Caribbean - C. America

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15
Q

Risks for travellers who are visiting friends and family?

A

Unlikely to seek pre-travel advice and so more likely to acquire a vaccine preventable illness

62% of falciparum occurred amongst travellers visiting friends and relatives

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16
Q

Which group of Travellers get respiratory illness commonlly

A

Business travellers

17
Q

Which group of travellers are most likely to become ill abroad?

A

Tourists.

18
Q

Investigations you should do for returning unwell travellers?

A 
Blood culture.
Malaria blood test.
HIV test
Urine/stool culture
throat swab

Standard: FBC, U+Es, CRP, LFTs, CXR

19
Q

Most common cause of parasitic diarrhoea?

A

Giardia

20
Q

Clinical features of falciparum malaria?

A

Fevers, rigors, vomiting, headache, arthralgia, malaise (cough, diarrhoea)

Fevers are usually daily or continuous

Commonly presents within 4 weeks of return from endemic area but can be delayed for much longer

21
Q

What species of mosquito cause malaria

A

Female anopheles mosquitos

22
Q

Serious complications of malaria?

A

AKI
Cerebal Malaria
Pulmonary oedema
Alkolosis/acidosis

23
Q

Types of malaria testing?

A

Blood film - look for it

Antigen testing

24
Q

Treatment of falciparum malaria?

A

Non severe:

PO (oral): Malarone
PO: Co-artem

Severe:

IV artesunate

25
Q

Where are you most likely to see flaciparum and where are you most likely to see vivax?

A

Falciparum - sub saharan Africa

Vivax South and South east asia

26
Q

Vivax malaria diagnosis?

A

Blood film only (antigen not sensitive) need several

27
Q

Vivax malaria treatment?

A

PO Chloroquinine

Followed by primaquine to eliminate liver (hypnozoite) stage

28
Q

Pattern of Fever in vivax malaria?

A

Every 3 days there is a peak of fever

29
Q

How many cases of imported malaria were reported in 2015?

A

1500

30
Q

What proportion of falciparum and vivax caused imported malaria?

A

Falciparum - 75%

Vivax - 15%

31
Q

Ebola infection management?

A

IV zmapp - monoclonal antibodies

Blood transfusion

32
Q

LFTs in ebola infection?

A

Derranged

33
Q

Clinical presenting signs and symptoms of ebola?

A 
Fever
Headache
Weakness
Dizziness
Diarrhoea
Abdo pain
etc...
34
Q

What is MERS

A

Middle eastern respiratory syndrome

Caused by a virus

> 85% in saudi arabia

35
Q

Treatment of MERS?

A

Oseltamivir

Extracorporeal membrane oxygenation

36
Q

Treatment of Avian flu?

A

Oseltamivir

37
Q

Maximum incubation period for MERS?

A

14 days

SBOMS (18 decks)

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