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Infection > Infection 8 Travel Related Infections + Neglected Tropical Diseases > Flashcards

Infection 8 Travel Related Infections + Neglected Tropical Diseases Flashcards

1
Q

Why are neglected tropical diseases classified as neglected?

A

Almost absent from global health agenda
Little funding
Associated stigma + social exclusion

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2
Q

What questions need to be asked when a travel related infection is suspected?

A

Where have they been?
When were they there? Incubation time
Symptoms
Any idea on how they got the infection
Vaccinated?
Others in group unwell?

Potential diseases in that area

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3
Q

What are the five species of malaria which affect humans?

A

Plasmodium falciparum
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae
Plasmodium knowlesi

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4
Q

What is the most severe species of malaria?

A

Plasmodium falciparum

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5
Q

What is the vector for malaria?

A

Female Anopheles mosquito

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6
Q

Incubation period of malaria

A

Minimum 6 days

Plasmodium falciparum can be 4 weeks
Plasmodium vivax/ovale can be 1 year

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7
Q

What can the incubation period of plasmodium falciparum be?

A

4 weeks

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8
Q

What can the incubation period of plasmodium vivax/ovale be?

A

Up to 1 year

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9
Q

What type of organism is plasmodium?

A

Protozoa

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10
Q

Investigation needed for suspected malaria

A

Blood film x3 - thick + thin smears
Blood tests - FBC, U+E, LFT
CXR - chest x ray
Head CT

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11
Q

Management of malaria

A

Removal of vector - bed nets, sanitation
Drugs - artesunate, quinine (IV/PO), doxycycline, primaquine (liver related malaria)

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12
Q

Drugs used to treat malaria

A

Artesunate IV or IM
Along side - Quinine
- Doxycycline

Primaquine - liver related malaria*

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13
Q

What drug should be given for liver related malaria?

A

Primaquine

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14
Q

What drug shouldn’t be used for malaria from plasmodium falciparum?
Why?

A

Chloroquine
Widespread resistance

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15
Q

Who should you not give primaquine to?

A

G6PD patients

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16
Q

What is the most common species of plasmodium causing malaria?

A

Plasmodium falciparum

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17
Q

Presentation of malaria

A

High heart rate
Low BP
O2 sats 90%
Mild confusion
Bite/puncture mark
Hepatosplenomegaly
Vomiting + nausea
Fever
Headache
Fatigue
Sweating + chills
Dry cough

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18
Q

Describe the life cycle of plasmodium falciparum

A

1- female anopheles mosquito bites human
2- injects sporozoites
3- sporozoites infect hepatocytes
4- sporozoites mature to merozoites
5- merozoites burst out of cell + infect bloodstream
6- merozoites attack erythrocytes
7- plasmodium asexually replicate and mature in RBCs
8- merozoites burst out of erthyrocytes (schizont)
9- process repeats

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19
Q

What is a schizont?

A

Name of erythrocyte when merozoites are ready to burst out of them

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20
Q

Name of erythrocyte when merozoites are ready to burst out of them

A

Schizont

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21
Q

What is incubation time?

A

Time from when a person becomes infected until they start to see the onset of symptoms

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22
Q

What causes a fever?

A

Cytokine release
Pyrogens

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23
Q

What are paroxysm fever?

A

Fevers that occur in short bursts

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24
Q

How does malaria cause symptoms of haemolytic anaemia?
What is the exception?

A

Destruction of erthyrocytes

Plasmodium falciparum doesnt

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25
Q

Symptoms of haemolytic anaemia

A

Pallor
Jaundice
Dark coloured urine
Weakness
Dizziness confusion

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26
Q

What is icterus?

A

Yellow eye - jaundice

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27
Q

Prevention of malaria

A

Insecticide spray
Clothing that covers whole body
Mosquito nets
Avoid still lakes
Chemoprophylaxis

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28
Q

Why should you avoid still lakes to prevent malaria?

A

Anopheles mosquitos lay eyes in stagnant water

29
Q

What are the categories for recurrent malaria?

A
  • Recrudescence - parasite not killed
  • Relapse- cleared merozoites, dormant hypnotises in liver are no longer dormant
  • Reinfection - cured but new case
30
Q

Blood test result of malaria

A

Low WBC, platelets + Hb
High urea, bilirubin, CRP

31
Q

Why does malaria cause by plasmodium falciparum not cause haemolytic anaemia?

A

1- P. falciparum creates sticky protein
2- protein coats surface of RBCs
3- RBCs clump together + occlude blood vessels
4- organ ischaemia

32
Q

What is Legionellosis?

A

Collection of conditions caused by Legionella bacteria

33
Q

What is the gram stain of Legionella bacteria?

A

Gram negative

34
Q

Most likely place of infection for Legionnaire’s disease
Examples

A

Where the water is at a temperature high enough to help bacteria grow
e.g. poorly maintained shower system, AC unit

35
Q

Mode of transmission of Legionella bacteria

A

Inhalation of droplets of water

36
Q

Incubation of legionnaire’s diease

A

2-10 days

37
Q

Initial signs and symptoms of Legionnaire’s disease

A

Headache
Muscle/chest pain
Chills
Fever >40°

38
Q

Progressive signs and symptoms of Legionnaire’s disease

A

Cough
Shortness of breath
Nausea
Vomiting
Diarrhoea
Confusion

39
Q

Treatment of Legionnaire’s disease

A

Antibiotics
clarithromyin

40
Q

What is the microorganism that causes Legionnaire’s disease?

A

Legionella pneumophilia

41
Q

What other condition does Legionnaire’s disease commonly present similar signs and symptoms to?

A

Pneumonia

42
Q

What is the characteristic image in malaria blood film?

A

Headphone/wedding ring

43
Q

Where do plasmodium species remain dormant within the human body?

A

Liver

44
Q

What is schistosomiasis?

A

Genus of flatworm

45
Q

Transmission of schistosomiasis

A

Through unprotected skin contact in areas of fresh water contaminated with helminths released from snails

46
Q

What type of microorganisms is helminths?

A

Parasite

47
Q

Symptoms of acute schistosomiasis

A

Fever
Diarrhoea
Coughs
Rashes
Abnominal pain
Muscle + joint pain

48
Q

Result of chronic inflammation associated with schistosomiasis

A

Damage due to host’s immune response

  • anaemia
  • cystitis
  • CVS + respiratory issues
  • neurological - seizures, dizziness
49
Q

Diagnosis of schistosomiasis

A

Confirmed by finding eggs in urine or stool sample
Blood test for antibiotics

50
Q

Treatment of acute schistosomiasis

A

Steroids - reduces inflammation

51
Q

Treatment of schistosomiasis

A

praziquantel

52
Q

What is praziquantel used for and when is it most effective (what does this mean)?

A
  • To treat schistosomiasis
  • Most effective once worms have matured
  • Patients often aren’t given treatment until a number of weeks post infection
53
Q

What is another name for typhoid fever?

A

Enteric fever

54
Q

Cause of typhoid fever

A

Salmonella typhi

55
Q

What type of microorganism is Salmonella typhi?

A

Bacteria
Rod shaped
Gram negative

56
Q

Gram stain of Salmonella typhi

A

Rod shaped gram negative

57
Q

Presentation of typhoid fever

A

Fever
Abdominal pain
Constipation

If left untreated:
Delirium
GI haemorrhage
Bowel perforation

58
Q

Where is typhoid fever most common?

A

Where there is poor sanitation and limited access to clean water

59
Q

Who are more susceptible to typhoid fever and why?

A

Children
Immune systems are still developing

60
Q

Treatment of mild typhoid fever

A

IV Ceftriaxone
Cephalosporin
Azithromycin
Macrolide

At home

61
Q

Treatment of serious typhoid fever

A

Infections of antibiotics in hospital

62
Q

Vaccinations of typhoid fever

A

1 injections or 3 tablets

63
Q

What is dengue fever cause by?

A

Dengue virus

64
Q

Transmission of dengue virus

A

Mosquitoes

65
Q

Presentation of dengue

A

Mild or asymptomatic
Intense headache
Fever
Widespread red rash
Muscle/joint pain

66
Q

Treatment of dengue

A

No specific treatments
Normally resolves itself within a few days
Supportive treatments - paracetamol
- take plenty of fluids

67
Q

Treatment of severe dengue

A

No treatment
Intensive care required - IV fluids
- O2 if needed
- blood transfusion
- platelet transfusion

68
Q

Symptoms of severe dengue

A

Restlessness
Acute fever
Severe abdominal pain
Petechiae - due to low platelets
Nosebleeds
Large decrease in BP - shock

69
Q

Why would aspirin and NSAIDs make dengue worse?

A

COX enzymes are blocked
Needed to help with clotting

Infection (16 decks)

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