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Inori Pre Reg > Infection Malaria > Flashcards

Infection Malaria Flashcards

1
Q

Who should avoid travelling to malaria area?

A

Asplenic

Preganant

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2
Q

Other than antimalarial, what other prevention methods are they?

A

Nets impregnated with permethrin is most effective

DEET 20-50% spray or lotion
50% provides the longest protection

Long sleeves and trousers after dusk

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3
Q

Who can use DEET spray?

A

On adults and children above 2 months

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4
Q

Advice on how to apply DEET?

A

Apply sunscree first and use at least SPF 30-50

As DEET reduces the SPF

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5
Q

Dose and treatment duration of doxycycline for malaria prophylaxis?

A

100mg OD

Take 1-2 days before entering pandemic area and continued for 4wks after leaving

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6
Q

Pt counselling in doxycycline?

A

Protect skin from sunlight - even on a bright but cloudy day
Do not use sunveds

Do not take indigestion remedies, or meds containing iron or zinc, 2hrs before or after meds

Swallow whole with plenty of fluid during meals while sitting or standing

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7
Q

Side effect of mefloquine?

A

Serious neuropsychiatric reactions

  • psychosis, suicidal ideation and suicide
  • proderomal symptoms for serious events like abnormal dreams, insomnia, nightmares, depression, anxiety, restlessness, confusion

So contra indicated if history of psychiatric disorders including depression or convulsions

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8
Q

Pt counselling on mefloquine?

A

Makes you dizzy so careful with driving
Mefloquine gas a long half life so side effects can persist up to several months after stopping

Stop and seek medical advice if neuropsychiatric reactions

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9
Q

Length of prophylaxis before travelling?

A

Usually 1 wk

Apart fro mefloquine which is 2-3wks
Malarone and doxycycline 1-2 days

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10
Q

Length of prophylaxis after travel?

A

Usually 4wks after

Except Malarone which is 1wk after

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11
Q

How long can you take chloroquine and proguanil as long term prophylaxis?

A

More than 5yrs

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12
Q

How long can you take doxycycline as long term prophylaxis?

A

2yrs

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13
Q

How long can you take mefloquine and Malarone as long term prophylaxis?

A

1yrs

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14
Q

What antimalarial need to be avoided in epileptic pts?

A

Chloroquine and mefloquine

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15
Q

What antimalarial needs to be avoided in renal impairment?

A

Progianil

Malarone and chloroquine if egft is below 30ml/min

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16
Q

What Antimalatials are suitable for pts with renal impairment?

A

Doxycycline or mefloquine

17
Q

What Antimalatials are recommended for Preganancy?

A

Chloroquine and proguanil (but a lot of resistance)

5mf folic acid is given with proguanil

18
Q

What Antimalatials should be avoided in pregnancy?

A

Doxycycline
Mefloquine
Malarone (if there is no alternative, may give in 2nd or 3rd trimester

19
Q

Antimalarial treatment in pts taking warfarin?

A

Start prophylaxis 2_3wks before
INR should be stable before departure

Monitor INR before, 7days after starting and after completing the course
For prolonged stay, check INR regularly in visiting country

20
Q

What type of mosquito causes malaria?

A

Anopheles

21
Q

What’s the mosquito that causes the most dangerous malaria?

A

P. Falciparum

22
Q

Symptoms of malaria?

A 
Rigors
Fever
Profuse sweating
Headache
N and V
Muscle oain
Bloody stools
Seizures
23
Q

When can you experience malaria symptoms?

A

Within 1yr, especially the first 3 months of return from malarial region

24
Q

Which antimalarial act as causal Prophylactic and prevent parasite from infecting RBC?

A

Malarobe
Atovaquonr and proguanil

Proguanil has mainly suppressive activity but also has some causal activity

25
Q

Which antimalarial works as a suppressive Prophylactic and destroy any parasite once release into blood?

A

Mefloquine
Chloroquine
Doxycycline

26
Q

What antimalarial drug is recommended for epilepsy?

A

Doxycycline
Or
Malarone

27
Q

What antimalarial are used for falciparum malaria?

A

Quinine
Malarone
Riamet

28
Q

What antimalarial is used for non falciparum malaria?

A

Chloroquine

29
Q

What antimalarial is used as standby treatment of malaria?

A

Quinine

Take only if you cannot access medical care in 24hrs of fever onset

Given with written instructions that urgent help is required if fever is over 38, 7 days or more after arriving in malarious zone

30
Q

What’s the normal range of WBCs?

A

4-10

31
Q

What’s the normal range of CRP?

A

Below 5mg/L

32
Q

What’s procalcitonin?

A

Marker for bacterial infection if increased

33
Q

What’s the normal range of procalcitonin?

A

Below 0.25mcg/L

34
Q

Sepsis symptoms in adults?

A 
SEPSIS
S=slurred speech or confusion
E=extreme shivering or muscle pain
P=passing no urine in a day
S=severe breathlessness
I=it feels like you're going to die
S=skin mottled or discoloured
35
Q

What the sepsis 6 management plan?

A
  1. Administer oxygen
  2. Take blood culture
  3. Give IV antibiotic
  4. Give IV fluids
  5. Check serum lactate and HB (ensure HB OVER 7G/DL)
  6. Urine output sk mayve catheterisation
36
Q

What’s typically used to treat sepsis?

A

Tazobactam STAT

and gentamicin

Inori Pre Reg (22 decks)

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