Infections

Question 1

Most common causes of travellers diarrhoea

Answer 1

Enterotoxic E. coli
Enteroinvasive E. coli
Enteroaggregate E. coli
Shigella
Salmonella
Campylobacter
Norovirus
Protozoa

Question 2

Malaria features

Answer 2

Plasmodium falciparum causes most severe type
Spread by Anopheles mosquitos
Suspect in fever in returned traveller
Fever, malaise, HA, anorexia, vomiting, myalgia
May need recurrent blood draws for thick and thin films every 6-12 hours for 48 hours to rule it out completely
Can present a month or so after exposure
Should be hospitalised

Question 3

Dengue features

Answer 3

Short incubation period 4-7 days
Spread by Aedes aegypti mosquitos
Fever + influenza like illness OR hemorrhagic complications eg epistaxis, prolonged periods
Diagnosis is clinical + some blood tests avail eg serology or PCR
Supportive treatment only

Question 4

Typhoid fever features

Answer 4

Incubation period 3-60 days
Vaccination 70% successful only
Requires culture to diagnose, serology unhelpful
Fever + GI sx

Question 5

Rickettsial disease
(usually from tick bites)

Answer 5

Fever + HA + myalgia
Rash may be present
Eschar may be present
Include Rocky Mountain Spotted fever, scrub typhus

Question 6

Chikungunya/Zika features

Answer 6

Fever + arthralgia +/- myalgia + rash
Arthritis is bilateral and involves small joints in hands and feet

Question 7

Meningitis immediate ABx pre-hospital

Answer 7

Neonate <3 months old benzene 50mg/kg
3m to 10yo ceftriaxone 100mg/kg (max 2g)
Adolescent/adult ceftriaxone 2g

Question 8

Complicating factors of UTIs

Answer 8

Male
Catheterisation
Recent instrumentation
Pregnant
Immunosuppressed
Not improved on ABx in community
>3 in a year
?stone
Abnormal renal tract
Suspected pyelonephritis
Prev resistant organism

Question 9

Common pathogens for encephalitis

Answer 9

Herpes simplex
Varicella
Measles
EBV
Toxoplasmosis
Enteroviruses
Adenoviruses

Autoimmune
Paraneoplastic
Acute demyelinating