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Year 4 > Infections in the returning traveller > Flashcards

Infections in the returning traveller Flashcards

1
Q

What is the commonest cause of death amongst travellers to the tropics?

A

Cardiovascular disease

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2
Q

What are the common presentations of disease after travelling?

A

Systemic febrile illness (sub-Saharan Africa)
Acute diarrhoea (Central asia)
Dermatological disease (Everywhere)
Chronic diarrhoea (Everywhere)

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3
Q

What are the commonest causes of fever in returning travellers?

A

Malaria (sub-Saharan Africa)
Dengue (Caribbean and Asia)
Infectious mononucleosis
Rickettsial infection (sub-Sahar Africa)
Salmonella (Asia)

40% have no identifiable cause

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4
Q

What are Rickettsial infections?

A

Caused by a variety of bacteria in Rickettsia genus
- behave like viruses as they live inside cells

Cause fever, headache, malaise, nausea, or vomiting

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5
Q

What included in a travel history?

A
  • Where? Precisely.. rural vs urban
  • When? Incubation periods and exposure Interval
  • What? Exposures
    Prophylaxis: Antimalarials, Vaccination, ‘Prophylactics’
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6
Q

Which diseases have a short incubation period <10 days?

A

Malaria (P. falciparum)
Enteric bacteria
Pneumonia
Dengue and other arboviral infections
Rickettsial infections
Viral haem. fever
Plague
Influenza
Anthrax

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7
Q

What is anthrax?

A

Caused by bacteria Bacillus anthracis

Lays dormant as a spore for as long as decades (not contagious)
Gets into the body and causes severe illness in humans and animals

Releases toxins

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8
Q

Which diseases have a medium incubation period (11-21 days)?

A

Malaria (P. falciparum)
Typhoid
Strongyloides
Leptospirosis
Rickettsial infections
Brucellosis
Lyme disease
Cutaneous myiasis

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9
Q

What is Strongyloides?

A

Parasitic worms

Eg,
Thread worm
Round worm

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10
Q

What is Lyme disease?

A

A bacterial infection spread by ticks

Its rarely fatal

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11
Q

Which diseases have a long incubation period (>21 days)

A

Malaria
Amoebic liver abscess
Viral hepatitis
Tuberculosis
Enteric protozoa
Enteric helminths
HIV
Schistosomiasis
Leishmaniasis

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12
Q

Which infection cause a high neutrophil count?

A

Septisaemia
Staph or strep infections
Meningicoccal infections
Non-typhoid salmonella
Bacillary dysentery
Tonsilitis

All the tropic ones have normal/low neutrophil counts

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13
Q

What is dysentery?

A

Infection of the intestines causes diarrhoea containing blood or mucus

Only severe cases require antibiotics

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14
Q

What is the platelet count in malaria and dengue fever?

A

Low

Infection is unlikely is platelet counts are normal

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15
Q

Which conditions cause low platelet counts?

A

Dengue
Enteric fever
HIV seroconversion
Malaria
Sepsis
Other viral infections

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16
Q

In what type of infection is CRP high?

A

In pyogenic infections

Often elevated in malaria

17
Q

What is the most common malaria species presenting in the UK?

A

Plasmodium falciparum
It’s most serious

Others include: P.vivax, P, ovale, P.malriae, and P.knowlesi

18
Q

What is the first-line treatment for c.diff?

A

Vancomycin 125mg for 10 days

  • For uncomplicated healthy patients
19
Q

What is the first-line treatment for aspiration pneumonia?

A

Amoxicillin and metronidazole

Replaced with clarithromycin if allergic

Doxycycline is preferred to clarithromycin when transferring from IV to oral

20
Q

What is the management of infective endocarditis?

A

Take 3 cultures, 6 hours apart before starting antibiotics

21
Q

Which bacteria is the most common cause of infective endocarditis?

A

Staphylococcus aureus

22
Q

What is the first-line antibiotic for pneumonia?

A

Amoxicillin

23
Q

What is the first-line antibiotic for neutropenic sepsis?

A

Piperacillin-Tazobactam (Tazosin)

24
Q

What are the malaria identifying symptoms?

A

Intermittent fever

M.vivax can cause fever months after infections because it incubates in the liver

25
Q

Where is each type of malaria most commonly contracted?

A

Vivax: Asia

Falciparum: sub Saharan Africa

26
Q

What are the dengue fever identifying symptoms?

A

Gradually rising fever

Can turn into haemorrhagic fever

27
Q

Where is dengue fever most commonly contracted?

A

South Americas

Also sometimes sub Saharan Africa and Asia

28
Q

What is Rabies?

A

A virus causes progressive brain and spinal cord inflammation

Transmitted through saliva (bites and scratches)

29
Q

How does rabies present?

A

Weakness or discomfort, fever, or headache

Later turns into abnormal behaviour

Always causes death if untreated

30
Q

What is the treatment for Rabies?

A

No actual cure

Treatment with immunoglobulins

Prevented with vaccine

31
Q

What are haemorrhagic fevers?

A

Infections that cause blood vessels to leak if untreated

Eg. Ebola, yellow fever, Dengue

32
Q

What are the contraindications for acyclovir?

A

Renal damage (low eGFR)

Pregnancy and breastfeeding

Year 4 (100 decks)

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