International Travel

Question 1

Japanese encephalitis 
Transmission 
Where
What % develop clinical disease
Vaccine type

Answer 1

Mosquito 
Asia and western pacific, farming 
<1%
High case fatality and sequelae
Inactivated vaccine, 2x doses

Question 2

Typhoid fever
Microbe
Geography 
Transmission 
Common features 
Rx

Answer 2

Salmonella typhi
Salmonella paratyphi

Septicaemic illness
Fever, hepatomegaly, abdominal pain, diarrhoea, vomiting, cough, malaise, headache.

Developing countries: asia, india, Africa

Contaminated food/water
Quinolones
Ceftriaxone if from india or vietnam

Question 3

Malaria
Four species 
Vector 
Which two species have hepatic stages?
Which is most severe?

Answer 3

Plasmodium vivax, malariar, ovale, falciparum
Anopheles mosquito
Vivax & ovale have hepatic stages, so can relapse
Falciparum is the most severe , potentially fatal

Question 4

Malaria
Incubation
Symptoms
Diagnosis

Answer 4

8-15 days
Headaches, abdominal pain, arthralgia, diarrhoea, vomiting
Pallor & jaundice from hemolysis

Nephrotic syndrome in P malariae( immune complex)

P falciparum
- cerebral malaria, severe anaemia, Hypoglycemia, ATN

Thick film: identify parasites
Thin film: identify species
3 films at 12-24h intervals to confidently exclude

Question 5

Malaria treatment
Falciparum

Vivax & ovale

Malariae

Answer 5

Quinine

Chloroquine then primaquine

Chloroquine

Question 6

Complications in typhoid fever

Answer 6

Intestinal perforation (0.5-3%)
Focal in immunocompromised : CNS, bone, endocarditis, kidney 
In haemoglobinopathy: osteomyelitis & septic arthritis

Question 7

Dengue fever 
Cause 
Mosquito name 
Endemic to
Clinical manifestations

Answer 7

Arbovirus, genus Flavivirus
Aedes aegypti
SEA, central & South America, Carribean, PI
Fever for 1-7d, frontal or retroOrbital headache, back pain, myalgia, arthralgia, nausea & vomiting

After fever resolves gets rash
After rash fades fevers reoccur!

Question 8

Dengue haemorrhagic fever
Occurs when

Features

Rx

Answer 8

Second infection with the arbovirus
Rare in children
Fever, haemorrhage, epistaxis, bleeding gums, capillary fragility and fluid leakage

Aggressive fluid resus

Question 9

Lassa fever
Endemic to
Exposure to
Symptoms at onset 
Complications 

Treatment

Answer 9

Nigeria, west Africa 
Rats urine, faeces
Flu-like
Mucosal bleeding
Haemorrhagic shock

Ribavirin

Question 10

Ebola
Virus family
Animal host
Spread via

Answer 10

Flavivirus
Fruit bats, other wild animals 
Contact with others
Supportive 
Vaccine now available

Question 11

Match

Spirochetes
Anopheles mosquito
Aedes mosquito
Rabbits

Answer 11

Leptospirosis
Malaria
Dengue, chikunuga, zika
Tularaemia (tick bite, LN, eyes)

Question 12

Two phases of Leptospirosis

Answer 12

Septicaemic- 1st week
Fever, chills, headache, transient rash, conjunctivitis, severe myalgias

Resolves for 1-4 days

Immune mediated
Fever returns
Aseptic meningitis, Weil syndrome (jaundice, nonoliguric renal failure, haemorrhage 2 thrombocytopenia), pulmonary haemorrhage

Question 13

Schistosomiasis

Treatment

Answer 13

Praziquantel

Question 14

Hook worm

Treatment
Disease associated

Answer 14

Mebendazole

Iron deficiency anaemia

Question 15

Strongyloides

Treatment

Answer 15

Ivermectin

Question 16

Ascariasis

Treatment

Answer 16

Albendazole

Question 17

Schistosomiasis

What activity
Where
Sx
Treatment

Answer 17

Swimming in infected lake

South America, Africa, indonesia, thailand, phillipines, middle east

Skin- itching rash, hypersensitivity
GI, granuloma of liver, lung, haematuria

Praziquantel