Lecture 12 Travel Related Infection Flashcards

1
Q

What is the vector for Malaria

A

Female anopheles mosquito

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2
Q

What is the 6 steps of the malaria cycle

A
  1. Mosquito bites human
  2. Takes blood and injects sporozoites (premature parasite)
  3. Sporozoites migrate to liver and infect liver cells
  4. Cells replicate to make Merozoites
  5. Merozoites rupture and invade and replicate in other red blood cells
  6. Mosquito take up red blood cells and take up Gametocytes which unit and form a zygote (7 days)
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3
Q

Name the 5 malaria species

A
  • Plasmodium falciparum (potentially severe)
  • Plasmodium vivax
  • Plasmodium ovale
  • Plasmodium malariae
  • Plasmodium knowlesi
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4
Q

What are the symptoms of a malaria infection

A
  • Fever
  • Rigors
  • Aching bones
  • Abdomen pain
  • Headache
  • Dysuria
  • Frequency
  • Sore throat
  • Cough
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5
Q

What are the signs of a malaria infection

A
  • None
  • Splenomegaly
  • Hepatomegaly
  • Mild jaundice
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6
Q

What are the complications of malaria

A
Cerebral malaria
Blackwater fever
Pulmonary oedema
Jaundice
Severe anaemia
Algid malaria- gram negative septicaemia
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7
Q

How is malaria diagnosed

A
•	Thick and thin blood films
o	Giemsa, Field’s stain
•	Quantitative buffy coat (QBC)
o	Centrifugation, UV microscopy
•	Rapid antigen tests
o	OptiMal
o	Parasight-F
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8
Q

How do you assess the severity of malaria

A
Severity Assessment: Complicated malaria =one or more of-
•	Impaired consciousness or seizures
•	Hypoglycaemia
•	Parasite count >2%
•	Haemoglobin <8mg/dL
•	Spontaneous bleeding/DIC
•	Haemoglobinuria
•	Renal impairment or PH<7.3
•	Pulmonary oedema or ARDS
•	Shock (algid malaria)
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9
Q

Name 2 malaria drugs

A
  • Quinine

* Artemisinins

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10
Q

What are the treatment options for uncomplicated P.falciparum

A
  • Riamet (3 days)
  • Eurartesim( 3 days)
  • Malarone (3 days)
  • Quinine (7 day)- plus oral doxycycline (or clindamycin)
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11
Q

What are the treatment options of complicated of severe P.falciparum malaria

A
  • IV artesunate IV quinine- plus oral doxycycline (or clindamycin)
  • When patient is stable & able to swallow, switch to oral treatments
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12
Q

What are the treatments of P. vivax, P. ovale, P. malariae, P. Knowlesi

A
  • Chloroquine (3 days)
  • Riamet (3 days)
  • Add primaquine (14 days) in vivax and ovale to eradicate liver hypnozoites
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13
Q

What are the causative organisms of Typhoid (Enteric) Fever

A
  • Salmonella typhi

* Salmonella paratyhphi

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14
Q

What are the clinical features of Typhoid fever during the 1st week

A

: fever, headache, abdomen discomfort, constipation, dry cough, relative bradycardia, neutrophilia, confusion

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15
Q

What are the clinical features of Typhoid fever during the 2nd week

A

fever peaks at 7-10 days, rose spots, diarrhoea begins, tachycardia, neutropenia

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16
Q

What are the clinical features of Typhoid fever during the 3rd week

A

complications): intestinal bleeding, perforation, peritonism, metastatic infections

17
Q

What are the clinical features of Typhoid fever during the 4th week

A

Recovery

18
Q

How is Typhoid fever diagnosed

A

Culture blood, urine and stool

Culture bone marrow

19
Q

How is typhoid fever treated

A
Oral azithromycin
IV ceftriaxone (if complicated)
20
Q

What is the transmission vector of dengue fever

A

Aedes aegypti

21
Q

What are the clinical features of dengue fever

A
  • Sudden fever
  • Severe headache, retro-orbital pain
  • Severe myalgia and arthralgia
  • Macular/maculopapular rash
  • Haemorrhagic signs: petechiae, purpura, positive tourniquet tests
22
Q

How is dengue fever diagnosed clinically

A

o Thrombocytopenia
o Leukopenia
o Elevated transaminases
o Positive tourniquet test

23
Q

How is dengue fever diagnosed in the laboratory

A

PCR, serology

24
Q

How is Dengue fever managed

A

No specific therapeutic agents

25
Q

What is the life cycle of Schistosomiasis

A
  1. Human infested, passing eggs from stool into fresh water
  2. Eggs hatch in freshwater
  3. Microscopic forms of parasite enter into freshwater snails where they replicate
  4. Sporocysts penetrate skin of human and migrate to the blood, enter gut and bladder
26
Q

What are the clinical features of the invasive stage of Schistosomiasis

A

o Cough, abdo discomfort, splenomegaly, eosinophilia

27
Q

What are the clinical features of the Katayama fever stage of Schistosomiasis

A

o Prostrate, fever, urticaria. Lymphadenopathy, splenomegaly, diarrhoea, eosinophilia

28
Q

What are the clinical features of the Acute disease stage of Schistosomiasis

A

o Eggs deposited in bowel (dysentery) or bladder (haematuria)

29
Q

How is Schistosomiasis diagnosed

A
  • Clinical diagnosis
  • Antibody tests
  • Ova in stools and urine
  • Rectal snip
30
Q

How is Schistosomiasis treated

A
  • Praziquantel, 2 doses 6 hours apart

* Prednisolone if severe

31
Q

Tick Typhus causes what type of rash

A

Maculopapular

32
Q

What are the clinical features of Rickettsiosis

A

abrupt onset swinging fever, headache, confusion, endovasculitis, rash (macular, petechial), bleeding

33
Q

How is Rickettsiosis diagnosed

A

Clinical features and Serology

34
Q

How is Zika virus transmitted

A

Aedes mosquitos
Sexual contact
Blood transfusion

35
Q

What are the symptoms of zika virus

A

headache, rash, fever, malaise, conjunctivitis, joint pains

36
Q

In pregnancy zika virus can cause___

A

Microcephaly

37
Q

What neurological complication can zika virus cause

A

Guillain-Barre syndrome