Malaria And Influenzaaa

Question 1

Malaria Symptoms

Answer 1

If you’ve been to a country where malaria was present, you need to look out for hese possible signs of malaria over the next 12 months
• High fever
• Cold chills
• Persistent headache
• Nausea or vomiting
•Diarrhoea
• Fatigue
• Muscle pain
• Sweats
• Chest pain
• Abdominal pain
• Persistent cough

Question 2

Mefloquine (lariam)-POM

Answer 2

Mefloquine (Lariam)
• Used for malaria prophylaxis (now rarely due to resistance)
• Neuropsychiatric reactions
Accronym: lari is mental or Me = Mental
. Do not use in epilepsy

Question 3

Malarone- POM is used as prophylaxis and treatment of…..

Answer 3

• Used for falciparum malaria prophylaxis, treatment of uncomplicated falciparum and treatment of non.
Talciparum malaria
• Used as alternative to mefloquine or dovcycline
• Suitable for short trips because only needs to be taken for 7 days after leaving endemic area

Question 4

quinine examples and it can prolongggg

Answer 4

Quinine- eg sulfate and bisulphate = used in treatment of falciparum and falciparum malaria

• associated with QT PROLONGATION = Q= QUEEN

Question 5

Malaria prophylaxis- physical

Answer 5

Protection against insect bites
• Prophylaxis not absolute & breakthrough infection can occur with any of the recommended drugs
• Protect against bites
• Mosquito nets impregnated with permethrin (most effective barrier against insects)
• Mats [repellents] & vapourised insecticides useful

Question 6

DEEET- children how old can use??? Is it safe in pregnancy and breast feeding??

Answer 6

• Diethyltoluamide (DEET) 50% (available as sprays & mr formulations). Safe to apply on children over 2 months old
• DEET (Safe to use in pregnancy & breastfeeding)
• DEET should be applied after Sunscreen
• DEET reduces the SPF of sunscreen, so sunscreen of SPF 30-50 should be applied
• Wear long sleeves & trousers after dusk to protect from bites

Question 7

MEFLOQUINE (1234)

Answer 7

• ONCE WEEKLY
• 2-3 WEEKS BEFORE
• 4 WEEKS AFTER

Question 8

DOXYCYCLINE(11242)

Answer 8

ONCE DAILY
1-2 BEFORE TRAVEL
4 WEEKS AFTER
- CAN BE USED FOR UP TO 2 YEARS

Question 9

ATOVA AND PROGUANIL (1121)

Answer 9

• 1 DAILY
• 1-2 DAYS BEFORE TRAVEL
• 1 WEEK AFTER TRAVEL
• AVA/PROGUANIL, MEFLOQUINE CAN BE USED FOR A YEAR

Question 10

OTHERS

Answer 10

ONCE WEEKLY
1 BEFORE

4 AFTAAAAA

Question 11

Return from malarial region - any illness occurring within how long needs to be reported???within how long of return

Answer 11

Any illness that occurs within 1 year especially within 3 months of return mav be malaria
• Advise travellers, to report any illness to their doctor immediately, particularly if it is within 3 months of return from malarial area
• Malaria is a Notifiable disease

Question 12

Malaria prophylaxis (EPILEPSY)

Answer 12

•Doxycycline (may interact with some antiepileptic drugs, will need to adjust dose)
•Atovaquone with Proguanil (Malarone)
Avoid in epileptics
•Avoid chloroquine ‚mefloquine in epileptic patients
• Memory trick: avoid quines for epilepsy

Question 13

Malaria prophylaxis
Pregnancy & Breastfeeding

Answer 13

Safe in pregnancy
• Avoid travelling to malarial areas if possible during pregnancy

Chloroquine can be given but not effective in most areas
• Mefloquine can be given in 2nd & 3rd trimesters, only give in 1* if benefits outweigh risks
Avoid in pregnancy (except it no alternatives)
•Doxycycline contraindicated (Unless no other choice and whole course canbe completed 15 weeks before gestation)
• Atovaguone/proguanil (avoid but can give in 2nd or 3rd trimester it no alternative) also need to give Folic acid with it

Question 14

Malaria prophylaxis
Anticoagulants- how long should in be measured for??

Answer 14

Pts on warfarin should start chemoprophylaxis 2-3 weeks before travel
• IN should be stable before travel
• IN should be measured before starting prophylaxis, 7 days after starting and after completing course.
• Check IN at regular intervals for prolonged stays
• Limited experience with DOACS and chemoprophylaxis

Question 15

Safety information of antimalarials- qulorquine can causeeeee MHRA too( what do quinine prolong? What does mefloquine cases, what does chloroquine cause )

Answer 15

Quinine: QT interval prolongation
• Mefloquine: Discontinue if neuropsychiatric symptoms (
e.g abnormal dreams, anxiety, depression, restlessness, confusion & insomnia)
• Chloroquine: Ocular toxicity in adults if dose exceeds
4mg/kg daily. Also MHRA( Increased risk fo
Cardiovascular events when used with macrolides antibiotics)

Question 16

Influenza what is type A,B,C- How does transmission spread???

Answer 16

Influenza is a highly infectious respiratory infection caused by viruses: Types A, B, and C.
• Type A: More severe, frequent outbreaks.
• Type B: Milder but can cause outbreaks.
• Type C: Mild or asymptomatic.
• Transmission: Spread through droplets, aerosols, or direct contact with respiratory secretions.Incubation period: 1-3 days.

Question 17

Symptoms & Complications of influenzae

Answer 17

Sudden onset symptoms:
• Common: Chills, fever, headache, extreme fatigue, muscle pain.
• Respiratory: Dry cough, sore throat, nasal congestion.
Complications:
• Respiratory: Bronchitis, bacterial pneumonia, ear infections in children.
• Non-respiratory: Rare, may include cardiac or neurological issues.

Question 18

At Risk Groups

Answer 18

Higher risk of severe illness:
• Children under 6 months.
• Pregnant women (including postpartum).
• Elderly (over 65 years).
•Patients with chronic diseases (respiratory, cardiac, diabetes, etc.).
•Severely immunosuppressed individuals.

Question 19

Management of Influenza

Answer 19

Aims:
• Reduce illness duration and severity.
• Prevent complications.
• Control infection spread.

Question 20

Treatment Guidelines- uncomplicated influenza what are the 2 treatment options

Answer 20

Uncomplicated Influenza:
• Usually managed at home.
• Antivirals (oseltamivir) for at-risk groups or severe cases.
Complicated Influenza:
• Treated in hospitals.
• Oseltamivir or inhaled zanamivir for severely immunosuppressed patients.

Question 21

Post Exposure Prophylaxis- influenza

Answer 21

• For those exposed in households, care homes, or other vulnerable settings.
• Oseltamivir for most; Zanamivir if oseltamivir resistance is suspected.

Question 22

Antiretroviral in influenza oooooooooooo zzzzzzzz

Answer 22

• Oseltamivir (Tamiflu) and Zanamivir for treatment and prevention.
• Oseltamivir resistance may occur, particularly in certain influenza strains.