Microbio - fever in a returning traveller

Question 1

Fever in a returning traveller + petechial rash. Top DDX?

Answer 1

Dengue

Question 2

Fever in a returning traveller + constipation. Top Ddx?

Answer 2

Enteric fever (typhoid)

Question 3

Rose spots

Answer 3

Enteric fever

Question 4

Fever in a returning traveller + scabby looking lesions. What are they called? and what is the top Ddx?

Answer 4

Eschar = necrotic tissue that’s cast off from surface of the skin

Rickettsial disease

Question 5

Major features of severe P. falciparum infection

Answer 5

Acidosis
Shock
Severe hypoglycaemia
Renal damage
ARDS
Jaundice and anemia
DIC
LOC + seizures

Question 6

Common Sx of P. falciparum infection

Answer 6

Fever
RIgors
Myalgia
Headache
Back pain
N+V

Question 7

Hypnozites

Answer 7

P. vivax and P. ovale

Question 8

Rings in RBCs

Answer 8

P. falciparum

Question 9

crescent shaped gametocytes

Answer 9

P. falciparum

Question 10

Tx of P. falciparum malaria

Answer 10

Uncomplicated = Quinine + Doxycycline for 7 days

Complicated = IV Artesunate

Question 11

Tx of P. vivax and P. ovale malaria?

Answer 11

Chloroquine then primaquine

Question 12

FBC results of P. falciparum

Answer 12

LOW PLATELETS

Normal WCC.

Question 13

Considerations when treating for P. vivax or P. ovale

Answer 13

Primaquine is used to target hypnozites BUT

• CI: pregnancy + breastfeeding
• must check G6PD level

Question 14

Tx of rickettsial disease

Answer 14

Doxycycline

Question 15

Diarrhoea in a returning traveller- what kinda organism would you suspect if disease is short lived?

Answer 15

Bacterial/viral

most commonly E. coli

Question 16

Diarrhoea in a returning traveller - name 2 organisms you would suspect in a long lasting infection?

describe the poo

Answer 16

PROTOZOA;

Entamoeba histolytica = bloody diarrhoea
Giardia Lamblia = foul smelling