Session 8 - Travel Related Infections & COVID-19

Question 1

What are the 3 considerations when making a differential diagnosis for travel infections?

Answer 1

Where they travelled to
Incubation period
Clinical presentation

Question 2

What is the vector of malaria?

Answer 2

Female anopheles mosquito

Question 3

What is the incubation period of malaria?

Answer 3

Minimum 6 days

Question 4

What are 8 symptoms of malaria?

Answer 4

Fever
Chills
Splenomegaly
Headache
Fatigue
Muscle and back pain 
Dry cough 
Nausea and vomiting

Question 5

What is the more severe form of malaria?

Answer 5

Falciparum

Question 6

What are 8 possible symptoms of severe falciparum malaria?

Answer 6

Tachycardia
Pulmonary oedema
Diarrhea
Acute kidney injury
Confusion
Clotting problems
Metabolic acidosis
Secondary infection

Question 7

What are 4 investigations to do for malaria?

Answer 7

Thick and thin blood smears
Blood tests: FBC, U&E, LFT
CXR
Head CT

Question 8

What are 2 forms of management for malaria?

Answer 8

Removal of vector

Drugs

Question 9

What are 3 drugs to use for malaria?

Answer 9

Artesunate
Quinine
Doxycycline

Question 10

What is the mechanism of infection for enteric fever?

Answer 10

Fascial oral from contaminated food or water

Question 11

What are 2 microorganisms that cause enteric fever?

Answer 11

Salmonella typhi

Salmonella parathyphi

Question 12

What are 4 virulence factors of Salmonella typhi?

Answer 12

Low infectious dose
Survives gastric acid
Fimbriae adhere to epithelium
Reside within macrophage

Question 13

What are patients susceptible to enteric fever?

Answer 13

Children

Question 14

What is the incubation period of enteric fever?

Answer 14

7-14 days

Question 15

What are 5 symptoms and signs of enteric fever?

Answer 15

Fever, headache, abdominal discomfort, dry cough, bradycardia

Question 16

What is the diagnostic investigation for enteric fever?

Answer 16

Blood culture

Question 17

What are the 3 treatment options for enteric fever?

Answer 17

IV Ceftriaxone
Azithromycin
Ciprofloxacin

Question 18

What is 3 protection methods for enteric fever?

Answer 18

Vaccination

Good water and food hygiene

Question 19

Wha are 2 complications of enteric fever?

Answer 19

Intestinal haemorrhage and perforation

Seeding

Question 20

What is the most common arbovirus?

Answer 20

Dengue

Question 21

What is the structure of coronavirus?

Answer 21

Large, enveloped, pleomorphic particles with distinctive arrangement of spikes projecting from surfaces

Question 22

What is the genetic material of coronavirus?

Answer 22

single stranded RNA

Question 23

What is the major surface antigen of coronavirus?

Answer 23

Spike glycoproteins - required for entry into cells

Question 24

How is coronavirus transmitted?

Answer 24

Respiratory route

Question 25

What are 3 potential modes of transmission of coronavirus?

Answer 25

Small droplets - suspended in air for significant amt of time Large droplets - fall rapidly to ground, transmitted over short distances Larger droplets - settling onto surfaces touched and transported by hands onto mucosal membranes

Question 26

What are 3 barriers to entry via the respiratory route?

Answer 26

Respiratory epithelial cells covered by thick mucus Ciliated respiratory epithelial cells that sweep mucus up from lower to upper tract Immunologic defenses

Question 27

How does coronavirus enter cells?

Answer 27

Spike glycoproteins on surface binds to ACE2 then gets endocytosed

Question 28

What is used to replicate coronavirus?

Answer 28

RNA dependent RNA polymerase

Question 29

What are 6 symptoms of coronavirus?

Answer 29

``` Fever Headache Muscle pain Extreme fatigue Dry cough Loss of taste or smell ```

Question 30

What are 3 ways to diagnose COVID?

Answer 30

Molecular tests - nasopharyngeal swab - extract RNA convert to DNA, PCR, then detect viral RNA SalivaDirect Test - RNA converted to DNA and amplify with PCR with primers then detect viral RNA Lateral flow test - saliva applied to pad with antibodies, antigen from virus bond with antibodies, flow along pad, bond with more antibodies at test line

Question 31

What are 5 treatments of COVID-19?

Answer 31

``` Dexamethasome Remdesivir NIV LMWH Vaccine ```

Question 32

Why are there many variants of coronavirus?

Answer 32

10h High error rate of viral RNA polymerases Lack of proofreading ability leads to mutations and genetic variation