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infection > the returning traveller > Flashcards

the returning traveller Flashcards

1
Q

what causes MERS

A

coronavirus

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2
Q

clinical features of mers

A

severe acute resp tract infection

  • fever
  • short of breath
  • cough
  • pneumonia
  • gi upset
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3
Q

what is pertussis

A

whooping cough

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4
Q

cause of pertussis

A

bordella pertussis gram negative fastidious bacteria

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5
Q

pathogenesis of pertussis

A

-toxin

attaches to and paralyses respiratory cilia that if followed by inflammation of the resp tract

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6
Q

3 stages of pertussis

A

catarrahl
paroxysmal
convalescent

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7
Q

catarrhal stage

A

mild fever, coryza and cough 1 week

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8
Q

paroxysmal stage

A

intermittent cough becomes paroxysmal and ends in an inspiratory “whoop”
-2-6 weeks

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9
Q

convalescent stage

A

non-paroxysmal cough 2-6 weeks

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10
Q

complication pertussis

A

apnoea
pneum
seizures

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11
Q

management of pertussis

A
  • vaccine 5 in 1

- antibiotics clarithromycin

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12
Q

viruses that cause hepatomegaly

A

malaria
typhoid
hepatitis

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13
Q

viruses that cause splenomegaly

A
  • malaria
  • relapsing fever
  • typhoid
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14
Q

viruses that cause lymphadenopathy

A
  • HIV
  • rickettsial
  • brucellosis
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15
Q

viruses that cause haemorrahge

A

viral haemorrhagic fever
dengue fever
yellow fever
meningococcal sepiteciaemia

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16
Q

2 main mosquitoes that carry viruses

A

aedes aegypti

aedes albopictus

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17
Q

risk if person bites you and treatment

A

-risk of bacterial infection
give phx co-amoxicalv
low risk of tetanus

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18
Q

dogs bites treatment

A
  • bacterial infection
  • tetanus
  • rabies
    treatment: co-amoxiclav
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19
Q

risk of infection from bat bite

A

rabies

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20
Q

money risk of infection and treamtnet

A
  • bacterial
  • rabies
  • tetanus
  • hep b prophylaxis aciclovir
  • bacterial co-amoxiclav
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21
Q

main causes of fever in the returning traveller

A
  • malaria
  • enteric fever
  • dengue
  • HIV seroconversion
  • Rickettsia
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22
Q

what causes malaria

A
  • parasite
  • plasmodium falciparum (main one)
  • vivax
  • malariae
  • ovale (west africa)
  • knowlesi
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23
Q

where is plasmodium knowlesi found

A

in long tailed and pig tailed macques in SE asia

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24
Q

which malaria parasite has the highest parasitaemia and merozoites produced

A 
falciparum
then 
vivax
ovale
malariae
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25
Q

where does malaria replicate and what is produced

A

replicates in liver and produces merozoites that invade mostly rbc

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26
Q

dx of malaria

A 
is a blood film 
-thick film for sensitivity
-thin film for 
quantification 
- do it 3 times
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27
Q

what is the rapid diagnostic test for malaria

A
  • parasite lactate dehydrogenase

- plasmodium histidine rich protein 2 in falciparum only

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28
Q

presentation of malaria

A
  • prodromal episodes of tiredness, aching

- non specific fever, -myalgia, headache, gi upset and cough

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29
Q

how does the fever present in malaria

A

-cyclical occurrence of sudden coldness followed by rigor then fever then sweating lasting 4-6 hours occurring every 2 days -or every 36-48 hrs for falciparum or even an almost continuous fever

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30
Q

lab findings for malaria

A

decreased platelets

increased bilirubin

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31
Q

severe malaria presentation

A
  • cerebral malaria
  • ards
  • anaemia
  • aki
  • hypo
  • shock (algid malaria)
  • gi
  • secondary infections gnb
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32
Q

what is complicated falciparum malaria

A
  • impaired consciousness or seizures
  • renal impairment
  • acidosis and elevated lactate
  • hypo
  • pulmonary oedema or ARDS
  • haemoglobin <80
  • spontaneous bleeding/ disseminated IV coagulation
  • shock algid malaria BP <90/60
33
Q

treatment of malaria falciparum

A

-IV therapy artesunate

or quinine

34
Q

treament for non-falciparum malaria

A
  • chloroquine

- primarquine

35
Q

what causes enteric fever

A

-bacteraemia with salmonella enterica serotype

typhi or paratyphi

36
Q

treatment of enteric fever

A

ceftriaxone 3rd generation for gram negative cover

37
Q

clinical features of enteric fever

A
  • abdo-> non specific-> fever
  • abdominal pain
  • constipation
  • diarrhoea
  • chills
  • headache
  • cough
  • myalgia
  • sore throat
38
Q

complication after week 3 enteric fever 3

A
  • intestinal perforation and haemorrhage
  • endocarditis
  • hepatic and splenic abscess
39
Q

exam findings for enteric fever

A
  • fever
  • abdo tenderness
  • hepato and splenomegaly
  • rose spots
  • chest signs
40
Q

enteric fever labs

A

increase ALT

decrease eosionphilics

41
Q

another name for enteric fever

A

typhoid

42
Q

what family member are dengue viruses

A

flaviviridae viruses

43
Q

how is enteric fever transmitted

A

faecal oral

44
Q

how is dengue fever transmitted

A

aedes aegypti and albopictus viruses

45
Q

clinical features of dengue

A
  • asymptomatic
  • fever and rash
  • retro-orbital headache
  • msk pain
  • leukopenia
  • thrombocytopenia
46
Q

dx of dengue

A

-serology or PCR

47
Q

complications of dengue

A
  • dengue haemorrhagic fever
  • dengue shock syndrome
  • severe plasma leakagen and organ impairment
48
Q

what is dengue haemorrhagic fever and how is it tested

A

-fever
-positive tournique test
platelets <100 haemoconcentration

49
Q

what is dengue shock syndrome

A

dhf plus shock

50
Q

what family is chikungunya from

A

genus alphavirus

51
Q

transmission of chikungunya

A

aedes mosquitoes

52
Q

clinical features of chikungunya

A
  • fever
  • arthralgia
  • joint swelling
  • rash
  • headache
  • muscle pain
  • nausea
  • fatigue
53
Q

persistent symptoms of chikungunya

A
  • persistent arthritis and arthralgia
  • oedematous polyarthritis
  • severe tenosynovitis
  • new onset raynaud phenomena
54
Q

zika virus transmission

A
  • aedes mosquito

- sexual transmssion

55
Q

what monkey was zika originaly from

A

rhesus

56
Q

manifestation of chikungunya

A
  • maculopapular rash
  • arthralgia
  • conjunctivitis
  • myalgia, headache, retro-orbital pain
  • low grade fever
57
Q

complications zika virus

A

-pregnancy causes congenital microcephaly, fetal loses and guillain barre syndrome

58
Q

what is schistosomiasis

A

worms

59
Q

treatment schistosomiasis

A

steroids and then praziquantel

60
Q

what is rickettsial

A

The rickettsiae are a diverse collection of obligately intracellular Gram-negative bacteria found in ticks,

61
Q

triad of rickettsial

A
  • fever, headache and malaise within 1-2 weeks of infection

- rash or an eschar at site of tick infection

62
Q

types of rickettsial 3

A
  • african tick bite fever
  • mediterrranean spotted fever
  • scrub typhus: mites in asia: splenomegaly, cough, hearing difficulties, and encephalitis
63
Q

dx of rickettsial

A

serology

64
Q

treamtent of rickettsial

A

doxycycline

65
Q

4 viral haemorrhagic fevers

A
  • Arenaviridae
  • Bunyaviridae
  • Flivoridae
  • Flaviridae eg dengue
66
Q

when does HIV seroconversion take place

A

2-3 weeks after exposure

67
Q

how does hiv seroconversion present

A 
like mononucleosis
-fever
adenopathy
pharyngitis
rash
myalgia
diarrhoea
headache
68
Q

what is hiv seroconversion

A

when hiv antibodies start to develop

69
Q

what is the commonest identified cause of traveller diarrhoea

A

giardia

70
Q

pathophysiology of giardai

A

cyst are passed in stools with motile trophozoites in duodenal aspirates

71
Q

presentation of giardia

A

-foul smelling malabsorptive diarrhoea, floating stool, post prandial bloating

72
Q

treatment of giardia

A

with metronidazole

73
Q

where is cutaneous larva migrans found

A

jamaica

74
Q

presentation of cutaneous larva migrans

A
  • feet and buttock
  • pruritic serpiginous eruption
  • rash
75
Q

treatment larva migrans

A

ivermectin

albendazole

76
Q

what is myasis

A

maggots of african tumbu fly that burrow larvae into skin

77
Q

presentation of myasis

A

-boils which exude serous fluid

78
Q

what is tungiasis

A

parasite flea in indies eggs put by flea into broken skin

infection (15 decks)

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