Travel medicine

Question 1

What are the 5 malaria species

Answer 1

falciparum
malariae
vivax
ovale
knowlesi

Question 2

Which malaria species can cause:
- chronic infection
- relapses (and how do you treat)

Answer 2

chronic - malariae
relapses - vivax and ovale (treat with primaquine)

Question 3

Diagnosis of malaria

Answer 3

Thick and thin films
Immunochromatographic tests

Question 4

Prophylaxis for malaria

Answer 4

atovaquone + proguanil
doxycycline
mefloquine (be mindful of resistance)

Question 5

Treatment uncomplicated malaria
Treatment for severe malaria
What constitutes severe malaria

Answer 5

artemether + lumefantrine
IV artesunate or IV quinine

reduced GCS, jaundice, oliguria, severe anaemia, hypoglycaemia, pulmonary oedema

Question 6

Typhoid
- species
- typical presentation
- treatment

Answer 6

S. typhi, paratyphi
Fever abdominal pain, constipation
Hepatosplenomegaly
Relative bradycardia and rose spots
- azith, levo

Question 7

Dengue
- presentation
- vector
- diagnosis
- complications

Answer 7

fever, rash, headache and retro-orbital pain, rash, MSK pain
-vector - Aedes aegyptii
- cytopaenias
- dengue haemorrhagic fever / shock syndrome

Question 8

Travellers diarrhoea:
- % with identifiable pathogen

Answer 8

40-60%

Question 9

Influenza
- treatments

Answer 9

neuraminidase inhibitors - oseltamivir, zanamivir
M2 inhibitors - amantadine, rimantadine

Question 10

Meningococcus
- clinical syndromes
- treatment

Answer 10

• bacteraemia without sepsis, menincogoggaemia without meningitis, meningitis, meningo-encephalitis
• IV BenPen 1.8g 4/24