travel medicine

Question 1

which type of malaria can present after many years ?

Answer 1

p ovale and p vivax

Question 2

what’s black water fever

Answer 2

thos exposed to malaria with hemolysis, hemoglobuniria , renal failure

Question 3

crtieria for severe malaria

Answer 3

Essentially any end organ
dysfunction
* Neurologic=confusion,prostration (severe weakness), seizures
* Respiratory=ARDS,pulmonaryedema
* Hematologic=DIC(anemia, thrombocytopenia, elevated LDH), jaundice, hemoglobinuriaàBlack water fever

Severeanemia(Hgb<50)
* Hypoglycemia(glucose<2.2)
* Acidosis(pH<7.25,HCO3<15)
* Renalimpairment(Cr>265)
* LacticAcidosis
* Hyperparasitemia
– ≥5% for non-immune adults
* Non immune = born in non-endemic countries or who have moved out of endemic country >6-12 mos
– ≥10% for semi-immune adults
* Semi-immune = birth and long term residence in an
endemic country and prior episodes of malaria.

Question 4

p vivax and p ovale, what to give to cover hypnozite ?

Answer 4

primaquine

Question 5

your first line tx for
- P falciparum
- non falciparum

Answer 5

• atovaquone proguanil ( assume resistnace)
• chloroquine ( assume sensitivity)

Question 6

severe complicated malaria, what to give ?

Answer 6

IV artersunate ( if not avialable –> iv quinidine)

Question 7

what to monitor for if give IV quinine ?

Answer 7

QT
hypoglycemia

Question 8

what’s weil dz in leptosprosis

Answer 8

jaundice+renal failure

Question 9

how can you acquire leptosprosis ?

Answer 9

from animal waste –> soil , water exposure

Question 10

exception to start droplet/contct + n95 precausions in viral hmrg fevers

Answer 10

flaviviruses ( yellow fever, dengue)

Question 11

ebola tx

Answer 11

supportive
monoclonal atb treatments

Question 12

measles virus
- transmission
- incubation
- sx
- complication
- post expo prophylaxis

Answer 12

• airborne
• 14 days
• fever, cough , rash, kopplik, conjunctiva, coryza
• pneumonia, encephalitis,m subacute slerosing panencephalitis
• mmr, measles immunoglobulin

Question 13

in what stn would you see subacute sclerosing pancephalitis as complication ?

Answer 13

measles

Question 14

what can entamoeba histolytica cause ?

Answer 14

luminal diseasE
liver abscess

Question 15

how to treat entamoeba histolytica ?

Answer 15

• paromomycin ( luminal) +/-
• mtz ( systemic )

Question 16

african sleeping sickness is =

Answer 16

trypanosoma brucei

Question 17

chagas =

Answer 17

trypanosoma cruzi

Question 18

how to treat giardia ?

Answer 18

mtz x 14 days

Question 19

name some meds you can use for helminth tx

Answer 19

praziquental
albendazole
mebendazole

Question 20

Clue to helminth infection ?

Answer 20

eosinophilia

Question 21

which helminths may not have eosinophilia ( where in the body)

Answer 21

in GIT

Question 22

echinoccocus can cause what ?
tx

Answer 22

liver cyst and lung cyst
albendazole, surgery, monitoring, aspration

Question 23

schistosoma
- cause what
- tx

Answer 23

• liver, bladder CA
• praziquantel

Question 24

taenia solium
- can cause what ?

Answer 24

taeniasis and neurocysticercosis
- tx w/ albendazole + praziquantel + steroids

Question 25

trichinella spiralis
-conseq
-tx ?

Answer 25

• gi sx
• muscle pain ( cyst)
• albendazole, mebendazole

Question 26

strongyloides
- sx
- if immunosup/,glucocorticoid, what happens ?
- tx ?

Answer 26

• diarrhea, eosinophilia, itchy, resp sx
• disseminated disease and ++ likely of acquiring gram neg infection ( i.e. meningitis) = fatal
• ivermectin : 1 or 2 doses