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Microbiology and antibiotics > Travel Medicine > Flashcards

Travel Medicine Flashcards

1
Q

Define traveller’s diarrhea

A

3 or more loose stools/day

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2
Q

How do most cases resolve?

A

Self-limiting

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3
Q

After how many days do most cases resolve?

A

1-2 days even without treatment

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4
Q

What is the commonest cause of acute TD

A

ETEC

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5
Q

When you have bloody TD what organism is causing it?

A

Salmonella
Campylobacter
Entamoeba histolytica

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6
Q

What is the commonest cause of watery TD?

A

ETEC
Viral
Cholera

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7
Q

What investigations do you do post travel in TD?

A

Stool microscopy and culture

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8
Q

Which organisms are water born in traveler and can be vaccinated for?

A

HepA
Thyphoid
Cholera

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9
Q

Which organisms are vector born in traveler and can be vaccinated for?

A

Yellow fever

Japanese Encephalitis

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10
Q

Which organisms are Respiratory born in traveler and can be vaccinated for?

A

Meningococcal

Influenza

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11
Q

Which organism is blood/body fluid born in traveler and can be vaccinated for?

A

HBV

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12
Q

Which organisms are environmentally caught in traveler and can be vaccinated for

A

Rabies

Tetanus

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13
Q

Does HepA cause a chronic infection?

A

No

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14
Q

How is HepA vaccine scheduled?

A

2 doses at least 6 months apart
No booster recommended

Available alone or in combo wit HBV and typhoid

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15
Q

Which organism causes typhoid?

A

Salmonella Typhi

S. paratyphi

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16
Q

What is the name of the typhoid vaccine?

A

Polysaccharid vaccine Typherix

Allows 3 year protection

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17
Q

What are the symptoms of cholera?

A

profuse watery diarrhea

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18
Q

what is the cholera vaccine composed of?

A

V. Cholerae O1 organism +

non-toxic B subunit of cholera toxin

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19
Q

What is yellow fever?

A

viral disease spread by mosquitoes

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20
Q

what does yellow fever cause?

A

hepatitis and encephalitis

21
Q

what are c/i for yellow fever vaccine?

A

severe egg allergy
immunodeficiency
pregnancy
infants

22
Q

How many doses are there of HepB vaccine?

A

2

0, 1, 6 months

23
Q

What is the post- exposure treatment of rabies?

A

BEST GIVEN WITHIN 48 hours

  • provide wound care (tetanus)
  • 4 doses of vaccine: 0, 3, 7, 14
  • human rabies immune globulin
24
Q

What is the incubation period of malaria?

25
Q

What does an incubation period of more than 3 weeks exclude?

A

Arboviruses (dengue) and viral hemorrhagic fevers

26
Q

most common health problems following travel?

A

TD
RTI
Skin problems

27
Q

what are the most life treatening traveler illnesses?

A

Falciparum malaria
Bacterial sepsis
Viral hemorrhagic fever

28
Q

How do you diagnose enteric fever?

A

FBE - normal WCC with left shift
LFT - commonly abnormal
Blood culture - gram negative bacilli, stool culture

29
Q

How do you treat enteric fever?

A

Ceftriaxone

Quinolone

30
Q

Where is Malaria endemic?

A

PNG
India/Pakistan
Africa
Indonesia

31
Q

How is malaria transmitted?

A

Anopheles mosquitoes

32
Q

Which plasmodia infect humans?

A

P. falciparum
P. vivax, P. ovale
P. malariae

33
Q

Why is P. falciparum dangerous?

A

Causes almost all deaths/severe disease
No dormant liver stage, no late relapse
Often drug resistant
MEDICAL EMERGENCY

34
Q

What is important about P. vivax?

A

Produce hypnozoites

Cause late relapse because has a liver phase?

35
Q

What are the symptoms of malaria?

A
  • Not specific
  • Flu-like illness, fever, chills
  • Pain (headache, muscle, back)
  • Fatigue, malaise
  • Nausea, vomiting, diarrhea,
  • Cough
36
Q

what is the mortality of malaria?

37
Q

Factors responsible for death:

A 
Parasitaemia 
Delayed presentation, missed diagnosis 
No prophylaxis 
Extreme of age 
Splenectomy 
Pregnancy
38
Q

How do you diagnose malaria?

A

FBE: might see hemolytic anemia, thromocytopenia

Thick blood smear
Thin blood smear and do parasite count

Antigen capture test: finger prick blood sample.

39
Q

What is the treatment of malaria for vivax and ovale?

A

chloroquine when in blood stage

primaquine for liver stage

40
Q

What is the treatment of malaria for vivax when it is resistant to chloroquine?

A

treat like falciparum

41
Q

What is the first line treatment of P. falciparum?

A

Riamet

Malarone

42
Q

what are the indications for malaria iv therapy?

A
  • cannot tolerate oral therapy
  • altered consciousness
  • > 5% parasitemia
  • Jaundice, oliguria, severe anemia, hypoglycemia, acidosis, ARDS
43
Q

what agents are used for malaria prophylaxis?

A

Chloroquine
Mefloquine
Doxycycline
Malarone

44
Q

How do you catch Dengue?

A

Mosquitoe Flavivirus

45
Q

what are the symptoms of dengue?

A

fever

classic rash

46
Q

how to diagnose?

A

Neutropenia with lymphocytosis
Thrombocytopenia
Mildly raised ALT and AST

4 fold rise in Ab over 2 weeks
Flavivirus PCR

47
Q

What is the management of dengue?

A

symptomatic

supportive

48
Q

Fever + rash? Cause?

A

Dengue
Typhoid
Ricketssia

49
Q

Fever+ diarrhea

A

TD
Malaria
Typhoid

Microbiology and antibiotics (2 decks)

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