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MD2 Intersession 1 > Travel Medicine > Flashcards

Travel Medicine Flashcards

1
Q

What pre-travel advice should be considered?

A 
Consider route of transmission of different infections
Discuss appropriate behavioural advice
Non-infectious risks
Vaccination
- Update routine
- Travel-related considerations
Medications; eg:
- Malaria prophylaxis
- Rx for travellers' diarrhoea
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2
Q

What pre-travel advice should be considered concerning food?

A

Raw food high risk

Avoid food from street vendors

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3
Q

What pre-travel advice should be considered concerning water?

A 
If chlorinated tap water unavailable/sanitation poor, stick to
- Beverages made with boiled water
- Cans and bottles
- Beer and wine
Avoid
- Ice
- Brushing teeth with tap water
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4
Q

What general preventative advice should be considered concerning vector-borne infections?

A

Minimise exposure
- Sleep in screened and/or air conditioned room
- Avoid outside activities, especially between dusk and dawn
- Cover arms and legs
- Insect repellents = DEET
- Permethrin impregnated clothing/mosquito nets
- Insecticide aerosol in room
Malaria prophylaxis

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5
Q

Which vaccines are live vaccines?

A

“MOBY-JeVRT” mnemonic

  • M = MMR
  • O = oral polio
  • B = BCG
  • Y = yellow fever
  • Je = new Japanese encephalitis
  • V = Varicella
  • R = Rotavirus
  • T = oraly typhoid
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6
Q

What is travellers’ diarrhoea?

A

3+ loose stools/day
Begins abruptly
Generally self-limited
- Most resolve within 1-2 days

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7
Q

What is the most commonly identified causative agent of travellers’ diarrhoea?

A

Enterotoxigenic E coli (ETEC)

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8
Q

What are the most common causes of watery travellers’ diarrhoea?

A

ETEC

Viral cholera

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9
Q

What are the most common causes of bloody travellers’ diarrhoea?

A

Shigella
Salmonella
Campylobacter
Entamoeba histolytica

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10
Q

What defines chronic travellers’ diarrhoea?

A

Usually >2 weeks

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11
Q

What is the common cause of chronic travellers’ diarhroea?

A

Parasites; eg: Giardia

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12
Q

What defines severe travellers’ diarrhoea?

A

Any of

  • > 7 bowel movements/day
  • Blood in stool
  • > 3 days without improvement
  • Fever
  • Abdominal pain
  • Chills
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13
Q

What is the management for travellers’ diarrhoea?

A

Rehydration with oral rehydration solution
Anti-diarrhoeal; eg: loperamide - symptom control
Empirical self-treatment for moderate-to severe cases
- Most places: azithromycin
- Few places: quinolone; eg: ciprofloxacin

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14
Q

What are the most common syndromes in the unwell returned traveller?

A 
Travellers' diarrhoea
Respiratory tract infections
Skin problems
- Infections
- Rashes
- Bites
Febrile illnesses
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15
Q

What points should be covered in a travel history?

A 
Destination
Duration
Type of activity and exposures
Symptom onset/incubation period
Pre-travel vaccines
Chemoprophylaxis
- Compliance
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16
Q

What are the symptoms of malaria?

A 
Initially resembles flu-like illness
Fever and chills
Pain
- Headache
- Muscles
- Back
Fatigue
Malaise
Nausea
Vomiting
Diarrhoea
Cough
17
Q

What investigations are used to diagnose malaria?

A 
FBE
- May be haemolytic anaemia
- WCC normal
- Thrombocytopaenia
Thick blood smear
Thin blood smear
- Species ID
Ag capture tests
- Dipstick tests: finger-prick blood sample
18
Q

What is the treatment for malaria?

A 
Blood stage = chloroquine
Liver stage (eg: vivax) = primaquine
19
Q

What are the options for malaria prophylaxis?

A

Mefloquine
Doxycycline
Malarone

20
Q

What are the causative agents of enteric fever?

A

Salmonella typhi

S paratyphi

21
Q

What are the symptoms of enteric fever?

A

Non-specific febrile illness
+/- diarrhoea/constipation
Sometimes a rash

22
Q

What is the treatment for enteric fever?

A

Ceftriaxone

Azithromycin

23
Q

What is the causative agent of dengue fever?

A

Flaviviruses, spread by mosquitoes

24
Q

What are the possible bacterial causes of fever in a returned traveller?

A 
Enteric fever
Meningococcus
Pneumococcus
Rickettsial
Zoones
25
Q

What are the possible parasitic causes of fever in a returned traveller?

A

Malaria
Schistisomiasis
Amoebic liver abscess

26
Q

What are the possible viral causes of fever in a returned traveller?

A

Dengue
Influenza
Other respiratory viruses
Hepatitis

27
Q

Which vaccines are compulsory when travelling to certain endemic areas?

A 
Yellow fever
Travellers to Hajj
- Meningococcal vaccine
- Pneumococcal vaccine
- Seasonal influenza
Travellers on working holidahs
- BCG
28
Q

Which serotypes are covered in the meningococcal vaccine?

A

A
C
W
Y

MD2 Intersession 1 (5 decks)

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