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BPT Infectious Diseases > Travel Medicine > Flashcards

Travel Medicine Flashcards

1
Q

What is the most common cause of fever in a returned traveller from Sub Saharan Africa?

A

Malaria

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2
Q

What is the most common cause of fever in a returned traveller from SE Asia?

A

Dengue

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3
Q

What is the most common cause of fever in a returned traveller from South Central Asia?

A

Enteric fever

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4
Q

What travel infections have an incubation period < 10 days?

A

Dengue, influenza, zika

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5
Q

What travel infections have an incubation 10-21 days?

A

Malaria, viral haemorrhagic fever, typhoid

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6
Q

What travel infections have an incubation period > 21 days?

A

Malaria, hepatitis, TB

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7
Q

How many times do you need to test for malaria?

A

Usually at least 3 times

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8
Q

Which are the main live vaccines?

A

MMR, yellow fever, BCG, varicella/zoster

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9
Q

What are the 5 parasitic amoeba that cause malaria?

A

p. falciparum, p. vivax, p. ovale, p. malariae, p. knowlesi

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10
Q

What is the most common cause of severe malaria?

A

p. falciparum

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11
Q

What diagnostic tests can be done for malaria?

A

Thick and thin blood films or antigen based rapid diagnostic tests

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12
Q

What are the clinical features of severe malaria?

A

Anaemia, jaundice, seizures, AKI, shock, impaired consciousness

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13
Q

What is the treatment for severe malaria?

A

IV artesunate with supportive treatment

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14
Q

Where is there artemisinin resistance?

A

Border between Thailand and Cambodia

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15
Q

What gene gives resistance of artemisinin?

A

Kelch gene on chromosome 13

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16
Q

Why do patients with p. vivax and p. ovale get relapse?

A

Because the life cycle contains dormant hyponozoites

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17
Q

What is the treatment for dormant hyponozoites?

A

Primaquine for 7-14 days

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18
Q

Who can’t be treated with primaquine?

A

Patients with G6PD deficiency

19
Q

What parasite density causes severe malaria?

A

> 10%

20
Q

What is the incubation period for typhoid?

A

5-21 days

21
Q

What is the classic presentation for typhoid?

A

Week 1: rising fever and relative bradycardia
Week 2: abdo pain and rose spots
Week 3: septic shock, intestinal perforation, hepato-splenomegaly

22
Q

What investigations should be done for typhoid?

A

Blood and stool cultures

23
Q

What is the sensitivity of blood cultures for typhoid?

A

50%

24
Q

What is the treatment for typhoid?

A

Azithromycin or ceftriaxone

Dexamethasone in severe infection

25
Q

What is the treatment for typhoid acquired in Pakistan?

A

Carbapenem

26
Q

What is the treatment for chronic carriage of typhoid?

A

Ciprofloxacin 500mg BD for 4/52

27
Q

What type of virus is dengue?

A

Flavivirus

28
Q

What type of virus is chikungunya?

A

Alpha virus

29
Q

What is the transmission for dengue?

A

Mostly from mosquitos

Can also be via blood transfusion, organ transplant, needle stick, mucosal splashes`

30
Q

Is there vertical transmission of dengue?

A

Yes if mother is viraemic at delivery

31
Q

What is the incubation period of dengue?

A

4-10 days`

32
Q

What are the classical symptoms of dengue?

A

High fever, malaise, headache, GI disturbance, aches and pains
May have transient macular rash

33
Q

What are the complications of dengue?

A

Vasculopathy (IV volume depletion), myocarditis, bradycardia, hepatitis, encephalitis, GBS, retinal vasculopathy, optic neuropathy

34
Q

What are the common laboratory findings for dengue?

A 
Thrombocytopaenia
Leukopaenia
Neutropaenia
Elevated APTT
Decreased fibrinogen
Increased transamimase AST > ALT
35
Q

What are the diagnostic tests for dengue?

A

Before day 5 – PCR or NS1 antigen

After day 5 serology

36
Q

What is the management for dengue?

A

Symptomatic care

37
Q

Who should the dengue vaccine be given to?

A

Seropositive patients living in endemic areas

38
Q

What is the incubation perod for zika?

A

3-14 days

39
Q

What are the most common symptoms of zika?

A

Usually asymptomatic

Can have rash, pruritus, headache, arthralgia, myalgia, conjunctivitis, fever

40
Q

What are the complications of zika?

A

GBS

Congenital infection – microcephaly, macular scarring/retinal mottling, congenital contractures, hypotonia

41
Q

What is the incubation period for chikungunya?

A

1-12 days

42
Q

What are the clinical features of acute phase chikungunya?

A

Fever, itchy rash, severe symmetrical distal joint pain, headache, myalgia, conjunctivitis, GI symptoms

43
Q

What is the treatment for chikungunya?

A

Analgesia

44
Q

What is chronic chikungunya?

A

Joint stiffness and pain lasting > 3 months

BPT Infectious Diseases (9 decks)

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