Travel medicine AB

Question 1

MERS Coronavirus - incubation period?

Answer 1

5-9 days

Question 2

MERS Coronavirus - clinical features?

Answer 2

Fevers, chills, rigors
Pneumonia, ARDS
Arthralgias, myalgias
Diarrhoea
Lymphopaenia, thrombocytopaenia
High LDH

Question 3

MERS-CoV - what is the treatment in severe cases?

Answer 3

Interferon alpha 2b

Ribavirin

Question 4

MERS-CoV - investigations?

Answer 4

PCR

Also lymphopaenia, thrombocytopaenia, high LDH

Question 5

Whipple’s disease - clinical features?

Answer 5

Migratory large joint arthralgias
Weight loss
Diarrhoea
Abdominal pain

Also dementia, eye signs, fever, skin signs, culture negative endocarditis, pleural effusions

Question 6

Whipple’s disease - diagnosis?

Answer 6

Small bowel biopsy or PCR

Question 7

Whipple’s disease - treatment?

Answer 7

Ceftriaxone then long term Bactrim

Question 8

Dengue - incubation period?

Answer 8

3-10 days

Question 9

Dengue - features of severity?

Answer 9

Plt

Question 10

Dengue - laboratory findings?

Answer 10

Early leucopaenia (most specific lab abnormality in early)
Thrombocytopaenia 
Mildly raised ALT, AST

Question 11

Typhoid - what is the micro?

Answer 11

Salmonella - aerobic, gram negative rods

Question 12

Typhoid - incubation?

Answer 12

1-4 weeks

Question 13

Typhoid - clinical?

Answer 13

Constipation
Abdo pain
Hepatosplenomegaly
Rose spot rash
Relative bradycardia

Potentially misleading symptoms (meningism)

Question 14

Typhoid - how many become chronic carriers?

Answer 14

25% (>1 year)

Persistence of bacteria in biliary tree

Question 15

Typhoid - laboratory findings?

Answer 15

Leukopaenia, anaemia, LFT derangement

Blood cultures Sn 40-80%

Question 16

Typhoid - treatment?

Answer 16

Cipro or Ceftriaxone for 14 days

Dexamethasone if severe

Question 17

Typhoid - complications?

Answer 17

Chronic carriage (assoc gallbladder ca)
GI bleeding, perforation
Acalculus cholecystitis
Endovascular
Osteomyelitis

And about a billion other things