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Infection 2023 > Travel related infection > Flashcards

Travel related infection Flashcards

1
Q

Why are travel infections more prevalent?

A 
Exotic destinations
More comorbidities
War/natural disasters
Migration
Emerging infections
Accidents abroad
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2
Q

Important factors to consider

A 
Calendar time (certain infections prevalent at certain times of the year)
Relative time (incubation period can allow some to be ruled out)
Place (important infections)
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3
Q

Bacterium associated with travel

A

Rickettsia

Spirochaete

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4
Q

Parasites associated with travel

A

Protozoa (Malaria)

Helminths (worm)

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5
Q

Why is travel history important?

A 
Different strains - present differently
Antibiotic resistance (less strict policies)
Prevent infection (to ward and lab workers)
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6
Q

Key places where encounter pathogens abroad

A

Sub-saharan Africa
SE Asia
S/C America

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7
Q

Acute incubation/onset

A

<10 days

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8
Q

Subacute onset

A

10-21 days

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9
Q

Chronic onset

A

> 21 days

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10
Q

What is eosinophilia a sign of?

A

Allergy

Parasite infection

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11
Q

Different signs/symptoms of travel illness

A 
Resp: SOB/Cough
GI: Diarrhoea
Skin: Rash
Jaundice (Liver/RBC breakdown?)
CNS: headache/meningism
Haematological (spleno/hepatomegaly/lymphadenopathy)
Eosinophilia
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12
Q

Ways of acquiring travel infections

A 
Food/water
Insect bite/tick
swimming
sexual
Animal contact
Recreational activates (eg caving = fungal risk)
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13
Q

Rodents = risk for

A

Leptospirosis

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14
Q

Tick bite = risk for

A

Rickettsia (AND game parks)

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15
Q

Dead slaughtered = risk for

A

Anthrax

Ebola

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16
Q

Farm = risk for

A

Q-Fever

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17
Q

Fresh water = risk for

A

Schistosomiasis

Leptospirosis

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18
Q

Caves = risk for

A

Histoplasmosis

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19
Q

Unpasteurised dairy

A

Brucellosis

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20
Q

Malaria patient presentation

A 
High temp
Low BP
Tachycardia 
Low O2 sats
Confusion
Icterus (jaundice of eyes)
Bite marks 
Hepatosplenomegaly
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21
Q

FCB malaria

A

Anaemic
WCC low
Platelets low

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22
Q

Biochem malaria

A 
Urea high
creatinine high
bilirubin high
Liver ALT and ALP = normal
CRP high
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23
Q

ADDITIONAL test malaria

A

BLOOD FILMS = show presence of parasite

headphones

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24
Q

5 main species of malaria

A 
Plasmodium:
falciparum
vivax
ovale
malariae
knowlesii
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25
Q

Vector malaria

A

Female Anopheles Mosquito

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26
Q

Malaria incubation

A

Minimum 6 days
Falciparum: 4 weeks
Vivax/ovale: 1 year+

27
Q

History malaria

A

fever, chills and sweats (3rd/4th day)

28
Q

Examination malaria

A

Few signs

Bites/splenomegaly

29
Q

Cardiovascular severe malaria

A

Tachycardia
Hypotension
Arrhythmias

30
Q

Respiratory severe malaria

A

ARDS

31
Q

GI severe malaria

A 
Diarrhoea 
LFT's deranged
Bilirubin high (haemolysis)
32
Q

Renal severe malaria

A

Acute kidney injury

33
Q

CNS severe malaria

A

Confusion/fits

34
Q

Blood severe malaria

A

Low/normal WBC
Thrombocytopenia
DIC

35
Q

Metabolic severe malaria

A

Metabolic acidosis

Hypoglycaemia

36
Q

Life cycle malaria

A

Mosquito gut–> salivary gland and bites human
Salivary gland of mosquito –> liver of human = sporozoite (exoerythrocytic)
Liver schizont then merozoites –> blood (erythocytic and haemolysis)
Back to mosquito via gametocytes

37
Q

Malaria investigations/tests

A 
3x blood film
FBC 
U&E
LFT
Glucose
Coagulation
CT scan (cerebral oedema?)
Chest X ray (pulmonary oedema?)
38
Q

Treatment P.falciparum

A

Artesunate

OR Quinine + doxycycline

39
Q

Treatment P. vivax, ovale, malariae

A 
Chloroquine
Additional primaquine (for dormant hypnozoites in liver)

dormant can cause recurrent malaria

40
Q

Prevention of malaria

A 
Know high risk area
Bite prevention (repellent, clothing, bed nets)
Chemoprophylaxis (continue after returning)
41
Q

Typhoid/paratyphoid (enteric fever) presentation

A

slightly anaemic
low WCC
high CRP
abdominal discomfort

42
Q

Blood culture typhoid/paratyphoid

A

Gram -ve bacilli
Salmonella typhi/paratyphi

(paratyphi A, B or C type)

43
Q

Virulance factors salmonella typhi/paratyphi

A

Low infectious dose
Survives gastric acid
Fimbriae adhere to epithelial over lymphoid tissue (peyers patches)
Reside within macrophages

44
Q

Signs and symptoms enteric fever

A

Systemic disease (sepsis/bacteraemia)
Incubation period: 7-14 days
fever, headache, abdominal discomfort, dry cough
BRADYCARDIA

45
Q

Complications enteric fever

A

Intestinal haemorrhage/perforation
10% mortality
Chronic carrier

46
Q

Which is milder paratyphoid/typhoid?

A

PARA

47
Q

Enteric fever investigation results

A

Moderate anaemia
Lymphopaenia
Mild raised LFT’s
Blood culture and faeces/bone marrow

48
Q

Treatment enteric fever

A 
Multi drug resistant (to penicillin)
Fluoroquinalones Ciprofloxacin (maybe but some resistant)
IV Ceftriaxone (cephalosporin)
Azithromycin (macrolide)
49
Q

If enteric is resistant to cetriaxone?

A

Meropenem

50
Q

Prevention enteric fever

A

Food and water hygiene precautions

Typhoid vaccine

51
Q

Non typhoidal salmonella symptoms

A

Food poisoning

diarrhoea, vomiting, abdo pain

52
Q

Non typhoidal salmonella eg

A

S typhimurium

S enteritidis

53
Q

Fever and rash causes

A 
Childhood viruses (measles, rubella, parvovirus)
Infectious mononucleosis (EBV/CMV)
Acute HIV
Rickettsia (spotted fever)
Dengue fever
54
Q

Investigations / signs dengue fever

A

severe myalgia
headache
Dengue PCR +ve
Rash

55
Q

What virus is dengue? Where is it found?

A

Arbovirus - aedes mosquito

Tropical/subtropical regions

56
Q

Range of infections dengue

A

4 serotypes
1st infection = asymptomatic/simple rash (classic dengue) only need supportive treatment

REinfection with new serotype = haemorrhagic/shock syndrome

57
Q

What is reinfection dependent on?

A

Antibody dependent enhancement (need to have had dengue before)

58
Q

What is Myiasis?

A

Fly larvae inside skin (tumbu/bot fly)

hang washing out, fly lays eggs, wear clothes and eggs burrow into skin and hatch

59
Q

Emerging diseases

A

Influenza pandemics
SARS Cov
MERS
SARS Cov 2

60
Q

Ebola

A

Viral haemorrhagic fever
Filovirus
50% mortality rate

61
Q

Symptoms ebola

A 
Flu like
Vomiting 
Confusion
Diarrhoea
Rash
Internal/external bleeding
62
Q

Ebola spread

A

Direct contact with bodily fluids

63
Q

Zika virus type and risk

A

Arbovirus (like dengue is)
Aedes mosquito and Sexual transmission
Congenital microcephaly, foetal loss

64
Q

Malaria order of cells

A

Sporozoite in liver
Matures into schizont
Then merozoites
Mosquito reinfected via gametocytes

Infection 2023 (29 decks)

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