Travel Related Infection Flashcards

Question

What is protective of malaria

Answer 1

Sickle cell G6PD Absence of Duffy Ab

Answer 2

Any illness within 1 year but particularly 3 months | Even if had prophyaxis

Answer 3

Thick and thin blood film Will shows species and % parasite >10% = very severe disease Rapid antien test -urine dip

Answer 4

3 -ve over 24 hours

Answer 5

``` FBC Blood glucose Urinanalysis - blood Stool MC+S if diarrhoea CXR - exclude pneumonia Blood culture - typhoid ```

Answer 6

Anaemia Thrombocytopenia Abnormal LFT Abnormal U+E

Answer 7

All patients with Falciparum need admitted as can deteriorate rapidly for IV artesunate ABG 12 lead ECG Clotting screen

Answer 8

``` Sepsis if develop superimposed bacterial ARDS / hypoxia Lactic acidosis AKI DIC - bleeding Severe haemolytic anaemia Hypoglycaemia due to massive stress response and impaired liver gluconeogensis Shock High parasitaemia >2% Haemoglobinuria Cerebral Malaria Blackwater fever ```

Answer 9

Algid malaria | Gram -ve bactaeraemia

Answer 10

Impaired consciousness Convulsions Seizure

Answer 11

``` Severe intravascular haemolysis High parasite % Anaemia Haemoglobinuria Renal failure 2 tubular necrosis ```

Answer 12

``` Oral Artesunate combination therapy (ACT) Riamet 3 days Malarone Quinine Doxycycline ```

Answer 13

IV artesunate IV quinine Oral doxycycline

Answer 14

Pain Nausea Headache

Answer 15

``` Nausea Tinnitus Deaf Rash Neuropsychiatric so CI if history ```

Answer 16

Cardiac depression N+V Cerebral

Answer 17

``` Senior HDU O2 Flud balance May need blood transfusion Dialysis Exchange transfusion Consider CVP monitor Blood glucose regular ECG 4 hourly obs Repeat bloods daily ```

Answer 18

CHloroquine | Primaquine to eradicate liver hyponosites which can remain dormant causing relapsing remitting

Answer 19

Check G6PD deficiency as cause haemolytic

Answer 20

Malarone Doxycycline Mosquito spray and nets

Answer 21

Salmonella typhi | Gram -ve

Answer 22

Faecla oral Poor sanitation Unclean water

Answer 23

``` Headache Fever + relative Brady = think typhoid Arthralgia Cough Abdo pain Constipation Bradycardia + neutropenia ```

Answer 24

``` Fever peaks 7-10 days Rose spots Diarrhoea HSM Tachycardia ```

Answer 25

``` Septicaemia GI bleed Bowel perforation Peritonism OM Cholecystitis Meningitis ```

Answer 26

Blood culture

Answer 27

Culture urine, stool, bone

Answer 28

IV ceftriazone | Vaccine

Answer 29

Dengue fever

Answer 30

Arbovirus / flavivirus Aedes mosquito - Day biter 4 serotypes

Answer 31

``` FEVER / ARTHRALGIA / RASH Fever <2 weeks Headache Arthralgia Maculopapular rash Facial flush Pleuritic pain D+V Pleural effusion and oedema can occur ``` First infection usually self-limiting DevelopAb Further infection though can cause haemorrhagic fever due to Ab depending enhancement

Answer 32

``` Thrombocytopenia causing mouth / nose bleed / PV Peripheral oedema Elevated LFT HSM Jaundice ```

Answer 33

``` Hypotension Brady Pleural effusion and oedema Ascites GI bleed Seizure Altered GCS ```

Answer 34

``` PCR +ve tourniquet test if poor country - Put BP cuff and pump up between D+S - Leave a few minutes - See if petechiae forms ```

Answer 35

Avoid bites Vaccine ``` Supportive Careful fluid Manage acidosis Transfusion / blood products Self-limting ```

Answer 36

Dengue Haemorrhagic Fever Dengue shock syndrome Cause DIC

Answer 37

Fluid FFP Platelets

Answer 38

Tick typhus bite

Answer 39

``` Maculopapular rash Swinging fever Headache COnfusion Bleeding Neck pain Reactive arthritis Vasculitis ```

Answer 40

Doxycycline if severe

Answer 41

Aedes moquito Sexual Blood

Answer 42

``` Usually asymptomatic Headache Rash Fever Malaise Conjunctivitis Joint pain GBS ```

Answer 43

Mosquito control | Vaccine

Answer 44

Microcephaly

Answer 45

Ebola Yellow fever Dengue

Answer 46

Fever within 21 days to endemic country

Answer 47

FEVER BLEEDING Conjunctivitis common as spread through mucosal bleeding If fever + conjunctivitis <21 days = VHF

Answer 48

Low platelet Low WCC Raised LFT Raised PT

Answer 49

``` Fever Fatigue Muscle pain Headache / sore throat D+V Rash Kidney and liver failure Internal and external bleeding ```

Answer 50

Urgent malaria test FBC, U+E, LFT, CRP, Glucose Clotting Culture / PCR

Answer 51

``` DO NOT COME TO SURGERY Public health for support High level isolation Supportive care No RX ```

Answer 52

Rule out life threatening Test malaria same day HIV test where appropriate

Answer 53

Nature - Swinging - Constant - How long Resp Sx - Haemoptysis / chest pain GI - Stool - blood ? - Bloating / appetite / weight loss GU - Urinary Sx and discharge - Any ulcers or lumps - HAEMATURIA Neuro - Headache / confusion / seizure Skin = important - Rash - Ulcers - painless think STI - Swelling - Itch Ocular - Conjunctivitis - VHF? Other - Myalgia / arthralgia - Night sweats - Bleeding ?

Answer 54

``` Lymphadenopathy - Cervical, axillary and inguinal Abdo exam - HSM / tender Eyes - Jaundice - Conjunctival haemorrhage Derm - Eschar - dark crusted bite - Rash Neuro ```

Answer 55

Leptospirosis

Answer 56

Anthrax | Plaque

Answer 57

Incubation

Answer 58

``` COVID Malaria Influenza - don't miss common Dengue Chikungungya Typhoid Ricketsia Plaque ```

Answer 59

VHF Lyme's Brucellosis All above can also present

Answer 60

``` Malaria - Depending on species Hep ABCE HIV Schistomiasis - Katayama Leishmaniasis AMoebeiasis TB ```

Answer 61

``` Recent travel + fever Rash + systemic Sx Malaria Possible TB Known HIV +Ve + unwell ```

Answer 62

``` REFER SECONDARY to exclude differential Bloods in everyone - FBC, U+E, LFT, CRP, clotting and gas - Malaria rapid diagnostic test + thick and thin blood films Serology depending on Hx - Monospot for EBV - Dengue / syphillis / hepatitis / rickettsia Culture as many places - Blood - Urine dip and MC+S - Can send urine for legionella and pneumococcal - Sputum if productvie - Stool CXR Swab - Any ulcer - CVOID +- resp for common DONT FORGET HIV ```

Answer 63

If falciparum present as this can rapid deteriorate