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Infection > Travel Related Infection > Flashcards

Travel Related Infection Flashcards

1
Q

what is malaria transmitted by?

A

the female anopheles mosquito

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2
Q

what organisms causes potentially severe forms of malaria?

A

plasmodium falciparum

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3
Q

name some signs of malaria

A

> none
splenomegaly
mild jaundice
hepatomegaly

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4
Q

name some symptoms of malaria

A 
> fever
> rigors
> aching bones
> abdominal pain
> headache
> dysuria
> frequency
> sore throat
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5
Q

what complications can arise from malaria?

A 
> blackwater fever
> pulmonary oedema
> severe anaemia
> algid malaria (gram negative septicaemia)
> encephalopathy
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6
Q

how is malaria diagnosed?

A

> thick and thin blood films
rapid antigen tests
quantative buffy coats

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7
Q

when assessing the severity of malaria what presentation indicates it is complicated?

A 
> hypoglycaemia
> impaired consciousness
> haemoglobinuria
> renal impairment
> pulmonary oedema
> shock
> spontaneous bleeding
> ?haem <8mg?
> parasite count 2% or more
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8
Q

how do you treat uncomplicated p. falciparum malaria?

A

> riamet 3 days
euratesim 3 days
malarone 3 days
quinine 7 days + oral doxycycline

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9
Q

how would you manage complicated severe p. falciparum?

A

> IV quinine + oral doxycycline

> IV artesunate

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10
Q

how would you manage vivax/ovale/malariae/Knowles malaria?

A

> chloroquine 3 days

> riamet 3 days (+ primaquine in ovale/vivax)

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11
Q

what methods of control exist to tackle malaria?

A

> draining standing water
larvicides
mosquito killing spray
behaviour (nets and mesh windows)

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12
Q

what is responsible for causing typhoid fever?

A

> salmonella typhi and paratyphi

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13
Q

what is the incubation period for typhoid fever?

A

7 days to 4 weeks

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14
Q

how does typhoid fever present in the 1st week?

A 
> fever
> confusion
> abdominal discomfort
> headache
> constipation
> dry cough
> relative bradycardia
> neutrophilia
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15
Q

how does typhoid fever present in the 2nd week?

A 
> fever peaks at 7-10 days
> rose spots
> diarrhoea begins
> tachycardia
> neutropenia
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16
Q

what complications can occur in the 3rd week of typhoid fever?

A

> intestinal bleeding
perforation
peritonism
metastatic infections

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17
Q

what percentage of patients relapse in typhoid fever?

A

10-15%

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18
Q

how is typhoid fever diagnosed?

A

> clinically by evaluating features

> culture of urine, blood, stool and bone marrow

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19
Q

how is typhoid fever managed?

A

> oral azithromycin in Asian uncomplicated TF

> IV ceftriaxone in complicated TF

20
Q

what transmits dengue fever?

A

aedes aegypti

21
Q

how does dengue fever present?

A 
> sudden fever
> severe headache (retro orbital pain)
> myalgia
> arthralgia
> macular popular rash
> haemorrhagic signs (petechiae, purpura)
22
Q

how is dengue fever diagnosed?

A 
> clinically:
   leukopenia
   thrombocytopenia
   elevated transaminase
   positive tourniquet test

> lab:
serology
PCR

23
Q

what are some complications of dengue fever?

A

> dengue haemorrhagic fever

> dengue shock syndrome

24
Q

how is complicated dengue fever treated?

A

> IV fluids
plasma
platelets

25
Q

how can dengue fever be prevented?

A

> avoiding bites

> vaccine (limited)

26
Q

how is schistosomiasis transmitted?

A

via fresh water snail, the parasite then penetrates the skin and travels to the portal vein

27
Q

name the parasites that cause schistosomiasis

A

> s. haematobium
s. mansoni
s. japonicum

28
Q

what are the symptoms of schistosomiasis in the first few hours?

A

swimmers itch that clears in 48 hours

29
Q

how does the invasive stage of schistosomiasis present?

A

> abdominal discomfort
cough
splenomegaly
eosonophillia

30
Q

describe the katayama fever stage in schistosomiasis

A 
> 15-20 days
> fever
> urticaria
> diarrhoea
> lymphadenopathy
> eosinophilia
31
Q

how does acute schistosomiasis disease present?

A

> 6-8 weeks
dysentery (with eggs in bowel)
haematuria

32
Q

how is schistosomiasis diagnosed?

A

> clinically
ova in stools
rectal strip
antibody test

33
Q

how is schistosomiasis treated?

A

> praziquantel

> prednisolone

34
Q

what information would you want from a returning traveller who has a fever?

A

> other symptoms
where they went to
precautions they took

35
Q

a returning traveller with a fever also presents with a rash.
give 3 differential diagnoses

A

> typhoid fever
typhus
dengue

36
Q

a returning traveller with a fever also presents with jaundice.
give 3 differential diagnoses

A

> yellow fever
malaria
hepatitis

37
Q

a returning traveller with a fever also presents with enlarged lymph nodes.
give 2 differential diagnoses

A

> leishmania

> trypanosomiasis

38
Q

a returning traveller with a fever also presents with liver signs.
give 3 differential diagnoses

A

> malaria
typhoid
amoebic abscess

39
Q

a returning traveller with a fever also presents with splenic signs.
give 3 differential diagnoses

A

> typhoid
malaria
visceral leishmiasis

40
Q

what investigations would you want to carry out in a returning traveller with a fever?

A 
> FBC
> LFT's
> malaria films
> urinalysis and culture
> stool microscopy and culture
41
Q

what are the clinical features of rickediosis (tick typhus)?

A 
> abrupt onset swinging fever
> headache
> bleeding
> confusion
> endovasculitis
> rash (petechial and macular)
42
Q

how is rickediosis treated?

A

tetracycline

43
Q

what infections can cause viral haemorrhagic fever?

A

> Ebola
lassa-fever
Marburg disease
congo-crimea haemorrhagic fever

44
Q

what is the max incubation time for viral haemorrhagic fever?

A

3 weeks

45
Q

how does zika present?

A 
> fever
> rash
> headache
> malaise
> conjunctivitis
> joint pain
> microcephaly
> gaulliane barre syndrome

Infection (13 decks)

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