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Year 3 > Travel Related Infection > Flashcards

Travel Related Infection Flashcards

1
Q

what are the unfamiliar features of imported disease?

A 
presenting features
isolation requirements
diagnostic methods
treatment/management
unexpected complications
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2
Q

how are travellers at risk of infection?

A

temptation to take risks away from home
different epidemiology of some diseases
incomplete understanding of health hazards
stress of travel
refugees - deprivation, malnutrition, disease, injury

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3
Q

name some infections that are common worldwide

A

influenza
community acquired pneumonia
meningococcal disease
STI

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4
Q

name some climate or environment related health problems

A 
sunburn
heat exhaustion and heatstroke
fungal infections
bacterial skin infections
cold injury
altitude sickness
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5
Q

infections controllable by public health measures: sanitation

A
  • Traveller’s diarrhoea
  • Typhoid
  • Hepatitis A or E
  • Giardiasis
  • Amoebiasis
  • Helminth infections
  • Viral gastroenteritis
  • Food poisoning
  • Shigella dysentery
  • Cholera
  • Cryptosporidiosis
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6
Q

infections controllable by public health measures: immunisation

A

poliomyelitis

diphtheria

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7
Q

infections controllable by public health measures: education

A

HIV

STIs

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8
Q

name some water related infections

A
  • Schistosomiasis
  • Leptospirosis
  • Liver flukes
  • Strongyloidiasis
  • Hookworms
  • Guinea worms
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9
Q

name some arthropod-borne infections and their vector

A
  • Malaria (mosquitos)
  • Dengue fever (mosquitos)
  • Rickettsial infections (ticks: typhus)
  • Leishmaniasis (sand flies: Kala-azar)
  • Trypanosomiasis (tsetse fly: sleeping sickness)
  • Filariasis (mosquitos: elephantiasis)
  • Onchocerciasis (black flies: river blindness)
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10
Q

name some emerging infectious diseases and where

A
  • Zika: Latin America, Caribbean
  • Ebola virus disease: West Africa
  • MERS-CoV: Middle East
  • Swine ‘flu (H1N1): worldwide
  • Avian ‘flu (H5N1 and H7N9): China
  • SARS: Far East, worldwide
  • West Nile Virus: USA
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11
Q

what is the malaria vector?

A

female Anopheles mosquito

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12
Q

name the 5 species of malaria

A 
plasmodium falciparum
plasmodium vivax
plasmodium ovale
plasmodium malariae
plasodium knowlesi
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13
Q

clinical features of malaria: symptoms

A 
fever
rigors
aching bones
abdo pan
headache
dysuria
frequency
sore throat
cough
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14
Q

clinical features of malaria: signs

A

none
splenomegaly
hepatomegaly
mild jaundice

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15
Q

list complications of malria

A 
cerebral malaria (encephalopathy)
blackwater fever
pulmonary oedema
jaundice
severe anaemia
algid maria
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16
Q

who is vulnerable to cerebral malaria (encephalopathy)?

A

non-immune visitors

children in endemic areas

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17
Q

what does cerebral malaria (encephalopathy) cause?

A

hypoglycaemia
convulsions
hypoxia

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18
Q

what is blackwater fever

A 
severe intravascular haemolysis
high parasitaemia
profiund anaemia
haemoglobinuria
acute renal failure
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19
Q

what kind of septicaemia (gram +ve/-ve) does algid malaria produce?

A

gram -ve

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20
Q

diagnosi of malaria

A

thick and thin blood films - Giemsa, Field’s stain
Quantitative buff coat
Rapid antigen tests - OptiMal, ParaSight-F

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21
Q

for complicated malaria you need one or more of:

A 
impaired consciousness or seizures
hypoglycaemia
parasite count >= 2%
haemoglobin <= 8mg/dl
spontaneous bleeding/DIC
haemoglobinuria
pH < 7.3
pulmonary oedema or ARDS
shock
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22
Q

SE of quinine

A 
nausea
tinitus
deafness
rash
hypoglycaemia
IV - cardiac depression , cerebral irritation
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23
Q

treatment of uncomplicated p falciparum

A

riamet 3 days
euratesim 3 days
malarone 3 days
quinine 7 days plus oral doxycycline or clindamycin

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24
Q

treatment of complicated or severe p falciparum

A 
IV artesunate (unlicensed in UK)
IV quinine + oral doxy/clindamycin
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25
Q

treatment of p vivax, p ovale, p malariae, p knowlesi

A

chloroquine 3 days
riamet 3 days
add primaquine 14 days in vivax and ovale to eradicate liver hypnozoites

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26
Q

when giving primaquine which exzyme do you need to check for deficiency in?

A

G6PD

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27
Q

what organisms cause enteric fever?

A

salmonella typhi

salmonella paratyphi

28
Q

clinical features of enteric fever: incubation period

A

7 days - 4 weeks

29
Q

clinical features of enteric fever: 1st week

A 
fever 
headache
abdo pain
constipation
dry cough
relative bradycardia
neutrophilia
confusion
30
Q

clinical features of enteric fever: 2nd week

A 
fever peaks at 7-10 days
rose spots
diarrhoea begins
tachycardia
neutropneia
31
Q

clinical features of enteric fever: 3rd week (complications)

A

intestinal bleeding
perforation
peritonism
metastatic infection

32
Q

diagnosis of enteric fever: clinical

A

not easy

based on evolution of features

33
Q

diagnosis of enteric fever: lab

A

culture blood, urine, stool

culture bone marrow

34
Q

treatment of enteric fever

A

oral azithromycin

IV ceftriaxone

35
Q

clinical features of dengue fever

A 
sudden fever
severe headaches, retro-orbital pain
severe myalgia and arthralgia
macular/maculopapular rash
haemorrhagic signs - petechiae, purpura, positive tourniquet test
36
Q

diagnosis of dengue fever: clinical

A

thrombocytopenia
leukopenia
elevated transaminases
positive tourniquet test

37
Q

diagnosis of dengue fever: lab

A

PCR

Serology

38
Q

management of dengue fever

A

no specific
IV fluids
fresh frozen plasma
platelets

39
Q

complication sof dengue fever

A

dengue haemorrhagic fever

dengue shock syndrome

40
Q

prevention of dengue fever

A

avoid bites

new vaccine - dengvaxis

41
Q

where is schistosomiasis found?

A

freshwater

freshwater snails

42
Q

what organisms can cause schistosomiasis ?

A

schistosoma haematobium

s. mansoni
s. japonicum

43
Q

clinical features of schistosomiasis: 1st few hours

A

swimmers itch clears after 24-48 hrs

44
Q

clinical features of schistosomiasis: invasive stage > 24 hrs

A

cough
abdo discomfort
splenomegly
eosinophilia

45
Q

clinical features of schistosomiasis: karaymama fever (15-20 days)

A 
prostrate
fever
urticaria
lymphadenopathy
splenomegaly
diarrhoea
eosinophilia
46
Q

clinical features of schistosomiasis: acute disease (6-8 weeks)

A

eggs deposited in bowel (dysentery) or bladder (haematuria)

47
Q

diagnosis of schistosomiasis

A

clinical diagnosis
antibody tests
ova in stools and urine
rectal snip

48
Q

treatment of schistosomiasis

A

praziquantel 20mg/kg, two doses 6 hrs apart

prednisolone if severe

49
Q

organisms and diseases of rickettsiosis

A 
tick typhus - r. conorrii, r. africae
rocky mountain spotted fever - r. rickettsi
endemic typhus - r. prowazeki
murine or endemic typhus - r. mooseri
scrub typhus - r, tsutsugamushi
50
Q

what type of rickettsiosis is most common imported to the UK?

A

tick typhus

51
Q

where does tick typhus come from?

A

Southern Africa
Mediterranean
Arabian Gult

52
Q

signs and symptoms of tick typhus

A 
abrupt onset swinging fever
headache
confusion endovasculitis
rash (macular, petechial)
bleeding
53
Q

diagnosis of tick typhus

A

clinical features

serology

54
Q

treatment of tick typhus

A

tetracycline

55
Q

give examples of viral haemorrhagic fevers

A

ebola
congo-crimea haemorrhagic fever
lassa fever
marburg disease

56
Q

what is the maximum incubation period for viral haemorrhagic fevers?

A

3 weeks

57
Q

what is the treatment for viral haemorrhagic fevers?

A

supportive

58
Q

what type of virus is zika?

A

flavivurus

59
Q

how is zika transmitted?

A

daytime biting Aedes mosquito
sexual contact
blood transfusion

60
Q

what is Zika related to?

A

dengue
yellow fever
Jap B encephalitis
West Nile virus

61
Q

clinical features of zika

A 
mild or no symptoms
headache
rash 
fever malaise
conjunctivitis
joint pains
Guillain-Barre syndrome
62
Q

in pregnancy what can zika cause?

A

microcephaly and other neurological problems

63
Q

returned traveller. what diseases cause rash?

A

typhoid
thypus
dengue

64
Q

returned traveller. what diseases cause jaundice?

A

hepatitis
malaria
yellow fever

65
Q

returned traveller. what diseases cause lymph nodes?

A

leishmania

trypanosomiasis

66
Q

returned traveller. what diseases cause hepatomegaly?

A

malaria
typhoid
amoebic abscess

67
Q

returned traveller. what diseases cause spleenomegaly?

A

visceral leishmaniasis
typhoid
malaria

Year 3 (164 decks)

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