Travel related infection

Question 1

climate or environment related health issues

Answer 1

sunburn,
heat exhaustion and heatstroke, 
fungal infections, 
bacterial skin infections, 
cold injury, 
altitude sickness

Question 2

public health measures to control infections?

Answer 2

sanitation eg typhoid, cholera,
immunisation eg diptheria, poliomyelitis,
education eg HIV, STDs

Question 3

examples of water-related infections

Answer 3

schistosomiasis, 
leptospirosis, 
liver flukes, 
strongyloidiasis, 
hookworms, 
guinea worms

Question 4

examples of arthropod-borne infections?

Answer 4

malaria, 
dengue fever,
rickettsial infections, 
leishmaniasis, 
trypanosomiasis, 
filariasis, 
onchocerciasis

Question 5

what is the malaria vector?

Answer 5

female anopheles mosquito

Question 6

the severe malaria species?

Answer 6

plasmodium falciparum

Question 7

symptoms of malaria?

Answer 7

fever, 
rigors, 
aching bones, 
abdo pain,
headache, 
dysuria, 
frequency, 
sore throat, 
cough,

Question 8

signs of malaria

Answer 8

splenomegaly,
hepatomegaly,
mild jaundice

Question 9

complications of malaria?

Answer 9

cerebral malaria (encephalopathy),
blackwater fever,
pulmonary oedema, 
jaundice, 
severe anaemia, 
algid malaria

Question 10

what is blackwater fever?

Answer 10

complication of malaria,

causes severe intravascular haemolysis, high parasitaemia, profound anaemia, haemoglobinuria, acute renal failure

Question 11

presentation of cerebral malaria?

Answer 11

encephalopathy,

arching of back

Question 12

investigations for malaria?

Answer 12

thick and thin blood films,
quantitative buffy coat,
rapid antigen tests

Question 13

what is the severity assessment for malaria?

Answer 13

complicated malaria = 1 or more of:

impaired consciousness or seizures, 
hypoglycaemia, 
parasite count >1%,
haemoglobin <9mg/dL,
spontaneous bleeding /DIC,
haemoglobinuria, 
renal impairment or pH <7.3,
pulmonary odema or ARDS,
shock

Question 14

treatment for uncomplicated malaria?

Answer 14

riamet (3 days),
or eurartesim (3 days),
or malarone (3 days),
or quinine (7 days) + oral doxycyline

Question 15

treatment options for complicated or sever p.falciparum malaria?

Answer 15

IV artesunate,

IV quinine + oral doxycyline

Question 16

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

Answer 16

chloroquine 3 days,
riamet 3 days,
primaquine (added in vivax and ovale to erradicate liver hypnozoites)

Question 17

malaria control programmes

Answer 17

draining standing water- mosquito breeding sites,
larvacides, 
mosquito killing sprays, 
bed nets, 
mesh windows

Question 18

organism responsble for typhoid fever?

Answer 18

salmonella typhi,

salmoneela paratyphi

Question 19

typhoid fever week 1 presentation

Answer 19

fever, 
headache, 
abdo discomfort, 
constipation, 
dry cough, 
bradycardia, 
neutrophilia, 
confusion

Question 20

typhoid fever week 2 presentation

Answer 20

fever peaks,
rose spots, 
diarrhoea,
tachycardia,
neutropenia

Question 21

typoid fever week 3 presentation (complications)

Answer 21

intestinal bleeding,
perforation,
peritonism,
metastatic infections

Question 22

investigations for typhoid fever?

Answer 22

culture blood,
culture urine,
culture stool,
culture bone marrow

Question 23

typhoid fever treatment?

Answer 23

oral azithromycin,

iv ceftriaxone

Question 24

dengue fever presentation

Answer 24

sudden fever,
severe headache, retro-orbital pain, 
severe myalgia and arthralgia,
macular/ maculopapular rash,
haemorrhagic signs- petechiae, purpura, +ve tourniquet test

Question 25

investigations for dengue fever?

Answer 25

clinical- thrombocytopenia, leucopenia, elevated transaminases, +ve tourniquet test, lab- PCR, serology

Question 26

complications on dengue fever?

Answer 26

dengue haemorrhagic fever, | dengue shock syndrome,

Question 27

prevention of dengue fever?

Answer 27

avoid bites, | vaccination

Question 28

treatment of dengue fever complications?

Answer 28

IV fluids, fresh frozon plasma, platlets

Question 29

transmission of schistosomiasis?

Answer 29

fresh water, | freshwater snails

Question 30

species of schistosomiasis?

Answer 30

s. haematobium, s. mansoni, s. japonicum

Question 31

schistosomiasis clinical features in 1st week?

Answer 31

``` swimmers itch, cough, abdo discomfort, splenomegaly, eosinophilia ```

Question 32

schistosomiasis clinical features in katayama fever stage?

Answer 32

``` fever, urticaria, lymphadenopathy, splenomegaly, diarrhoea, eosinophilia ```

Question 33

schistosomiasis clinical features in acute disease stage?

Answer 33

eggs deposited in bowel and bladder, causing dysentery and haematuria

Question 34

investigations for schistosomiasis?

Answer 34

antibody tests, ova in stool and urine, rectal snip

Question 35

treatment for schistosomiasis

Answer 35

praziquantel

Question 36

tick typhus presentation

Answer 36

tick-bite eschar, | maculopapular rash

Question 37

cause od rickettsiosis?

Answer 37

tick typhus

Question 38

rickettsiosis clinical features?

Answer 38

``` abrupt onset swinging fever, headache, confusion, endovasculitis, rash, bleeding ```

Question 39

diagnosis of rickettsiosis?

Answer 39

clinical features, | serology

Question 40

management of rickettsiosis?

Answer 40

tetracycline

Question 41

cause of viral haemorrhagic fevers?

Answer 41

ebola, congo-crimea haemorrhagic fever, lassa fever, marburg disease

Question 42

zika virus transmission?

Answer 42

aedes mosquitos, sexual contact, blood transfusion

Question 43

presentation of zika virus in adult

Answer 43

``` asymptomatic, headache, rash, fever, malaise, conjunctivits, joint pain ```

Question 44

presentation of zika virus in baby of pregnant mother?

Answer 44

microcephaly, neurological problems, guillain-barre syndrome

Question 45

main investigations in traveller?

Answer 45

``` fbc, malaria films, liver function tests, stool microscopy and culture, urine analysis and culture, blood culture, cxr ```