Travel related infection

Question 1

What makes travellers more vulnerable to infection?

Answer 1

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

Question 2

What are examples of climate or environmental related health problems?

Answer 2

Sunburn
Heat exhaustion
Fungal infections
Bacteria skin infections
Cold injury
Altitude sickness

Question 3

What infections are controllable by improved sanitation?

Answer 3

Travellers diarrhoea
Typhoid
Hep A or E
Giardiasis
Amoebiasis
Helminth infections
Viral gastroenteritis
Food poisoning
Shigella dysentry
Cholera
Cryptosporidiosis

Question 4

What infections are controllable by immunisation?

Answer 4

Poliomyelitis

Diphtheria

Question 5

What infections are controllable by education?

Answer 5

HIV

STDs

Question 6

What are examples of water-related infections?

Answer 6

Schistosomiasis
Leptospirosis
Liver flukes
Strongyloidasis
Hookworms
Guinea worms

Question 7

What are examples of arthropod-borne infections?

Answer 7

Malaria - mosquitos
Dengue fever - mosquitos
Rickettsial infections - ticks
Leishmaniasis - Sand flies
Trypanosomiasis - tsetse fly
Filariasis - mosquitos
Onchocerciasis - black flies

Question 8

What are emerging infectious diseases?

Answer 8

Zika virus in latin america and caribbean
Ebola virus in west Africa
Swine flu worldwide
Avian flu in China
SARS 
West Nile Virus

Question 9

What are the important tropical diseases that need to be known?

Answer 9

Malaria
Typhoid
Dengue Fever
Schistosomiasis
Rickettsiosis
Viral haemorrhagic fevers
Zika fever

Question 10

What is the vector for malaria?

Answer 10

Female Anopheles mosquito

Question 11

What species causes severe malaria?

Answer 11

Plasmodium falciparum

Question 12

What are symptoms of malaria?

Answer 12

Fever
Rigors
Aching bones
Abdo pain
Headache
Dysuria
Frequency
Sore throat
Cough

Question 13

What are possible signs of malaria?

Answer 13

Splenomegaly
Hepatomegaly
Mild jaundice

Question 14

What are potential complications of malaria?

Answer 14

Cerebral malaria
Blackwater fever
Pulmonary oedema
Jaundice
Severe anaemia
Algid malaria

Question 15

What is Blackwater fever?

Answer 15

Severe intravascular haemolysis
high parastiaemia
profound anaemia
haemoglobinuria
acute renal failure

Question 16

What are features of cerebral malaria?

Answer 16

Arching posture of back
Small brain infarcts
Convulsions
Hypoxia

Question 17

What drugs should be used to treat malaria?

Answer 17

Malarone
Riamet
Quinone

Question 18

How is Malaria diagnosed?

Answer 18

Thick and thin bloodfilms
Quantitative buffy coat
Rapid antigen tests

Question 19

What are features indicative of complicated malaria?

Answer 19

One or more of:
Impaired consciousness or seizures
Hypoglycaemia
Parasite count >2%
Haemoglobin<8mg/dL
Spontaneous bleeding
Haemoglobinuria
Renal impairment
pH<7.3
Pulmonary oedema or ARDS
Shock

Question 20

How is complicated malaria treated?

Answer 20

IV quinine plus oral doxycycline

Question 21

How is malaria controlled?

Answer 21

Mosquito breeding sites - drainage of standing water
Larvacides
Mosquito killing sprays
Human behaviour

Question 22

What are causative organisms of typhoid fever?

Answer 22

Salmonella typhi

Salmonella paratyphi

Question 23

What are clinical features in the 1st week of typhoid fever?

Answer 23

Fever
Headache
Abdominal discomfort
Constipation
Dry cough
Relative bradycardia
Neutrophilia
Confusion

Question 24

What are clinical features in the 2nd week of typhoid fever?

Answer 24

Fever peaks at 7-10 days
Rose spots
Diarrhoea begins
Tachycardia
Neutropenia

Question 25

What are complications in the 3rd week of typhoid fever?

Answer 25

Intestinal bleeding Perforation Peritonism Metastatic infections

Question 26

How is typhoid fever diagnosed?

Answer 26

Blood culture Urine cultures Stool culture Bone marrow culture

Question 27

How is typhoid fever treated?

Answer 27

Oral azithromycin - uncomplicated | IV ceftriaxone - complicated

Question 28

What species transmits dengue fever?

Answer 28

Aedes aegypti mosquito

Question 29

What are classical features of Dengue fever?

Answer 29

``` Sudden fever Severe headache, retro-orbital pain Severe myalgia and arthralgia Macular/maculopapular rash Haemorrhagic signs - petechiae, purpura, positive tourniquet test ```

Question 30

How is dengue diagnosed?

Answer 30

``` Thrombocytopenia Leucopenia Elevated transaminases Positive tourniquet test PCR Serology ```

Question 31

What are potential complications of dengue?

Answer 31

Dengue haemorrhagic fever | Dengue shock syndrome

Question 32

What are vector organisms for schistosomiasis?

Answer 32

Freshwater snails

Question 33

What species cause schistosomiasis?

Answer 33

S.haematobium S.mansoni S.japonicum

Question 34

What is the progression of schistosomiasis?

Answer 34

``` Swimmers itch Invasive stage Katayama fever Acute disease Chronic disease ```

Question 35

What are features of the invasive stage of schistosomiasis?

Answer 35

Cough Abdominal discomfort Splenomegaly Eosinophilia

Question 36

How is schistosomiasis diagnosed?

Answer 36

Antibody tests Ova in stools and urine Rectal snip

Question 37

How is schistosomiasis treated?

Answer 37

Praziquantel 20mg/kg

Question 38

What are clinical features of rickettsiosis?

Answer 38

``` Abrupt onset swinging fever Headache Confusion Endovasculitis Rash Bleeding ```

Question 39

How is rickettsiosis diagnosed?

Answer 39

Serology

Question 40

How is rickettsiosis treated?

Answer 40

Tetracycline

Question 41

What are features of zika?

Answer 41

``` Mild symptoms Headache Rash Fever Malaise Conjunctivitis Joint pains Can cause microcephaly and other neuro problems in pregnancy ```