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Infection > Travel-related infection > Flashcards

Travel-related infection Flashcards

1
Q

What are climate or environment related health problems?

A 
Sunburn
Heat exhaustion/heatstroke
Fungal infections
Bacterial skin infections
Cold injury
Altitude sickness
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2
Q

What infections can be controlled by sanitation?

A 
Traveler's diarrhoea
Typhoid
Hep A or E
Giardiasis
Amoebiasis
Helminth infections
Viral gastroenteritis
Food poisoning
Shigella dysentery
Cholera
Cryptosporidiosis
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3
Q

What are infections controllable by immunisation?

A

Poliomyelitis

Diphtheria

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4
Q

What are infections controllable by education?

A

HIV

STIs

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5
Q

What are water related infections?

A 
Schistosomiasis
Leptospirosis
Liver flukes
Strongyloidiasis
Hookworms
Guinea worms
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6
Q

What are arthropod-borne infections?

A 
Malaria
Dengue fever
Rickettsial infections
Lesihmaniasis
Trypanosomiasis
Filariasis
Onchocerciasis
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7
Q

What are emergency infectious diseases?

A 
Zika
Ebola
MERS-CoV
Swine flu
Avian flu
SARS
West Nile virus
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8
Q

What is the main imported disease?

A

Malaria

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9
Q

What is the malaria vector?

A

Female mosquito

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10
Q

What is the malaria life cycle?

A

Transmission of sporozoites by bite
Sporozoites travel to liver + enter hepatocytes
Sporozoites multiply asexually, schizonts formed containing thousands of merozoites
Release of merozoites into bloodstream
Merozoites enter erythrocytes and mature to trophozoites, rec cell schizonts formed containing thousands of merozites, release of merozoites into bloodstream causes fever and manifestations of malaria

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11
Q

What are the 5 species of malaria?

A 
Plasmodium falciparum
P. vivax
P. ovale
P. malariae
P. knowlesi
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12
Q

What is the potential y severe species of malaria?

A

P. falciparum

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13
Q

What are the symptoms of malaria?

A 
Fever
Rigors
Aching bones
Abdo pain
Headache
Dysuria
Frequency
Sore throat
Cough
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14
Q

What are the signs of malaria?

A

None
Splenomegaly
Hepatomegaly
Mild jaundice

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15
Q

What are complications of malaria?

A 
Cerebral malaria (encephalopathy)
Blackwater fever
Pulmonary oedema
Jaundice
Severe anaemia
Algid malaria
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16
Q

What is blackwater fever?

A 
Severe intravascular haemolysis
High parasitaemia
Profound anaemia
Haemoglobinuria
Acute renal failure
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17
Q

How is malaria diagnosed?

A

Thick & thin blood films
Quantitative buffy coat (QBC)
Rapid antigen tests

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18
Q

What is complicated malaria?

1+ of:

A 
Impaired consciousness or seizures
Hypoglycaemia
Parasite count >2%
Haemoglobin <8mg/dL
Spontaneous bleeding/DIC
Haemoglobinuria
Renal impairment or pH<7.3
Pulmonary oedema or ARDS
Shock
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19
Q

What are drugs for malaria?

A

Quinine

Artemisinins

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20
Q

What are treatment options for uncomplicated P.falciparum malaria?

A 
*Riamet = 3 days
Eurartesim = 3 days
Malarone = 3 days
**Quinine = 7 days
Plus oral doxycycline
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21
Q

What are treatment options for complicated/severe P.falciparum malaria?

A

IV artesunate
IV quinine
plus oral doxycycline

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22
Q

What are treatment options for non-P.falciparum forms of malaria?

A 
Chloroquine = 3 days
Riamet = 3 days
add Primaquine (14 days)
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23
Q

What are malaria control programmes?

A

Drain standing water - mosquito breeding sites
Larvacides
Mosquito killing sprays
Human behaviour: nets, mesh

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24
Q

What bacteria cause typhoid fever?

A

Salmonella typhi

Salmonella paratyphi

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25
Q

What causes typhoid?

A

Poor sanitation

Unclean drinking water

26
Q

What are the clinical features of typhoid?

A

1st week: headache, fever, abdominal discomfort, constipation, dry cough, relative bradycardia, neutrophilic, confusion

2nd week: fever peaks 7-10days, rose spots, diarrhoea begins, tachycardia, neutropenia

3rd week: intestinal bleeding, perforation, peritoneum, metastatic infections

4th week: relapse or recovery

27
Q

What is the incubation period for typhoid?

A

7 days - 4wks

28
Q

What are the investigations for typhoid?

A

Lab cultures blood, urine, stool & bone marrow

Mainly salmonella typhi

29
Q

What is the treatment of typhoid fever?

A

Oral azithromycin

IV ceftriaxone

30
Q

What is the commonest human arbovirus infection?

A

Dengue

31
Q

How is dengue transmitted?

A

Mosquito

32
Q

What are signs/symptoms of dengue?

A 
Sudden fever
Severe headache, retro-orbital pain
Severe myalgia and arthralgia
Macular/maculopapular rash
Haemorrhagic signs: petechiae, purpura, positive tourniquet test
33
Q

What is the positive tourniquet test?

A

More than 10 to 20 petechiae per square inch

34
Q

How can dengue be diagnosed clinically?

A

Thrombocytopenia
Leucopenia
Elevated transaminases
Positive tourniquet test

35
Q

How can dengue be diagnosed in the lab?

A

PCR

Serology

36
Q

What are complications of dengue?

A

Dengue haemorrhagic fever (DHF)

Dengue shock syndrome (DSS)

37
Q

What is the management of dengue?

A

IV fluids
Fresh frozen plasma
Platelets

38
Q

What is the prevention for dengue?

A

Avoid bites

New vaccine - limited use

39
Q

How is schistosomiasis transmitted?

A

Parasites in infected fresh water snails

40
Q

What are the 3 most common schistosomiasis species?

A

Schistosoma haematobium
S. mansoni
S. japonicum

41
Q

What are the clinical features of schistosomiasis?

A

Swimmers itch - 1st few hours
Invasive stage - after 24hrs = cough, abdominal discomfort, splenomegaly, eosinophilia
Katayama fever - after 15-20 days = freer, urticaria, lymphadenopathy, splenomegaly, diarrhoea, eosinophlia
Acute disease - after 6-8wks = eggs deposited in bowel (dysentry) or bladder (haematuria)
Chronic disease

42
Q

What is the diagnosis for schistosomiasis?

A

Clinical
Antibody tests
Ova in stools/urine
Rectal snip

43
Q

What is the treatment for schistosomiasis?

A

Praziquantel

44
Q

What is the other name for Rickettsiosis?

A

Typhus

45
Q

What is the most common typhus imported to UK?

A

Tick typhus

46
Q

What are the clinical features of tick typhus?

A 
Abrupt onset swinging fever
Headache
Confusion
Endovasculitis
Rash (macular, petechial)
Bleeding
47
Q

What is the diagnosis for tick typhus?

A

Clinical features

Serology

48
Q

What is the treatment for tick typhus?

A

Tetracycline

49
Q

What are viral haemorrhage fevers?

A

Ebola
Congo-Crimea haemorrhagic fever
Lassa fever
Marburg disease

50
Q

What is the max incubation period for viral haemorrhagic fevers?

A

3 weeks

51
Q

What is Zika transmitted by?

A

Mosquitos

52
Q

How is Zika transmitted?

A

Sexual contact

Blood transfusion

53
Q

What are the clinical features of Zika?

A 
No or mild symptoms
Headache
Rash
Fever
Malaise
Conjunctivitis
Joint pains

In pregnancy:
Microcephaly
Neuro problems

54
Q

What can Zika cause as a complication?

A

Guillain-Barre syndrome

55
Q

When examine what tropical disease should you think of for: rash?

A

Typhoid
Typhus
Dengue

56
Q

When examine what tropical disease should you think of for: jaundice?

A

Hepatitis
Malaria
Yellow fever

57
Q

When examine what tropical disease should you think of for: lymph nodes?

A

Leishmania

Trypanosomiasis

58
Q

When examine what tropical disease should you think of for: liver problems?

A

Malaria
Typhoid
Amoebic abscess

59
Q

When examine what tropical disease should you think of for: splenomegaly?

A

Visceral leishmaniasis
Typhoid
Malaria

60
Q

What investigations should you do if you suspect a tropical disease?

A 
FBC
Malaria films
LFTs
Stool microscopy &amp; culture
Urine analysis &amp; culture
Blood culture
CXR
Specific tests

Infection (13 decks)

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