Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 - infection > Travel Related Infection > Flashcards

Travel Related Infection Flashcards

1
Q

Modern Tropical Medicine - lots of different diseases from a variety of _________

A

destinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are some unfamiliar features of imported diseases that people may experience?

A
  • Presenting features
  • Isolation requirements
  • Diagnostic methods - Blood film for malaria
  • Treatment/Management
  • Unexpected complications - Bleeding, coma, shock, seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What increases vulnerability of travelers to infection?

A
  • Temptation to take risks away from home - food, water, animals, sex
  • Different epidemiology of some diseases - HIV, TB, polio, diphtheria
  • Incomplete understanding of health hazards
  • Stress of travel
  • Refugees: deprivation, malnutrition, disease, injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Some infections are common worldwide such as what?

A
  • influenza
  • community-acquired pneumonia
  • meningococcal disease
  • sexually transmitted diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Infections Controllable by Public Health measures include what? - Sanitation

A

Travelers’ diarrhoea

Typhoid

Hepatitis A or E

Giardiasis

Amoebiasis

Helminth infections

Viral gastroenteritis

Food poisoning

Shigella dysentery

Cholera

Cryptosporidiosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Infections Controllable by Public Health measures include what? - Immunization

A

Poliomyelitis

Diphtheria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Infections Controllable by Public Health measures include what? - Education

A

HIV

STD’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are examples of Water-related infections? (drinnking and swimming)

A
  • Schistosomiasis
  • Leptospirosis
  • Liver flukes
  • Strongyloidiasis
  • Hookworms
  • Guinea worms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are exmples of Arthropod-borne infections?

A
  • Malaria (mosquitos)
  • Dengue fever (mosquitos)
  • Rickettsial infections (ticks: typhus)
  • Leishmaniasis (sand flies: Kala-azar)
  • Trypanosomiasis (tsetse fly: sleeping sickness)
  • Filariasis (mosquitoes: elephantiasis)
  • Onchocerciasis (black flies: River Blindness)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are some Emerging Infectious Diseases?

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
  • …etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are some Important Tropical Diseases?

A
  • Malaria
  • Typhoid
  • Dengue Fever
  • Schistosomiasis
  • Rickettsiosis
  • Viral haemorrhagic fevers
  • Zika fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is malaria?

A

Parasitic infection of the red blood cells of the human

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the Epidemiology of malaria?

A
  • Most important imported disease
  • United Kingdom (HPA, 2015)
  • 1400 cases/year
  • 6 deaths/year

•Worldwide (WHO, 2012)

  • 207 million cases/year
  • 627,000 deaths/year

Disease of the tropics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the Malaria vector?

A

female Anopheles mosquito

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the life cycle of malaria?

A

Injects sporozoites as it is taking a blood meal - they are premature forms of the parasite, migrate to liver and invade the liver cells and they replicate and then enter into the circulation, red blood cells

Female mosquito takes blood meal and the gametocytes fuse to form zygote and then the mosquito gets more sporozoites

Many drugs work in the different stages of this

7 days for this to happen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the 5 species of malaria and their severities?

A

Plasmodium falciparum - Potentially severe

“benign”:

  • Plasmodium vivax
  • Plasmodium ovale
  • Plasmodium malariae
  • Plasmodium knowlesi (like P malariae; Far East, 2004)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the symptoms of malaria?

Often vague and unspecific symptoms

Symptoms common to many infections

Often people think its influenza

A
  • fever
  • rigors
  • aching bones
  • abdo pain
  • headache
  • dysuria
  • frequency
  • sore throat
  • cough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the signs of malaria?

A
  • none
  • splenomegaly
  • hepatomegaly
  • mild jaundice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are some complications of malaria?

A
  1. Cerebral malaria (encephalopathy) - non- immune visitors, children in endemic areas hypoglycaemia, convulsions, hypoxia
  2. Blackwater fever - severe intravascular haemolysis, high parasitaemia, profound anaemia, haemoglobinuria, acute renal failure
  3. Pulmonary oedema
  4. Jaundice
  5. Severe anaemia
  6. Algid malaria - Gram-negative septicaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how is a diagnosis of malaria made?

A
  • Thick & thin blood films - Giemsa, Field’s stain
  • Quantitative buffy coat (QBC) - centrifugation, UV microscopy
  • Rapid antigen tests - OptiMal, ParaSight-F

Diagnosis based on clinical suspension if a person has come back from a at risk area

(purple dots are malaria parasites)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Quantitative Buffy Coat (QBC) Test

A

Quantitative buffy coat (QBC) is a laboratory test to detect infection with malaria or other blood parasites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is a blood film?

A

a thin layer of blood smeared on a glass microscope slide and then stained in such a way as to allow the various blood cells to be examined microscopically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Severity assessment:

Complicated malaria = one or more 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 (algid malaria) - ?Gram negative bacteraemia
24
Q

what are the Treatment options for
uncomplicated P. falciparum malaria?

A
  • Riamet ® (artemether-lumefantrine) 3 days
  • Eurartesim ® (dihydroartemisinin-piperaquine) 3 days
  • Malarone ® (atovaquone-proguanil) 3 days
  • Quinine 7 days - S/E nausea, tinnitus, deafness (cinchonism), rash, hypoglycaemia - plus oral doxycycline (or clindamycin)
25
Q

what are the Treatment options for
complicated or severe P. falciparum malaria?

A
  • IV artesunate (unlicensed in UK)
  • IV quinine (S/E cardiac depression, cerebral irritation, N&V) plus oral doxycycline (or clindamycin)

When patient is stable & able to swallow, switch to oral treatments

26
Q

what is the Treatment of
P. vivax, P. ovale, P. malariae, P. knowlesi?

(treatment for the other types of malaria)

A
  • chloroquine 3 days
  • Riamet ® (artemether-lumefantrine) 3 days

•add primaquine* (14 days) in vivax and ovale, to eradicate liver hypnozoites
*check for G6PD deficiency

27
Q

what are some malaria control programmes?

A
  • Mosquito breeding sites - Drainage of standing water
  • Larvacides - (Paris green), temphos, biological
  • Mosquito killing sprays - DDT, malathion, (dieldrin)
  • Human behaviour - Bed nets, Mesh windows
28
Q

Typhoid (Enteric) Fever is caused by what?

A
  • Salmonella typhi
  • Salmonella paratyphi
  • Global cases: 27 million infections/yr
  • Global deaths: over 200,000/yr

UK cases: 500/yr

Type of salmonella fever

Mainly developing world

poor sanitation, unclean drinking water

29
Q

what are the clinical feature sof typhoid fever?

A
  • Incubation period: 7 days - 4 week
  • 1st week: fever, headache, abdo. discomfort, constipation, dry cough, relative bradycardia, neutrophilia, confusion
  • 2nd week: fever peaks at 7-10 days, Rose spots, diarrhoea begins, tachycardia, neutropenia
  • 3rd week (Complications): intestinal bleeding, perforation, peritonism, metastatic infections
  • week 4 (Recovery): 10 - 15% relapse
30
Q

how is the diagnosis of typhoid fever made?

A
  • Clinical - not easy, evolution of features
  • Laboratory (Salmonella typhi, S. paratyphi):

Culture blood, urine & stool

Culture bone marrow

31
Q

what is the treatment of typhooid fever?

A
  • Oral Azithromycin - now drug of choice for Asian-acquired, uncomplicated enteric fever
  • IV Ceftriaxone - if complicated, or concerned regarding absorption
  • Increasing ciprofloxacin resistance
32
Q

what is Dengue?

A
  • Commonest human arbovirus infection
  • Dengue infection: 100 million cases/year
  • Dengue Deaths: 25,000/year

Dengue fever is a mosquito-borne tropical disease caused by the dengue virus. Symptoms typically begin three to fourteen days after infection. These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. Recovery generally takes two to seven days

33
Q

what is the Transmission of Dengue?

A

Tiger mosquito

Day time biting mosquito

Likes little pools of water

Lives near humans

34
Q

what are the features of Classical Dengue Fever

A
  • Sudden fever
  • Severe headache, retro-orbital pain
  • Severe myalgia and arthralgia
  • Macular/maculopapular rash
  • Haemorrhagic signs: petechiae, purpura, positive tourniquet test
35
Q

How is a Dengue Diagnosis made?

A

• Clinical:

  • Thrombocytopenia
  • Leucopenia
  • Elevated transaminases
  • Positive tourniquet test (a clinical diagnostic method to determine a patient’s haemorrhagic tendency. It assesses fragility of capillary walls and is used to identify thrombocytopenia)

• Laboratory: PCR, serology

36
Q

what is the management of dengue?

A
  • No specific therapeutic agents
  • Complications
  • Dengue haemorrhagic fever (DHF)
  • Dengue shock syndrome (DSS)
  • Rx: IV fluids, fresh frozen plasma, platelets

•Prevention - avoid bites and new vaccine (Dengvaxia), 2016; limited use

37
Q

Schistosomiasis is from what?

A

fresh water and freshwater snails

38
Q

what are the types of distribution of schistosomiasis?

A
  • S. haematobium
  • S. mansoni
  • S. japonicum
39
Q

what is the Schistosomiasis life cycle?

A
40
Q

what are the clinical feature sof schistosomiasis?

A
  • Swimmers Itch (1st few hrs) - clears 24-48hrs
  • Invasive stage (after 24hrs) - cough, abdo discomfort, splenomegaly, eosinophilia
  • Katayama Fever (after 15-20 days) - prostrate, fever, urticaria, lymphadenopathy, splenomegaly, diarrhoea, eosinophilia
  • Acute disease (6-8 weeks) - eggs deposited in bowel (dysentery) or bladder (haematuria)
  • Chronic disease
41
Q

how is the diagnosis of schistosomiasis made?

A

Clinical diagnosis

Antibody tests

Ova in stools and urine

Rectal snip

42
Q

what is the treatment of shcistosomiasis?

A

PRAZIQUANTEL 20mg/kg, two doses 6hrs apart

Prednisolone if severe

43
Q

what does Rickettsiosis cause?

A
  • Tick typhus (commonest imported to UK) - from Southern Africa, Mediterranean, Arabian Gulf
  • Clinical features - abrupt onset swinging fever, headache, confusion, endovasculitis, rash (macular, petechial), bleeding
44
Q

what is the diagnosis and management of Rickettsiosis?

A
  • Diagnosis: clinical features, serology
  • Management: tetracycline
45
Q

Viral Haemorrhagic Fevers - Serious infections but rare in UK, what are some examples?

A

Ebola

Congo-Crimea haemorrhagic fever

Lassa fever

Marburg disease

46
Q

how are viral haemorrhagic fevers delt wirh?

A
  • Maximum incubation period 3 weeks
  • Rule out common severe infections
  • Isolation: High Security Infection Unit
  • Treatment: supportive!
47
Q

what is the zika virus

A
  • flavivirus
  • Transmitted by daytime-biting Aedes mosquitos
  • Also by sexual contact, blood transfusion
  • Related to dengue, yellow fever, Jap B encephalitis and West Nile viruses
  • Pacific outbreak 2013-14
  • Latin America pandemic 2015-16
48
Q

what are the clinical feature sof zika virus?

A
  • Clinical: no or mild symptoms - headache, rash, fever, malaise, conjunctivitis, joint pains (like dengue)
  • In pregnancy, can cause microcephaly and other neurological problems
  • Can cause Guillain-Barre syndrome
49
Q

what is the management of zika virus?

A
  • No antiviral therapy
  • Mosquito control measures
  • Vaccines in development
50
Q

what are Covid 19 symptoms?

A
  • Fever, dru cough and tiredness
  • Aches and pains, nasal congestion, headache, conjunctivitis, sore throat, diarrhoea, loss of taste or smell, rash, discoloration of fingers/toes
  • Symptoms usually mild and begin gradually
51
Q

what are Risk factors of covid 19?

A
  • Most (80%) recover without needing hospital treatment
  • Around 1 out of every 5 people become seriously ill and develops difficulty breathing
  • Older people, and those with medical problems like high blood pressure, heart and lung problems, diabetes, or cancer, are at higher risk of serious illness
  • Anyone can become seriously ill with COVID
52
Q

what is the management of covid 19?

A
  • IPC/PPE
  • Supportive
  • No proven RX (trials)
  • Preventing the spread of the virus
53
Q

what should be asked in a history of a fever in the returning traveller?

A
  • Is it tropical?
  • Travel history - Is it travel related?
  • Precautions taken
  • Risks - e.g. swimming in fresh water
  • Symptoms
  • Incubation periods
54
Q

Approach to fever in the returning traveller - what are some examination signs?

A
  • rash - typhoid, typhus, dengue
  • jaundice - hepatitis, malaria, Yellow fever
  • lymph nodes - leishmania, trypanosomiasis
  • liver - malaria, typhoid, amoebic abscess
  • spleen - visceral leishmaniasis, typhoid, malaria
55
Q

Approach to fever in the returning traveller - what are some investigations?

A

Normal tests as well as specific ones for specific conditions that you think they have

General:

  • FBC
  • malaria films
  • liver function tests
  • stool microscopy & culture
  • urine analysis & culture
  • blood culture(s)
  • CXR

Specific tests (as indicated):

dengue

respiratory viral/atypical

hepatitis A, B, C

tick typhus (Rickettsia)

schistosomiasis

amoebic

leptospirosis/hantavirus

viral haemorrhagic fevers

56
Q

Approach to fever in the returning traveller - what treatment is required?

A
  • Isolation: ?personal protective equipment
  • Supportive measures (resuscitation)
  • Empirical treatment if patient unwell
  • Antimicrobial therapy based on likely diagnosis
  • aim to treat life-threatening conditions e.g. typhoid, septicaemia

•Specific treatment - once diagnosis is established

Year 3 - infection (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions