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Year 3 Infection (JK) > Travel related infections > Flashcards

Travel related infections Flashcards

1
Q

Why are travellers vulnerable to infection? (5)

A

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

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2
Q

List some infections common worldwide

A

influenza
STD
community acquired pneumonia
meningococcal

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3
Q

List some climate or environment related health problems

A 
sunburn 
heat exhaustion and heat stroke 
cold injury 
altitude sickness 
fungal infections 
bacterial skin infections (staph aureus)
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4
Q

Infections controllable with sanitation

A 
travellers diarrhoea
hepatitis A/E 
typhoid 
cholera 
food poisoning 
shigella dysentery 
helminth infection
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5
Q

Infections controllable with immunisation

A

poliomyelitis

diptheria etc

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6
Q

Infections controllable with education

A

HIV and AIDS

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7
Q

6 water related infections

A 
schistosomiasis 
leptospirosis
liver flukes 
stronglyloidiasis 
hook worms 
guinea worms
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8
Q

List some arthropod borne infections

A

malaria
dengue fever
rickettsial infections
leishmaniasis

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9
Q

list some emerging infectious diseases

A

zika
ebola
swine and avian flu

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10
Q

Vector for malaria

A

female anopheles mosquito

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11
Q

5 species of malaria

A

severe = plasmodium falciparum

P. vivax, ovale, malariae, knowlesi

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12
Q

symptoms of malaria

A

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

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13
Q

Possible signs of malaria

A

splenomegaly
hepatomegaly
mild jaundice

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14
Q

6 complications of malaria

A 
cerebral malaria 
blackwater fever 
jaundice 
pulmonary oedema 
severe anaemia
algid malaria = gram -ve septicaemia
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15
Q

Black water fever

A

severe complication of malaria causing haemoglobinuria, acute renal failure, high parasitaemia, profound anaemia and severe intravascular haemolysis

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16
Q

3 ways to diagnose malaria

A

thick and thin blood films - giemsa, fields stain
quantitative buffy coat - centrifugation, UV microscopy
Rapid antigen tests

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17
Q

Try and name the 9 things which makes malaria complicated

A 
haemoglobinuria 
haemoglobin <8mg/dl
parasite count >2%
pulmonary oedema or ARDS 
renal impairment or pH<7.3
hypoglycaemia 
cerebral malaria 
spontaneous bleeding 
shock - algid malaria
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18
Q

4 treatments and durations for uncomplicated P. falciparum

A

riamet - 3 days
eurartesim - 3 days
malarone - 3 days
quinine - 7 days (+oral doxycycline)

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19
Q

Side effects of quinine

A

nausea, deafness, tinnitus, rash, hypoglycaemia

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20
Q

2 treatments of complicated P.falciparum

A

IV artesunate

IV quinine + oral doxycycline

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21
Q

Side effects of IV quinine

A

cardiac depression, nausea and vomiting

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22
Q

3 treatments of P.vivax, ovale, malariae, knowlesi and duration

A

chloroquine - 3 days
riamet - 3 days
primaquone

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23
Q

When is primaquone used in treatment?

A

P. vivax and ovale

or to eradicate liver hypnozoites

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24
Q

What must you check for before giving primaquine?

A

G6PD deficiency

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25
Q

4 malaria control programmes

A

mosquito breeding sites - drain standing water
larvacides
mosquito killing sprays
human behaviour

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26
Q

2 causative organisms of typhoid fever

A

salmonella typhi

salmonella paratyphi

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27
Q

How is salmonella (para) tyhphi spread?

A

poor sanitation and unclean drinking water

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28
Q

incubation period of typhoid fever

A

7 days to 4 weeks

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29
Q

1st week typhoid fever symptoms

A

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

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30
Q

2nd week typhoid fever symptoms

A

fever peaks at 7-10days, rose spots on trunk, diarrhoea, tachycardia, neutropenia

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31
Q

3rd week complications of typhoid fever

A

perforation, intestinal bleeding, peritonism, metastatic infection

32
Q

relapse % in 4th week of typhoid fever

A

10-15

33
Q

Why is clinical diagnosis of typhoid fever difficult?

A

evolution of features

34
Q

Lab diagnosis of typhoid fever

A

salmonella typhi or paratyphi
culture blood, urine and stool
culture bone marrow??

35
Q

Treatment of typhoid fever

A 
oral azithromycin 
IV ceftriaxone  (complicated)
36
Q

What mosquito transmits dengue fever?

A

aedes aegypti

37
Q

onset of symptoms of dengue fever

A

sudden onset of

  • fever
  • arthralgia and myalgia
  • headache and retroorbital pain
38
Q

signs of dengue fever

A

macular/maculopapular rash

haemorrhagic signs - petechiae, purpura, +ve tourniquet test

39
Q

tourniquet test

A

capillary fragility

40
Q

4 clinical diagnostics of dengue fever

A

thrombocytopenia
leucopenia
high transaminases
+ve tourniquet test

41
Q

2 lab diagnosis of dengue fever

A

PCR and serology

42
Q

Complications of dengue fever

A

dengue haemorrhagic fever

dengue shock syndrome

43
Q

3 Treatments of complications of dengue fever

A

IV fluids
fresh frozen plasma
platelets

44
Q

2 ways to prevent dengue fever

A

avoid bites

new vaccine dengvaxia (2016)?

45
Q

3 causative organisms of schistosomiasis

A

s. haematobium
s. mansoni
s. japonicum

46
Q

What animal is used in the transmission of schistosomisasis?

A

fresh water snails

47
Q

5 stages of schistosomisasis

A 
swimmers itch (hrs)
invasive stage (>24hrs)
katayama fever (15--20 days)
acute disease (6-8 weeks)
chronic disease
48
Q

invasive stage of schistosomisasis signs

A

cough
splenomegaly
abdominal pain

49
Q

katayama fever of schistosomisasis signs

A

fever
urticaria
diarrhoea
Lymph nodes

50
Q

acute disease schistosomisasis signs

A

eggs in bowel or bladder

51
Q

diagnosis of schistosomisasis

A

clinical
antibody tests
ova in stools and urine
rectal snip

52
Q

Treatment of schistosomisasis

A

praziquantel

prednisolone if severe

53
Q

signs of rickettsiosis

A

tick bite

amculopapular rash

54
Q

2 causative organisms of rickettsiosis

A

R. conorii

R. africae

55
Q

clinical features of rickettsiosis

A 
swinging fever 
confusion 
bleeding 
headache
endovasculitis 
rash
56
Q

How is rickettsiosis diagnosed?

A

clinical features and serology

57
Q

management of rickettsiosis

A

tetracycline

58
Q

List some viral haemorrhagic fevers

A

ebola

CCHF

59
Q

maximum incubation of VHF?

A

3 weeks

60
Q

treatments of viral haemorrhagic fevers

A

isolation

supportive

61
Q

what type of virus is zika?

A

flavivirus

62
Q

Mosquito in zika and when they bite

A

aedes mosquito

daytime

63
Q

How else can zika be transmitted?

A

sexual contact and blood transfusion

64
Q

What other infections is zika related to?

A

dengue fever and yellow fever

65
Q

clinical features of zika

A 
headache 
rash 
fever 
malaise 
joint pains 
conjunctivitis
66
Q

What can zika cause in pregnancy?

A

microcephaly and neurological problems

67
Q

What can zika virus cause?

A

guillian barre syndrome

68
Q

treatment for zika virus

A

no antivirals
mosquito control measures
vaccines in development

69
Q

History in a returning traveller with fever

A

tropical area? precautions? risk? symptoms? incubation period

70
Q

Infections causing a rash

A

typhoid, typhus and dengue

71
Q

Infections causing jaundice

A

hepatitis, malaria, yellow fever

72
Q

Infections causing LN

A

leishmaniasis and trypanosomiasis

73
Q

infections affecting the liver

A

malaria, typhoid, amoebic abscess

74
Q

Infections affecting the spleen

A

visceral leishmaniasis, typhoid, malaria

75
Q

Investigations for fever in returning traveller

A 
FBC 
malaria blood films 
LFT 
CXR 
blood culture 
stool microscopy and culture 
urinalysis and culture
76
Q

Treatment for fever in returning traveller

A

Isolation - PPE?
supportive measures
empirical treatments
specific treatment

Year 3 Infection (JK) (12 decks)

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