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Infection > travel related infections > Flashcards

travel related infections Flashcards

1
Q

what are public health measures to control infection ?

A

sanitation
immunisation
education

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2
Q

what are examples of water-related infections ?

A 
schistosomiasis 
leptospirosis 
liver flukes
strongyloidiasis 
hookworms 
guinea worms
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3
Q

what are examples of arthropod-borne infections ?

A 
malaria - malaria 
dengue fever - malaria
rickettsial infection - ticks
leishmaniasis - sand flies
trypanosomiasis - tsetse flies
filariasis - mosquitoes (elephantiasis)
onchocerciasis - black flies (river blindness)
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4
Q

what malaria species is the potentially severe infective type ?

A

plasmodium falciparum

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5
Q

what are symptoms of malaria ?

A 
fever
rigor 
aching bones
abdo pain
headache
dysuria
frequency
sore throat
cough
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6
Q

what are signs of malaria ?

A

splenomegaly
hepatomegaly
mild jaundice

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7
Q

what are complications of malaria ?

A 
cerebral malaria - convulsions, hypoxia
blackwater fever - intravascular haemolysis, profound anaemia, haemoglobinuria, acute renal failure 
pulmonary oedema
jaundice
severe anaemia
algid malaria - gram -ve septicaemia
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8
Q

how do you diagnose malaria ?

A

thick and thin blood films - Giesma, Field’s stain
quantitative Buffy coat - UV microscopy
rapid antigen test

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9
Q

what features would indicate a complicated malaria ?

A 
impaired consciousness or seizures
hypoglycaemia
parasite count >2%
haemoglobin <8mg/dl
DIC
haemoglobinuria
renal impairment pH <7.3
pulmonary oedema
shock
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10
Q

how do you treat uncomplicated malaria ?

A

quinine 7 days, plus oral doxycycline or clindamycin

riamet, euratesim, malarone

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11
Q

how do treat complicated malaria ?

A

IV quinine plus oral doxycycline or clindamycin

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12
Q

what are side effects of quinine ?

A 
nausea 
tinnitus
deafness
rash
hypoglycaemia

IV - cardiac depression, cerebral irritation, nausea + vomiting

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13
Q

what are some malaria control programmes ?

A

mosquito breeding site drainage
larvacides
mosquito killing spray DDT
human behaviour - mesh

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14
Q

what is the causative organism of typhoid (enteric) fever ?

A

salmonella typhi

salmonella paratyphi

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15
Q

what is the clinical progression of typhoid fever ?

A

incubation 1-4 weeks

1st week- fever, headache, abdo discomfort, constipation, bradycardia, neutrophilia, confusion
2nd week - fever peaks, rose spots, diarrhoea, tachycardia, neutropenia
3rd week - intestinal bleeding, perforation, peritonism, metastatic infection
week 4 recovery

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16
Q

how do you diagnose typhoid fever ?

A

clinical

lab - culture urine and stool, marrow

17
Q

how do you treat typhoid fever ?

A

oral azithromycin

IV ceftriaxone - increasing resistance

18
Q

what is the commonest arbovirus worldwide ?

A

Dengue fever

19
Q

what is the classical presentation of dengue fever ?

A 
sudden fever
severe headache, retro-orbital pain
severe myalgia, arthralgia
macular/macropapular rash
haemorrhagic signs - petechiae, purport, positive tourniquet test
20
Q

how do you diagnose dengue fever ?

A

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

21
Q

how do you manage dengue fever ?

A

no specific therapeutic agents
dengue haemorrhage fever and dengue shock syndrome - fluids, FFP, platelets
prevent bites and get vaccine

22
Q

what are the causative organisms of schistosomiasis ?

A

S. haematobium
S. mansoni
S. japonicium

23
Q

what are the stages and clinical features of schistosomiasis ?

A

swimmers itch 1st few hours - clears 24-48hrs
invasive stage >24 hours - cough, abdo discomfort, splenomegaly, eosinophilia
katakana fever 15-20 days - prostrate, fever, urticaria, lymphadenopathy, splenomegaly, diarrhoea, eosinophilia
acute disease 6-8 weeks - eggs in bowel and bladder, dysentery/heamaturia

24
Q

how is schistosomiasis diagnosed ?

A

clinical
antibody test
ova in stools and urine
rectal snip

25
Q

how do you treat schistosomiasis ?

A

praziquantel 20mg/kg, two doses 6 hours apart

prednisolone if severe

26
Q

what is rickettsiosis ?

A

tick typhus

R. conorii, R.africae

27
Q

what are clinical features of rickettsiosis ?

A 
abrupt onset swinging fever
headache
confusion
endovasculitis
rash - macular, petechial
bleeding
28
Q

what are examples of viral haemorrhage fevers ?

A

ebola
congo-crimea haemorrhagic fever
lassa fever
Marburg disease

maximum incubation is 3 weeks

29
Q

how do you manage viral haemorrhagic fevers ?

A

rule out common severe infection
isolation
supportive treatment

30
Q

what is Zika virus ?

A

flavivirus
transmitted by mosquito, sexual contact, blood transfusion
related to dengue, yellow, Jam B

31
Q

what are clinical features of Zika virus ?

A 
no or mild symptoms
headache
rash
fever
malaise
conjunctivitis
joint pain
Guillain-Barre syndrome

can cause microcephaly in pregnancy

32
Q

what diseases give you rash ?

A

typhoid
typhus
dengue

33
Q

what diseases give you jaundice ?

A

hepatitis
malaria
yellow fever

34
Q

what diseases affect the lymph nodes ?

A

leishmaniasis

trypanosomiasis

35
Q

what diseases affect the liver ?

A

malaria
typhoid
amoebic abscess

36
Q

what diseases affect the spleen ?

A

visceral leishmaniasis
typhoid
malaria

Infection (13 decks)

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