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Community And Wellness > Travelers Health > Flashcards

Travelers Health Flashcards

1
Q

When should a pre travel evaluation be obtained?

A

At least one month before travel
-Medical history
-Vaccines
-Allergies
-Pregnant

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2
Q

What are the three categories for immunizations when traveling

A
  1. Routine prevention
  2. Required for travel
  3. Recommended based on the risk of exposure to disease
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3
Q

What are infections that are transmissible by contaminated food and water?

A

Travelers diarrhea
Hepatitis A and E
Transmission of parasitic infections

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4
Q

What are vector born disease/

A

Malaria
Dengue
Chikungunya
Zika

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5
Q

What is malaria/

A

Plasmodium parasite in mosquito transmission through bite, fever, sweats, myalagias, confusion

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6
Q

What is Dengue?

A

mosquito born fever, rash, bleeding manifestations (vaccine)

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7
Q

What is chikungunya?

A

Mosquito born fever, myalgias, arthritis, rash (no vaccine)

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8
Q

What is Zika virus?

A

mosquito born pregnancy transmit to fetus
-congenital defects, microcephaly
-no vaccine

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9
Q

What can rafting and exposure to floodwaters result in?

A

Exposure to leptospirosis

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10
Q

What is leptospirosis?

A

Bacterial illness infecting humans from direct contact with animal urine
-through cuts, mucous membranes, or conjunctiva

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11
Q

What is schistosomiasis?

A

Infection with parasitic blood flukes
-from bathing in fresh water contaminated by cercariae carried by snails
-“snail fever”

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12
Q

What is stronglyoidiasis?

A

Infection with the helminth
-Filariform larvae penetrate the skin and migrate via the blood stream and lymphatics to the lungs
-Strongyloides stercoralis
-S. Stercoralis

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13
Q

What is the most common cause of death among travelers?

A

Traffic accidents

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14
Q

If someone has a unstable medical condition should they fly?

A

No

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15
Q

If someone has a medical condition that could lead to inflight illness what might they need to have?

A

A medical certificate

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16
Q

Can someone with TB or epilepsy fly/

A

TB: NO
Epilepsy: yes
>1 seizure in the prior month should not fly

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17
Q

What can the lower partial pressure of oxygen in a flight cause to individuals with pulmonary issues/

A

Hypoxia

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18
Q

What should asthmatics carry on the flight with them?

A

A rescue inhaler
-SABA (short-acting beta agonist)

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19
Q

What is a CI to air travel (pulmonary)

A

Pneumothorax

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20
Q

If someone has OSA what must the get approved before coming onto the flight?

A

Portable oxygen concentrator

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21
Q

How to determine if a patient needs supplemental oxygen?

A

Use 6 minute walk test
-Resting pulse ox is not fully predictive of in-flight hypoxia

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22
Q

Does DVT get worse with air travel?

A

Yes
-long distance travel, either air or land (2-3 fold increase)

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23
Q

What is a life threat to a mother and fetus?

A

Malaria prophylaxis key

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24
Q

What are risk factors for venous thromboembolism/

A

Recent major surgery
Prior VTE
Active malignancy
Pregnancy

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25
Q

What are some contributing factors to VTE?

A

Venous stasis secondary to immobility
Elevate levels of activation of coagulation factors

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26
Q

Does dehydration or alcohol consumption contribute to increased risk of VTE?

A

No

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27
Q

What are the prevention guidelines for VTE?

A

WITHOUT risk factors: ambulate every 1-2 hours
With:
-ambulate every 1-2 hours and graduated compression Stockings

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28
Q

What is a medication option for people at high risk of VTE?

A

Thromboprophylaxis

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29
Q

What are pregnant women more susceptible to when traveling?

A

VTE
Malaria
SARS
Zika
-should consider postponing travel to areas with mosquito borne Zika virus transmission due to the chances of congenital microcephaly

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30
Q

Should someone with diabetes have their insulin in the checked in bag?

A

No it will denature
-carry insulin in the carry-on bag

31
Q

What are the pre-travel immunizations?

A

Yellow fever
Meningococcal
Typhoid
Hep A/B
Rabies
Cholera
Japanese encephalitis
Covid

32
Q

What are the pre-travel prophylaxis?

A

Malaria
Travelers diarrhea

33
Q

What is the yellow fever infection/

A

Mosquito borne
-transmitted by Aedes aegypti

34
Q

When should the yellow fever vaccine when administered to travelers?

A

> 9 months yoa traveling to an area of high transmission
-live vaccine
-only given at designated vaccination centers

35
Q

What are the precaution of the yellow fever vaccine?

A

> 60 yoa
6-8months old
Pregnant

36
Q

What serogroup is the most common cause of epidemic meningococcal disease?

A

Serogroup A
-spreads via respiratory secretions
“Meningitis belt” of Africa

37
Q

Is type B meningococcal infection a specific travel related infection?

A

No
- usual recommended for 10 and older high risk patients

38
Q

What causes typhoid fever?

A

Salmonella enterica typhi
-fecal-oral

39
Q

What type of travelers are at high risk of infection of typhoid fever?

A

Visiting family and friends

40
Q

What are the two types of typhoid vaccines?

A
  1. Oral, live
    -four dose (Days 1,3,5,7)
    -ages >6yoa
  2. Inactivated vaccine
    -Preferred 2 weeks prior to travel
    >2yoa
41
Q

Hep A vaccine recommendation

A

Unvaccinated adults
-single dose any time prior to travel
-second dose 6-12 months after
Unvaccinated children
-Havrix: 0 and 6-12 months
-Vaqta: 0 and 6-18 months

42
Q

Is a booster necessary for Hep A vaccine?

A

no

43
Q

How is Hep a/ b transmitted?

A

Hep A: fecal oral
Hep B: blood

44
Q

How many doses of Hep B are there?

A

3 dose if not previously vaccinated

45
Q

How is rabies transmitted?

A

viral illness (MC worldwide=dogs) (MC USA=bats)
-leads to encephalopathy and death
-children at higher risk

46
Q

When is pre-exposure rabies prophylaxis taken?

A

Three dose
-0,7,21 and or 28

47
Q

When is post-exposure rabies prophylaxis taken?

A

4 doses (unvaccinated)
0 IG, 3, 7, 14 (day)
2 dose (vaccinated)
0, 3 no IG

48
Q

What causes cholera?

A

Diarrheal illness caused by gram negative bacterium vibrio cholera
-live attenuated oral vaccine
-single dose 10 days before travel

49
Q

Can someone younger than 18 yoa take the cholera vaccine?

A

No

50
Q

What causes the Japanese encephalitis?

A

Arborviral encephalitis
-inflammation of the brain caused by infection with an arbovirus MC mosquito

51
Q

Where are the highest rates of Japanese encephalitis at?

A

Asia and parts of western pacific
-Rural agricultural areas

52
Q

What is the Japanese encephalitis vaccine?

A

IXIARO
-2 months to 2yoa: two half strength doses (0,28 days)
-3yoa to 18yoa: two dose (0-28 days)
-18-65: two dose (0, 7-28 days)
- single booster if ongoing risk

53
Q

What causes malaria?

A

Protozoan plasmodium
-P.falciparum causes the most severe disease and life-threatening within hours

54
Q

What is the first line protection of malaria in sensitive areas?

A

Chloroquine

55
Q

What are the four types of malaria chemoprophylaxis approach?

A

Mefloquine (lariam): 250mg tablet once weekly
Atovaquone-proguanil (malarone): 250mg/100mg once daily
-safe in pregnancy
Doxycycline: 100mg daily
Tafenoquine: 100mg 2 tablets daily

56
Q

What is the most common illness in travelers/

A

Travelers diarrhea
MC E.coli
Prevention: boil it, peel it, forget it

57
Q

Are prophylactic ATB recommended for travelers diarrhea/

A

NO

58
Q

What medication is preferred for travelers diarrhea/

A

Rifampin 200mg TID
Pregnancy:
-3rd gen cephalosporin (keflex) or
-Azithromycin (z-pack) use for children

59
Q

What are the non antibiotic agents for prevention of travelers diarrhea/

A

Bismuth subsalicylate or BSS
Pepto-Bismol
Side effects: black tarry stools, black tongue

60
Q

What is recommended for mild travels diarrhea?

A

NO antibiotics
Pepto-Bismol
Loperamide

61
Q

What is recommended treatment of moderate travers diarrhea/

A

Antibiotics may be used (rifampin)
Azithromycin: young, pregnant, renal insufficiency

62
Q

What is recommended for severe travels diarrhea?

A

Antibiotics should be used
-Rifampin
-Azithromycin
-fluroquincolones

63
Q

What is barotrauma?

A

Tissue injury caused by a change in pressure
-Pulmonary barotrauma: most serious
-Ear barotrauma: pain and vertigo MC

64
Q

What is a pneumothorax? (pulmonary barotrauma)

A

Air that leaks out of the lungs can be trapped in the space between the lungs and the chest wall

65
Q

What is a pneumomediastinum? (pulmonary barotrauma)

A

Air may be forced out of the lungs into the tissues surrounding the heart

66
Q

What is subcutaneous emphysema (pulmonary barotrauma)

A

Under the skin of the neck and upper chest

67
Q

What is an air embolism? (pulmonary barotrauma)

A

Air in the blood vessels
-most serious pulmonary barotramua

68
Q

What is decompression sickness?

A

The bends or generalized barotrauma
-affects the whole body

69
Q

What is nitrogen narcosis?

A

Caused by the raised partial pressure of nitrogen in nervous system tissue from breathing in excess gasses
-occurs at depths greater than 100 feet

70
Q

What is high altitude illness?

A

Pathological syndromes that can develop following an initial ascent to high altitude

71
Q

What is acute mountain sickness (AMS)

A

Headache, Anorexia, dizziness, fatigue
-caused by rapid exposure to low amounts of o2 at high elevation

72
Q

What is high altitude cerebral edema? (HACE)

A

Poor concentration, lethargy, ataxia, altered consciousness, coma
-severe progression of AMS

73
Q

What is high altitude pulmonary edema (HAPE)

A

Dry cough, SOB at rest, production of frothy pink sputum, decreased exercise tolerance

Community And Wellness (39 decks)

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