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Gastro > Tropical Gastro > Flashcards

Tropical Gastro Flashcards

1
Q

What questions should be asked to a returned travellers

A 
Where they have been 
When did they go
When did they get back 
When did they start to become unwell
Did they have insect bites
What are their symptoms
Is anyone else unwell
What activities did they do when they were away
Any chance of HIV / STI
What precautions did they take?
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2
Q

What are common symptoms of a returned traveller

A 
Fever
Rash
Hepatosplenomegaly
Lymphadenopathy
Insect bites
Wounds
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3
Q

What can fever be a symptom for?

A 
Respiratory tract infections 
Travellers diarrhoea
Malaria
Enteric fever (typhoid / paratyphoid fever)
Arboviruses (dengue or chikungunya)
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4
Q

How can we diagnose acute traveller’s diarrhoea

A

3 loose stools within 24 hours

Fever

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5
Q

What is the pathogen usually identified>

A

It usually is not identified

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6
Q

What 2 types of viruses are picked up on cruise ships

A

Norovirus and rotavirus

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7
Q

What investigations do we do for acute traveller’s diarrhoea

A

Stool culture

Stool wet prep on recently passed stool for amoebic trophozoites

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8
Q

What is the treatment for Acute traveller’s diarrhoea

A

Suportive with fluids

Usually they will get better themselves

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9
Q

What symptom would warrant further treatment?

A

Bloody diarrhoea

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10
Q

What drug can stop worsening

A

Fluoroquinolone (ciprofloxacin) single dose

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11
Q

What are the symptoms of enteric fever

A

Headache
Constipation or diarrhoea
Dry cough

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12
Q

Where is enteric fever most common

A

Indian subcontinent and south east asia

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13
Q

What is the incubation period for enteric fever

A

7-18 days

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14
Q

What are 4 complications of enteric fever

A

GI Bleeding
GI perforation
Encephalopathy
Bone and joint infection

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15
Q

What is the causative organism for enteric fever

A

Salmonella typhi or paratyphi

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16
Q

What precautions should be taken for enteric fever

A

Water, food and hand hygiene

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17
Q

What can cause pre-hepatic fever and jaundice

A

Malaria

18
Q

What can cause hepatic fever and jaundice

A 
Hepatitis A and E 
Leptospirosis
Malaria
Enteric fever
Typhus 
Viral haemorrhagic fever
19
Q

What investigations do we do for Malaria

A

Blood film and rapid antigen

20
Q

What other investigations do we do for Traveler’s diarrhoea

A 
Blood film for red cell fragmentation
FBC/ UE/ LFT / Coagulation
Blood cultures
USS abdomen
Serological testing for viruses
21
Q

What management and treatment is used for Traveler’s diarrhoea

A

Appropriate isolation and infection control proceudres
Supportive - may need sialysis if acute kidney injury
If acute liver failure - hepatology / transplant unit
Directed to pathogen isolated
Discussion with infectious diseases

22
Q

What are the common presentations of amoebic liver abscess.

When do they develop?

A 
Fever
cough
aching abdominal pain
hepatomegaly 
usually male 
Usually 2-4 weeks
23
Q

What investigations are appropriate for amoebic liver abscess

A 
CXR  raised right hemi-diaphragm
LFTs - abnormal
USS/ CT
Serology 
Stool microscopy- often negative
24
Q

Where are helminth infections usually found

A

In the gut or the tissue

25
Q

What are Helminth infections often associated with

A

Eosinophilia

26
Q

What is the other name for Roundworms

A

Nematodes

27
Q

What is the other name for Flukes

A

Trematodes

28
Q

What is the other name for Tapeworms

A

Cestodes

29
Q

What is the most common helminthic infection in the world

A

Intestinal nematodes (round worms)

30
Q

What is the cycle of helminth infections

A 
Eff ingested, 
hatched in small intestine, 
invade the gut wall 
Travel into the venous system 
Reaches the liver, heart and lungs
Break into the alveoli
Ascend the tracheobronchial tree 
Swallowed in the gut
Develop into adult worm 
Adult worm starts to produce eggs
31
Q

Where can we get Taenia solium from?

A

Pork

32
Q

Where can we get saginatum from?

A

Beef

33
Q

Where can we get Taenia solium eggs from?

A

Autpinoculation or from human faeces

34
Q

What can Taenia solium eggs cause

A

Cystticercosis - tissue cysts in the muscle and brain

35
Q

What are the symptoms of Giardia lamblia

A

Diarrhoea (chronic), malabsorption and weight loss

36
Q

What type of infection is Giardia lamblia?

A

Protozoan infection

37
Q

How can we diagnose Giardia lamblia?

A

Look for cytes or parasites in the stool

38
Q

What is the treatment for Giardia lamblia?

A

Metranidazole

39
Q

What is the triatome known as?

A

The kissing bug

40
Q

What does Chagas’ Disease cause?

A

parasympathetic denervation affecting the colon / oesophagus
Megaoesophagus

41
Q

What parasite causes Chagas’ Disease

A

Trypanasoma cruzi

Gastro (67 decks)

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