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PathY5 > Tropical Medicine: Fever in the Returning Traveller > Flashcards

Tropical Medicine: Fever in the Returning Traveller Flashcards

1
Q

Name one cause of fever and rash

A 
Dengue
Chikungunya
Ricketsia
Enteric Fever
acute HIV
Measles
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2
Q

Name one cause of fever and abdo pain

A

Enteric Fever

Amoebic Liver abscess

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3
Q

Name one cause of fever and normal or low blood count

A 
Dengue
Malaria
Ricketsia
Enteric Fever
Chikungunya
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4
Q

Name one cause of fever and haemorrhage

A

VHF
Meningococcaemia
Leptospirosis
Ricketsia

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5
Q

Name one cause of fever and eosinophilia

A

Acute schistosomiasis
Drug hypersensitivity
Fascioliasis
Other parasite

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6
Q

Name one cause of fever and pulmonary infiltrates

A

Bacterial/ Viral pathogens
Legionellosis
Acute Schistosoiasis
Q fever (Coxiella Burnetti)

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7
Q

Name one cause of fever and altered mental status

A

Cerebral Malaria
Encephalitis of any cause
Trypanosomiasis

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8
Q

Name one cause of mononucleosis syndrome

A

EBV
CMV
Toxoplasma
Acute HIV

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9
Q

Name one cause of fever persisting for more than 2 weeks

A 
Malaria
Enteric fever
EBV
CMV
Toxoplasmosis
acute HIV
acute schistosomiasis
Brucellosis
TB
Q fever 
Vixceral lesihmanisis
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10
Q

Name one cause of fever with onset over 6 weeks

A

Vivax malaria
Acute hepatitis
TB
Amoebic liver abscess

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11
Q

What diseases are mosquitos responsible for?

A 
Malaria (Anopheles)
Dengue (Aedes)
West Nile virus
Lymphatic Filariasis
Yellow Fever
Zika Virus
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12
Q

How many cases a year of malaria are there in the UK?

A

1500

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13
Q

What are the 5 Plasmodium species?

A 
Falciparum
Vivax
Ovale
Malariae
Knowlesi
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14
Q

What are the features of falciparum?

A

Invades erythrocytes

Double dotted rings

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15
Q

What is the blood film appearance of Vivax?

A

Schaffner dots

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16
Q

What is the blood film appearance of Ovale?

A

Enlarged red cells
Schaffner dots
comet forms

17
Q

What is the blood film appearance of Malariae?

A

Daisy head appearance

Square ring forms

18
Q

What is the life cycle of malaria?

A

o Within humans, there is an erythrocytic stage and an exo-erythrocytic stage

o Malaria breaks down red cells -> haemolysis

o There is also a liver stage (where the parasite lies dormant in the liver)

19
Q

How do we prevent malaria?

A

o Awareness of risk
o Bite prevention
o Chemoprophylaxis
o Diagnose promptly and treat without delay

20
Q

What are the clinical features of malaria?

A

Cyclical fevers or continuous without spikes

Malaria paroxysm

21
Q

What are the complications of severe malaria?

A 
ARDS
Hepatic failure
Altered consciousness
Circulatory collapse
Renal failure

Biochemical changes:
Metabolic acidosis, severe anaemia, haemoglobinuria, coagulopathy, DIC, hypoglycaemia

22
Q

How do you diagnose malaria?

A

3 thick (parasites) and thin (species and quantity) blood films using fields or Giemsa stain

Malaria antigen detection tests (Paracheck PF or optiMAL-IT)

23
Q

What is the treatment of mild F malaria?

A

Adult - Malarone (Atovaquone and proguanil)

Child- (Artemisinin Combination Therapy Artemisinin + lumefantrine)

Oral quinine/ Doxycycline

24
Q

What is the treatment of severe F malaria?

A 
IV artesunate (+/- quinine)
Glucose and hydration support
25
Q

What type of virus is dengue?

A

Flavivirus - short incubation - urban areas

26
Q

What are the symptoms of Dengue?

A 
Fever
Muscle aches
Headache
Rash (erythroderma)
Hepatitis
Encephalitis
27
Q

How do you investigate Dengue?

A

Serology
PCR
(Dengue cross reacts with other viruses via IgE)

28
Q

What is the treatment of Dengue?

A

Supportive

Fever calms down after 5 days

29
Q

What causes typhoid?

A

S. typhi (Gram negative rod)
Long incubation
South Asian bacteria

30
Q

What are the symptoms of typhoid?

A 
High prolonged fever
Rose spots
Dry cough
Headache
Constipation - GI bleed, perforation
Encephalopathy
31
Q

What is the treatment of typhoid?

A

Ceftriaxone then azithromycin (7 days)

32
Q

What is the pathology of mononucleosis?

A

Atypical lymphocytes cause by EBV or CMV resulting in exudative tonsillar enlargement

33
Q

What causes Ricketsia?

A

Obligate intracellular bacteria which invades endothelial cells and causes vasculitic rash

Many bugs are vectors: ticks, lice and mites

34
Q

How do you diagnose Ricketsia?

A

Fever/ headache/ Myalgia/ Eschar

Serology

35
Q

How do you treat Ricketsia?

A

Doxycycline

36
Q

What organisms cause short diarrhoeal illnesses?

A

Bacteria or virus

37
Q

What organisms cause long diarrhoeal illnesses?

A

Protozoa (e.g. Giardia)

Helminths

38
Q

What causes skin rash and eosinophilia?

A

Katayama fever (or helminths)

39
Q

What is Katayama fever associated with?

A

Swimming in Fresh water

PathY5 (98 decks)

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