wk 5 - 6 topical infection

Question 1

tropical infections can be divided into 3

Answer 1

returned travellers (acute,enteric fever, fever and jaundice) 
protozoan infections
helminthic infections

Question 2

questions to ask a returned traveller 10

Answer 2

where?
rural/urban? 
accomodation? 
when? when did they return? 
when did they start feeling unwell?
insect bites? 
symptoms?
anyone else unwell? 
activities? 
precautions?

Question 3

what is likely to be found in a returned traveller infection on examination

Answer 3

pyrexia 
rash
hepatosplenomegaly 
lymphadenopathy
insect bites 
wounds

Question 4

associated diseases of a returned travellers fever 5

Answer 4

resp tract infectioin - pneumonia, flu 
diarrhoea
malaria
enteric fever (typhoid/paratyhpoid fever)
arboviruses - dengue/chikungunya

Question 5

most common bacteria causing acute travellers diarrhoea, name 3 others

Answer 5

enterotoxigenic E.Coli

campylobacter
salmonella
shigella

Question 6

if the patient was on a cruise ship, what would be expected organism 2

Answer 6

noravirus

rotavirus

Question 7

t/f dysentery (bloody diarrhoea) is caused by E.coli157

Answer 7

true

Question 8

name for profuse watery diarrhoea

Answer 8

cholera

toxin mediated disease, associated with outbreaks

Question 9

what 2 investigations would be carried out for acute travellrs diarrhoea

Answer 9

stool culture

stool wet prep - ameobic trophozoites

Question 10

t/f a single dose of azithromycin can stop worsening in travellers diarrhoea

Answer 10

ffalse 
floroquinolone (ciproflaxin)

Question 11

when would a macroslide begiven

Answer 11

if suspected pathogen is antibiotic resistant - v common in asia

Question 12

which fever is most common in those returning from india/SE asia, and often due to people visiting family/friends

Answer 12

enteric fever ((typhoid/paratyphoid)

Question 13

likely incubation period of enteric fever

Answer 13

7-18days (can be up to 60)

Question 14

associated symptoms of enteric fever

Answer 14

fever
headache
constipation/diarrhoea
dry cough

Question 15

what 2 organisms cause enteric fever q

Answer 15

salmonella tyhpi

parayphi

Question 16

if enteric fever patient has severe sepsis, what is given

Answer 16

Iv ceftriaxone

-cephalosporin, bind to cell wall

Question 17

t/f 70% of salmonella tyhpi/paratyphi are resistance to azithromycin

Answer 17

false

70% resistance to ciprofloxacin (floroquinolone)

Question 18

investigation if malaria suspected

Answer 18

blood film and rapid antigen

Question 19

amoebiasis is an infection of sml intestine by a parasite, causing diarrhoea with blood/mucus. what organism causes this

Answer 19

entamoeb histolytica

protozoa

Question 20

associated symptoms of amoebic dysentry

Answer 20

ab pain
fever
blood diarrhoea/colitis - perforation
toxic and unwell, abd tenderness

Question 21

3 investigations if ameobiasis is suspected

Answer 21

stool microscopy for trophozoites or cysts (determines E.histolytica from e.dispar)
AXR - toxic megacolon
Endoscopy for biopsy - if no evidence of toxic dilation

Question 22

amoebiasis can be assymptomatic, what would be found in the stools which would identify this

Answer 22

sheds cysts in stoools

Question 23

if a liver abscess develops from amoebiasis, can have subacute presentation for over 2–4weeks. Outline this presentation

Answer 23

fever,sweats
upper ab pain 
sometimes history of GI 
hepatomegaly 
point tenderness over right lower ribs

Question 24

associated investigations for amoebic liver abscess

Answer 24

abnormal LFTs
CXR - raised hemi-diaphragm
USS/CT scan
serology
stool microscopy - often -ve

Question 25

pyogenic vs amoebic liver abscess

Answer 25

pyogenic - bacterial

amoebic - e.histolytica

Question 26

giarhia intestinalis (lamblia) invades duodenum and proximal jejunum, how does it spread?

Answer 26

faecal-oral route

contaminated water most common

Question 27

presentation of giardiasis

Answer 27

watery, smelly diarrhoea
bloating, flatulence
ab cramps
weight loss

Question 28

investigations for giardiasis

Answer 28

stool microscopy for cysts

PCR

Question 29

treatment for Giardiasis

Answer 29

metronidazole

Question 30

drugs used to clear gut lumen of parasites

Answer 30

paramomycin

diloxanide

Question 31

most common helminth infection

Answer 31

ascariasis - intestinal nematodes

Question 32

outline the lifecycle of helminth infections

Answer 32

eggs injested
hatch in sml intestines
 invade gut walls intovenous system 
via liver - heart - lungs 
break into alveoli 
ascend tracheobronchial tree
swallowed and in gut develop into adult worms, producing eggs

Question 33

chronic infection of trematodes can lead to

Answer 33

hepatomegaly
liver fibrosis
portal hypertension

Question 34

cestodes (tapeworms) are acquired by eating undercooked meat containing cysts. name given if ingested by pork/beef

Answer 34

pork - taenia solium

beef - saginatum

Question 35

t/f saginatum can cause seizures

Answer 35

false

taenia solium can

Question 36

chagas disease is caused by Triatome (trypanasoma cruzi) and affects the colon and oesophagus by

Answer 36

parasympathetic denervation

megaoesophagus