Week 5 - Travel related infections Flashcards

1
Q

What would an FBC of malaria show?

A
  • Decreased Hb
  • Decreased WBC
  • Decreased platelet count
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2
Q

Why does malaria affect the liver?

A
  • Increased breakdown of RBCs

- Liver cannot cope with increased demand and jaundice ensues followed by liver damage

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3
Q

What is the infectious cause of malaria?

A
-Plasmodium of which there are 4 species:
P.falciparum
P.Vivax
P.Ovale
P.malariae
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4
Q

What is the vector for malaria?

A

-Female anopheles mosquito

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5
Q

Does malaria require isolation?

A

-No, there is no case-case spread

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6
Q

Where is malaria common?

A
  • Africa (bar the south)
  • India
  • S.America
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7
Q

How long is the incubation period of malaria?

A

-1-3 weeks

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8
Q

Which plasmodium species is most severe?

A

-P.falciparum

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9
Q

What are the complications of p.falciparum malaria?

A
  • CVS complications -> tachy, hypotension, arrhythmias
  • Resp -> ARDS
  • GIT -> jaundice and diarrhoea
  • Renal -> AKI
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10
Q

Describe the pathogenesis of malaria

A
  • Plasmodium in mosquito matures into sporozoite and takes a blood meal injecting parasite
  • Parasite infects liver cells and forms a schizont which rupures and enters bloodstream
  • Infects RBC and matures resulting in lysis of RBC and infects another
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11
Q

What are the investigations of malaria is suspected?

A
  • Contact infectious disease physician
  • Blood smear x 3
  • FBCs, U+Es, LFTs, glucose
  • Head CT if CNS problems
  • CXR
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12
Q

What are the treatments of malaria?

A
  • Treatment is species specific
  • P,falciparum -> quinine
  • P.vivax, ovale or malariae -> primaquine and chloroquine
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13
Q

How is malaria prevented?

A
  • Knowledge of at risk areas via CDC
  • Bite prevention -> covered clothes etc
  • Chemoprophylaxis
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14
Q

Why is history so important in infectious disease?

A
  • Recognise imported diseases
  • Infection prevetion
  • Different strains of pathogen have different virulence/resistance
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15
Q

What is enteric fever?

A

-Typhoid or paratyphoid

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16
Q

How does enteric fever present?

A

-Constipation, severe cramps, vomiting, bacteraemia, abdomen tenderness, splenomegaly, temp, low BP

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17
Q

What are the features of FBC in enteric fever?

A
  • Decreased WBC

- Decreased Hb

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18
Q

What are the features of LFTs in enteric fever?

A
  • Increased ALT

- Increased CRP

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19
Q

What is the infectious agent of enteric fever?

A
  • Salmonella Typhi

- Salmonella Paratyphi A, B or C

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20
Q

In what countries in enteric fever common and why?

A

-Africa, Asia and S.america due to poor sanitation

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21
Q

Who does enteric fever mainly affect?

A

-Children

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22
Q

What is the mechanism of infection of enteric fever?

A

-Faecal-oral from contaminated food/water

23
Q

What is the gram status of salmonella?

A

-Gram negative bacilli

24
Q

What gives salmonella typhi its virulence?

A

-Endotoxin, VI antigen, invasins and fimbrae

25
Q

Where specifically in the GI tract does salmonella typhi invade?

A

-Payers patches

26
Q

What is the incubation period of salmonella typhi?

A

-7-14 days

27
Q

What is the firstline treatment for salmonella?

A

-Ceftriaxone or macrolide

28
Q

How is enteric fever prevented?

A
  • Food and water hygeine
  • Precautions
  • Vaccines
29
Q

What are the serotypes of influenzae?

A

-A, B C

30
Q

How are influenzae viruses spread?

A

-Cough/sneeze

31
Q

What is the incubation period for influenzae?

A

-2 days

32
Q

What is the presentation of influenzae?

A

-Headache, sore throat, fever, muscle ache, cough

33
Q

Does influenzae require treatment?

A

-No, it is self-limiting

34
Q

What are possible complications of influenzae?

A
  • Pneumonia

- Sinusitis

35
Q

How can you prevent influenzae?

A
  • Frequent hand washing

- Vaccinations of elderly and at risk

36
Q

Why do you have to vaccinate from influenzae yearly?

A

-Rapidly evolving virus so new strain year on year

37
Q

What to viral peptides are responsible for influenzae virulence?

A

-Haemogluttin and Neurominadase

38
Q

What is antigenic drift?

A

-Small mutations which occur continually over time from person-person

39
Q

What is antigenic shift?

A

-Complete change in viral protein composition

40
Q

Describe the presentation of legionnaires disease

A

-Fever, SoB, Productive cough, decreased O2 satsm Increased RR, increased HR (SIRS)

41
Q

What investigations would you do for legionella?

A

-CXR, sputum sample, blood culture, FBC, U+E,

42
Q

Describe the gram status of legionella pneumophilia

A

-Gram negative bacilli (flagellated)

43
Q

How is legionella transmitted?

A
  • Airborne

- Contaminated water droplets

44
Q

What type of cells does legionella infect?

A

-Type 2 pneumocytes

45
Q

What is the first line treatment for legionella?

A

-Erythromycin

46
Q

Name some causes of travellers diarrhoea

A
  • Norovirus
  • E.coli
  • Campylobactor
  • Salmonella
  • Shigella
  • rotavirus
  • Vibrocholera
47
Q

What is icterus?

A

-Yellow sclera

48
Q

Name the travel-related infection associated with a confluent macular rash

A

-Dengue fever

49
Q

How would you diagnose dengue fever?

A

-PCR and serology

50
Q

Name a travel related infections associated with lava

A

-Myiasis (bot fly)

51
Q

What is dysentry?

A

-Blood and mucus in stool

52
Q

What are some important questions you would ask a patient to elicit travel history?

A
  • Where have you been and for how long?
  • When did you return?
  • When did your symptoms start in relation to your return?
  • Is your travel companion ill?
  • Did you do any recreational activities?
  • Did you take any precautions before going away? (vaccinations)
53
Q

Describe the common presentation of malaria

A
  • Fever and chills
  • Muscle weakness,myalgia and fatigue
  • Shaking
  • Headache and syncope
  • Decreased BP, increased HR, Decreased Sats