Travelers

Question 1

When is dysentary classified?

Answer 1

When there is blood mixed in the stool

Question 2

Primary pathogen for travelers diarrhea?

Answer 2

E. Coli

Question 3

Prophylaxis for TD?

Answer 3

Bismuth

Pepto

Question 4

Pts at high risk for TD can be given Abx prophylaxis

What is the DOC?

Answer 4

Rifaximin

Quinolones if low resistance

Question 5

Tx for Mild, Mod, Severe TD

Answer 5

Mild TD: Loperamide

Mode: Loperamide +/- Abx

Severe Including Dysentary, Azithromycin 1,000 mg x 1 dose +/- loperamide

Question 6

Travel Vaccines

Inactive 7

Answer 6

• Hep A (Havrix, VAQTA)
• Hep B (engerix-B recombinant HB)
• Hep A/B (Twintrix)
• Japanese enceph (Ixiaro)
• Mengingococcus (Menveo, Menactra)
• Polio (IPOL)
• Typhoid IM (Typhim Vi)

Question 7

Travel vaccines Active 3

Answer 7

• Cholera-PO (Vaxchora)
• Typhoid-PO (Vivotif)
• Tellow fever SC (YF-VAX)

Question 8

What pathogen is typhoid fever caused by?

How is it spread?

Answer 8

Salmonella typhi

Water or food contaminated by human feces or from a chronic asymptomatic carrier

Question 9

When should both forms of the typhoid vaccine be given?

Answer 9

1 wk for oral

2 wks for IM

Question 10

How is Hep B transmitted?

Answer 10

Blood or bodily fluids

Question 11

How long does the 3 dose hep be series take to complete?

Answer 11

6 months

Question 12

How is mengingitis spread

Answer 12

Respiratory secretions

Question 13

What do mosquitos transmit? 5 things

Answer 13

1. Malaria
2. Japanese encephalitis
3. Yellow fever
4. dengue
5. Zika

Question 14

How should permethrin be used?

Answer 14

On clothing and gear dont apply to skin

Question 15

Malaria drug side effects?

Answer 15

Nausea is big

Question 16

What 3 drugs are recommended if you are traveling soon and when should they be given?

Which ones are used in pregnancy?

Answer 16

1. 1-2 days prior to travel
2. Malarone (Atovaquone/Proguanil) Not used in severe renal impairment
3. Vibramycin, Doryx (Doxycycline) also not used in children under 8
4. Primaquine (not used in G6DP Deficiency)
5. None are used in pregnancy

Question 17

How are the quick start malaria drugs taken?

Answer 17

Daily otal

Question 18

When should chloroquine be started? Stopped?

Answer 18

Weekly regimen that should be started 1-2 wks prior to travel and stopped 4 wks after

THe advanced start regimens are safe in pregnancy

Question 19

What side effects does chloroquine have? 2 bigs ones

Answer 19

Retinal toxicity

Visual changes

Question 20

Mefloquine (Lariam)

Not used in? 3

Answer 20

1. Pts with underlying psych conditions
2. Seizures
3. Arrythmias

Question 21

What is the vaccine for Japanese Encephalitis?

Answer 21

Ixiaro

Question 22

The yellow fever vaccine YF-VAX is contraindicated in what?

Answer 22

Pts with hypersensitivity to eggs

Question 23

What is the primary prophylactic treatment for altitude sickness?

What is a contraindication?

Answer 23

Acetazolamide

125 mg BID

Preferred start the day before

Contraindicated in pts with sulfa allergy