.microbio E3: Traveler's Medicine And Global Med

Front 1

What is the recommended drug for early treatment of traveler's diarrhea stemming from food and water supply contamination:
A. in children and pregnant women
B. in adults and adolescents

Back 1

A. in children and pregnant women : Azythromycin
B. in adults and adolescents : Ciprofloxacin

Front 2

Hep A vaccine is effective
A. 1-2 weeks after immunization
B. 2-4 weeks after immunization
C. 4 weeks after immunization

Back 2

B. 2-4 weeks after immunization

indicated for > 1 y/o, complete series requires escond injection

Front 3

True or False:
Typhoid vaccine is oral and approved for patients 6+ years old.

Back 3

True

Front 4

True or False:
Chloroquine is CONTRAINDICATED for pregnant women.

Back 4

FALSE.

CHLOROQUINE IS ACTUALLY REALLY GOOD IN THAT IT IS NOT CONTRAINDICATED FOR PREGNANT WOMEN!

Front 5

In what geographic regions should chloroquine NOT be prescribed for malaria? (What areas are resistant,usually?)

A. North America
B. South America
C. Europe
D. Mediterranean basin
E. Sub-saharan Africa

Back 5

B. South America
E. Sub-saharan Africa

Front 6

Doxycycline could be used as prophylaxis for what traveling disease?

Back 6

Malaria! Though causes photosensitivity and is contraindicated in pregnant women and children.

Front 7

With regards to dosing schedules of chloroquine- mefloquine and doxycycline-malarone-primaquine prophylactics, which dosing schedule is being described?
*start 1 wk prior to travel
*weekly while in country
*weekly for 4 weeks after returning

Back 7

chloroquine- mefloquine

Front 8

With regards to dosing schedules of chloroquine- mefloquine and doxycycline-malarone-primaquine prophylactics, which dosing schedule is being described?
*start 1-2 days prior to travel
*daily while in country
*daily for 1 week after returning (if _____, ______ or 4 weeks after returning (______)

Back 8

Doxycycline-malarone-primaquine

spaces: Malarone, primaquine
lastspace: doxycycline

Front 9

Where is Yellow Fever endemic?
A. North America
B. South America
C. Africa
D. Asia
E. Euroupe

Back 9

B. South America
C. Africa

Front 10

Where is the "meningitis belt"?
A. North America
B. South America
C. Africa
D. Asia
E. Euroupe

Back 10

C. Africa
(specifically, Sub-Saharan Africa)

Front 11

Vaccine given for this condition is on days 1, 7, and 21/28 days for pre-exposure prophylaxis. Indicated for all ages. Unlcear how long protection lasts.

A. Yellow fever
B. Typhoid
C. Rabies
D. Dengue
E. Japanese Encephalitis

Back 11

C. Rabies

Front 12

Which vaccine is contraindicated for pregnant women and people in immune-compromised states?

A. Japanese Encephalitis
B. Rabies
C. Yellow Fever
D. Typhoid

Back 12

C. Yellow Fever

Front 13

If taking cholroquine as prophylaxis, what is the dosing regimen?

Back 13

Dosing is weekly - 1 week prior to travel thru 4 weeks after return.

Front 14

If traveling to a chloroquine-resistant area, can consider taking Mefloquine, Doxycycline, Malarone (Atovaquone/ Proguanil), Primaquine. Match each to its contraindicaiton/side effect(s).
1. Not rec for preggers or children, SE: photosensitivity, GI symptoms
2. Not rec for preggers, can cause hemolysis if G6PD deficient so needs testing prior to use
3. Not rec for preggers, more expensive than other regimens, not safe with renal impairment
4. Contraindicated w/ psychiatric history, cardiac arrhythmia, seizures
5. Safe in pregnancy and infancy

Back 14

1. Doxycycline
2. Primaquine
3. Malarone
4. Mefloquine
5. Mefloquine

Front 15

Regarding population pyramids, when larger numbers of the population are in the younger age groups, and the population is rapidly growing with very large fertility rates and lower than average life expectancies, what type of population pyramid do you have?

A. Expansive
B. Constrictive
C. Stationary

Back 15

Expansive. These are common in developing countries, like Honduras.

Front 16

What type of population pyramid exhibits lower numbers of younger people?

A. Expansive
B. Constrictive
C. Stationary

Back 16

B. Constrictive

Front 17

What type of population pyramid is characterized by slowly growing population where the births roughly equal deaths and number of individuals in different age groups are roughly equal? Where is this seen?

A. Expansive
B. Constrictive
C. Stationary

Back 17

C. Stationary

Seen in Scandinavian countries (Northern Europe- Denmark, Sweden, Norway)

Front 18

True or False:
The largest cities in the world are growing rapidly and shifting from the more developed regions to the less developed regions of the world.

Back 18

True. In 1950s, the largest cities were London, New York City, Tokyo. In projected 2015, the largest cities will be New Delhi, Mumbai.

Front 19

Causes of death worldwide differs in developed regions and developing regions. What are the % of each in each?

Noninfectious diseases, infectious diseases,
injuries

Back 19

Developed regions: 77% non infectious disease, 14% infections, 9% injuries

Developing regions: 55% infections, 37% noninfectious disease, 8% injuries

Front 20

As for leading causes of death, what are the top leading causes of death in developing countries versus developed countries?

Back 20

In developing countries, they are infectious things like AIDS, lower respiratory infections, diarrheal diseases.

In developed countries, they are things like chronic noninfectious things like ischemic heart disease, cerebrovascular diasese, COPD.

Front 21

Ecology influences the distribution of infectious diseases. What are two-factor, three-factor and four-factor complexes?

Back 21

Two-factor complexes (ex. polio): Agents transmitted directly from person to person. There is wide geographic distribution; affected by human behavior but not much affected by temperature or rainfall.

Three-factor complexes (ex. Malaria): Involves transmission thru a vector intermediate. Limited geogrpahically by distribution of vector.

Four-factor complex (Ex. EEE): Transmission between nonhuman vertebrate and arthropod host with human as accidental host. Geographic distribution even more limited than for previous complexes.

Front 22

Which of the following is FALSE regarding effect of climate on infectious diseases?

A. Tropical agents generally develop more rapidly and to higher infectious titers in warm temps
B. Arthropods generally develop more rapidly at warmer temps
C. Temps affect size of adult arthropods. They are larger in warmer climates and therefore require more blood meals.
D. Rainfall and other water sources are essential to many 3 and 4-factor complexes.
E. Increase in rainfall increases food for rodents and increases rodent population

Back 22

C. Temps affect size of adult arthropods. They are larger in warmer climates and therefore require more blood meals.

This is only partially true because arthropods are actually SMALLER in the tropics and THEREFORE require more bloodmeals.

Front 23

Name some of the ten factors favoring the emergence of infectious diseases.

Back 23

Population growth
Speed and ease of travel
Dam building
Movement into previously uninhabited forested areas
Relocation of animals
Global warming
War and political crises
Day care
Nursing homes
Antibiotic overuse

Front 24

True or False:
Co-infection of TB and HIV lead to worse outcomes.

Back 24

TRUE

Front 25

Diarrheal diseases account for ____% of childhood mortality in the developing world. Primary pathogens are rotavirus and enterotoxigenic E. coli. Morbidity and mortality are due mainly to _________ or _______.

Back 25

20-25%,

due to dehydration or bacteremia (as in Shigella)

Major intervention is : oral rehydration therapy!

Front 26

True or False:
HIV infection increases the incidence of clinical malaria and its severity and case fatality.

Back 26

TRUE