Travel Medicine Verified Multiple Choice and Conceptual Actual Exam
Questions With Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update
Diarrhea developing during or within 10
What is traveler's diarrhea days of return from travel to resource-lim-
ited regions
Which regions are high risk for traveler's South/Southeast Asia, Africa,
diarrhea South/Central America, Mexico
mild = 1-2 unformed stool/day
mod = 1-2 unformed stool/day w malaise,
How is traveler's diarrhea classified by
n/v, abdo pain
etiology
severe/classic = >3 unformed stool/day,
significantly interferes with activities
Fever, Hematochezia/Melena, Mucoid
what is dysentery
Stools
Which bacterial pathogens most com- Enterotoxigenic E. coli, Shigella spp.,
monly cause traveler's diarrhea Campylobacter jejuni
Which viral pathogen is most common in
Rotavirus
traveler's diarrhea
Which parasitic pathogens can cause Giardia lamblia, amebiasis, Cryp-
traveler's diarrhea tosporidium spp.
Food/water-transmitted E. coli releasing
toxins
What is enterotoxigenic E. coli (ETEC) watery diarrhea, no fever; incubation 1-3
days, self limiting
MCC traveler's diarrhea
E. coli that adheres to endothelium ’ wa-
tery diarrhea, acute or chronic; incuba-
What is enteroaggregative E. coli tion 8-48 hours
(EAEC)
potential to require abx bc symptoms
may persist
Zoonotic pathogen (poultry, cattle, wa-
What is Campylobacter jejuni infection ter)
’mucosal inflammation, profuse diarrhea
, Travel Medicine Verified Multiple Choice and Conceptual Actual Exam
Questions With Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update
which may lead to dysentery
incubation ~3 days
What complication is associated with
Post-diarrheal Guillain-Barré syndrome
Campylobacter jejuni
Fecal-oral Shigella infection
’ 4phases of incubation then watery diar-
rhea then dysentery then postinfectious
What is shigellosis
symptoms
highly infectious! only 10 cells will cause
infx
S. flexneri and S. dysenteriae
Which Shigella species cause severe
disease vs s. sonnei which is less severe and not
assx w travelers diarrhea
Toxic megacolon, HUS (S. dysenteriae
What are complications of shigellosis
type 1), reactive arthritis
Foodborne Salmonella enterica/bongori
from poultry, eggs, milk
What is nontyphoidal salmonellosis ’moderate nonbloody diarrhea, fever; in-
cubation 6-48 hours
self limiting usually
Bacteremia, endovascular in-
fections, intra-abdominal/CNS/pul-
What are complications of nontyphoidal monary/GU/bone-joint infections
salmonellosis
more common in infants, eldery, im-
munocomp
Food, water, fecal-oral, anal-oral, sexual;
How is giardiasis transmitted cysts can survive in cold water; incuba-
tion 1-3 weeks
Acute watery diarrhea with cramps,
bloating (1wk) -- dehydration
What are giardiasis clinical phases
Chronic greasy foul diarrhea with flatus,
cramps (can be daily or intermittent)
How is giardiasis diagnosed Stool ova & parasites
, Travel Medicine Verified Multiple Choice and Conceptual Actual Exam
Questions With Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update
Clincally based on history of travel
stool cultures in severe cases (not need-
How is traveler's diarrhea diagnosed ed every time unless symptoms persist
past day 5/6 or if parasites are suspected
then need stool for O&P)
What supportive care for traveler's diar- Fluid replacement (ORS, broths, juices),
rhea BRAT diet, possible IV fluids
Mild/moderate cases only; avoid if febrile
or dysenteric (they need abx)
When are antimotility agents indicated
for travelers diarrhea
use loparamide (imodium), can use lo-
motil but higher abuse potential
4 mg once, then 2 mg per loose stool,
What is loperamide dosing
max 16 mg/day
Severe/prolonged illness with fever,
When are antibiotics used in traveler's
dysentery; may shorten duration by 1-2
diarrhea
days
Single-dose fluoroquinolones (lev-
ofloxacin 500 mg, ciprofloxacin 750 mg,
Which antibiotics are preferred for travel-
ofloxacin 200 mg) with antimotility
ers diarrhea empirically
for toxigenic NONBLOODY diarrhea
Dysentery, febrile diarrhea, travel from
Asia/india, pregnancy, post-FQ persis-
When is azithromycin preferred for trav-
tent diarrhea
elers diarrhea
good for c. jejuni (thailand)
400 mg BID × 3 days for noninvasive
What is rifaximin use in traveler's diar- ETEC; not for dysentery/febrile cases
rhea
ok alt to fluoroquinolones
Which antibiotic for Campylobacter jejuni Azithromycin (due to FQ resistance)
What is first-line therapy for shigellosis Fluoroquinolones (ciprofloxacin)
What is second-line therapy for shigel-
Ceftriaxone or azithromycin
losis
Questions With Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update
Diarrhea developing during or within 10
What is traveler's diarrhea days of return from travel to resource-lim-
ited regions
Which regions are high risk for traveler's South/Southeast Asia, Africa,
diarrhea South/Central America, Mexico
mild = 1-2 unformed stool/day
mod = 1-2 unformed stool/day w malaise,
How is traveler's diarrhea classified by
n/v, abdo pain
etiology
severe/classic = >3 unformed stool/day,
significantly interferes with activities
Fever, Hematochezia/Melena, Mucoid
what is dysentery
Stools
Which bacterial pathogens most com- Enterotoxigenic E. coli, Shigella spp.,
monly cause traveler's diarrhea Campylobacter jejuni
Which viral pathogen is most common in
Rotavirus
traveler's diarrhea
Which parasitic pathogens can cause Giardia lamblia, amebiasis, Cryp-
traveler's diarrhea tosporidium spp.
Food/water-transmitted E. coli releasing
toxins
What is enterotoxigenic E. coli (ETEC) watery diarrhea, no fever; incubation 1-3
days, self limiting
MCC traveler's diarrhea
E. coli that adheres to endothelium ’ wa-
tery diarrhea, acute or chronic; incuba-
What is enteroaggregative E. coli tion 8-48 hours
(EAEC)
potential to require abx bc symptoms
may persist
Zoonotic pathogen (poultry, cattle, wa-
What is Campylobacter jejuni infection ter)
’mucosal inflammation, profuse diarrhea
, Travel Medicine Verified Multiple Choice and Conceptual Actual Exam
Questions With Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update
which may lead to dysentery
incubation ~3 days
What complication is associated with
Post-diarrheal Guillain-Barré syndrome
Campylobacter jejuni
Fecal-oral Shigella infection
’ 4phases of incubation then watery diar-
rhea then dysentery then postinfectious
What is shigellosis
symptoms
highly infectious! only 10 cells will cause
infx
S. flexneri and S. dysenteriae
Which Shigella species cause severe
disease vs s. sonnei which is less severe and not
assx w travelers diarrhea
Toxic megacolon, HUS (S. dysenteriae
What are complications of shigellosis
type 1), reactive arthritis
Foodborne Salmonella enterica/bongori
from poultry, eggs, milk
What is nontyphoidal salmonellosis ’moderate nonbloody diarrhea, fever; in-
cubation 6-48 hours
self limiting usually
Bacteremia, endovascular in-
fections, intra-abdominal/CNS/pul-
What are complications of nontyphoidal monary/GU/bone-joint infections
salmonellosis
more common in infants, eldery, im-
munocomp
Food, water, fecal-oral, anal-oral, sexual;
How is giardiasis transmitted cysts can survive in cold water; incuba-
tion 1-3 weeks
Acute watery diarrhea with cramps,
bloating (1wk) -- dehydration
What are giardiasis clinical phases
Chronic greasy foul diarrhea with flatus,
cramps (can be daily or intermittent)
How is giardiasis diagnosed Stool ova & parasites
, Travel Medicine Verified Multiple Choice and Conceptual Actual Exam
Questions With Reviewed 100% Correct Detailed Answers
Guaranteed Pass!!Current Update
Clincally based on history of travel
stool cultures in severe cases (not need-
How is traveler's diarrhea diagnosed ed every time unless symptoms persist
past day 5/6 or if parasites are suspected
then need stool for O&P)
What supportive care for traveler's diar- Fluid replacement (ORS, broths, juices),
rhea BRAT diet, possible IV fluids
Mild/moderate cases only; avoid if febrile
or dysenteric (they need abx)
When are antimotility agents indicated
for travelers diarrhea
use loparamide (imodium), can use lo-
motil but higher abuse potential
4 mg once, then 2 mg per loose stool,
What is loperamide dosing
max 16 mg/day
Severe/prolonged illness with fever,
When are antibiotics used in traveler's
dysentery; may shorten duration by 1-2
diarrhea
days
Single-dose fluoroquinolones (lev-
ofloxacin 500 mg, ciprofloxacin 750 mg,
Which antibiotics are preferred for travel-
ofloxacin 200 mg) with antimotility
ers diarrhea empirically
for toxigenic NONBLOODY diarrhea
Dysentery, febrile diarrhea, travel from
Asia/india, pregnancy, post-FQ persis-
When is azithromycin preferred for trav-
tent diarrhea
elers diarrhea
good for c. jejuni (thailand)
400 mg BID × 3 days for noninvasive
What is rifaximin use in traveler's diar- ETEC; not for dysentery/febrile cases
rhea
ok alt to fluoroquinolones
Which antibiotic for Campylobacter jejuni Azithromycin (due to FQ resistance)
What is first-line therapy for shigellosis Fluoroquinolones (ciprofloxacin)
What is second-line therapy for shigel-
Ceftriaxone or azithromycin
losis
