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MCQs in Tropical Medicine

Rob Skelly DTM+H FRCP

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Answer 67

In a cholera epidemic
True a. cases have copious watery diarrhoea
False b. intravenous rehydration therapy has no place
True c. the most important public health intervention is the provision of clean water and good sanitation
False d. mass chemoprophylaxis with oral tetracycline should be arranged urgently
False e. mass vaccination should be undertaken


Provision of clean water and adequate sanitation is the most important measure. Health education is also important. Many cases can be managed with oral rehydration therapy alone, given via nasogastric tube if necessary. Intravenous therapy should be given in patients more than 10% dehydrated.

Antibiotics reduce the duration of diarrhoea from a mean of 1.8 days to a mean of 0.8 days. Stool volume, intravenous fluid requirements and length of hospital stay are reduced by antibiotics. Tetracyclines, chloramphenicol, cotrimoxazole, doxycycline, ampicillin, ciprofloxacin and furazaladone have been used successfully. Treatment of household contacts with 200mg of doxycycline (single dose) is recommended but mass chemoprophylaxis is not.

Copyright: Rob Skelly 2006