Certificate of Knowledge in Travel Medicine Examination Update
The ISTM Exam Committee has been working feverishly on the upcoming Certificate of Knowledge in Travel Medicine exam. It will be administered on May 7, 2003, prior to the opening of the 8th CISTM in New York City. Some 500 questions written by the committee now fill the question bank. Those questions are going through a series of review processes and will be narrowed to 200 for the actual exam.
The scope of the ISTM exam is international, and will not test knowledge of specific national guidelines. Its focus will be on the concepts involved in giving pre-travel health advice. No post-travel treatment questions will be included, since this is not an exam in tropical medicine. Those passing the exam will be granted a Certificate in Travel Health or "CTH." The exam is open to all licensed travel medicine practitioners, including physicians, nurses, pharmacists, and others.
Candidate Bulletins of Information (CBI) and applications for the exam will be available by the end of September. All ISTM members will receive a CBI and application in their membership renewal packets in October. The CBI will also appear on the ISTM website soon.
We are happy to report four more nurses have joined exam committee. They are Laurie Bank, U.S.; Irmgard Bauer, Australia; Jane Chiodini, U.K.; and Margaret Bodie-Collins, Canada.
Please visit the "Travel Med. Exam" page on the ISTM website to find important references, conferences and courses which may help one prepare for the Certificate of Knowledge exam. Please note the ISTM will NOT sponsor its own review course for the exam.
Below are 20 sample questions you'll want to review to help familiarize yourself with the types of questions that will appear on the exam. An answer key follows the questions. These same questions are also posted on the website.
We hope you will strongly consider taking the ISTM Certificate of Knowledge in Travel Medicine exam! Please email any questions you may have regarding the exam to exam@istm.org.
Sincerely,
Phyllis Kozarsky on Behalf of the Exam Committee
1. According to International Health Regulations, national governments must report which of the following diseases to the World Health Organization (WHO) for maintenance of an infected area list?
A. Meningococcal meningitis
B. Ebola hemorrhagic fever
C. Yellow fever
D. Human immunodeficiency virus
2. A 25-year-old male is admitted to the hospital for unexplained high fever and diarrhea over the last week. He returned 4 months ago from a 1-month trip to India. He states that he took mefloquine weekly as prescribed (without missing any doses) prior to his trip, during his trip, and for 4 weeks after he returned. The most appropriate first diagnostic step is
A. a stool examination for ova and parasites
B. a blood culture to rule out typhoid fever
C. a blood smear for malaria parasites
D. an amoebic serology
3. Which of the following vaccinations is contraindicated for a traveller who has the Acquired Immunodeficiency Syndrome (AIDS) and a CD4 count of <200/?L (normal range 400/?L - 1500/?L)?
A. Japanese B encephalitis
B. Hepatitis A
C. Pneumococcal
D. Varicella
4. A traveller to Mexico develops sudden onset of severe, watery diarrhea, with four bowel movements in the first hour and a fever of 38.5 C? (101.3? F). The best treatment at this time is
A. metronidazole
B. ciprofloxacin
C. oral rehydration solution
D. bismuth subsalicylate tablets
5. Malaria chemoprophylaxis should always be recommended to travellers who are going for a 2-week visit to oceans or beaches in which of the following countries?
A. Kenya
B. Morocco
C. Thailand
D. Fiji
6. The risk of death from hepatitis A for a traveller 50-years-old or greater is approximately
A. 1%
B. 1-3%
C. 5-8%
D. 10-13%
7. The risk of developing dengue hemorrhagic fever or dengue shock syndrome is increased among travellers who have a history of
A. being bitten frequently by mosquitoes of different species
B. allergy to bee stings
C. past dengue infection
D. no prior travel to dengue risk areas
8. A traveller with chronic obstructive pulmonary disease and who is oxygen-dependent wishes to take a long-distance flight. Which of the following statements regarding oxygen use aboard commercial aircraft is correct?
A. Airlines are required to provide oxygen without prior notification.
B. Airlines are prohibited from providing oxygen for medical use aboard aircraft except in an emergency.
C. Individuals who are oxygen-dependent at sea level should not fly on commercial airlines.
D. Arrangements for oxygen use must be made with the airline several days in advance of a flight.
9. An unvaccinated traveller is at risk of contracting yellow fever in which of the following countries?
A. Nicaragua
B. South Africa
C. Brazil
D. Indonesia
10. Two tablets of bismuth subsalicylate taken 4 times daily during a 1-week trip to a developing country decreases the incidence of traveller's diarrhea by approximately what percentage?
A. 15
B. 40
C. 60
D. 90
11. The most common cause of death among travellers to developing countries is
A. malaria
B. motor vehicle accidents
C. drowning
D. hepatitis A
12. The term "morbidity" is used to describe
A. recovery rates after an illness
B. death rates
C. illness rates
D. time of illness to recovery
13. Plasmodium falciparum resistance to mefloquine is found primarily in
A. sub-Saharan Africa
B. Central America
C. South America
D. Southeast Asia
14. Wild polio virus is still in circulation in which of the following countries?
A. India
B. Brazil
C. Turkey
D. Vietnam
15. traveller's diarrhea due to quinolone-resistant Campylobacter species is most common in which of the following countries?
A. Peru
B. Mexico
C. Nepal
D. Thailand
16. How many people worldwide die from malaria each year?
A. 50,000 -100,000
B. 500,000 - 750,000
C. 1,000,000 - 3,000,000
D. 10,000,000 - 12,000,000
17. The concurrent administration of which of the following pairs of vaccines and medications may result in a reduced efficacy of the vaccine?
A. Oral typhoid vaccine and ciprofloxacin
B. Meningococcal meningitis vaccine and rifampin
C. Yellow fever vaccine and mefloquine
D. Japanese B encephalitis vaccine and acyclovir
18. Which of the following regimens is inappropriate for malaria chemoprophylaxis for a healthy adult travelling to India?
A. Mefloquine
B. Chloroquine
C. Atovaquone/Proguanil
D. Doxycycline
19. A family of four is leaving in January for a 2-year stay in Chad. The family consists of a 46-year-old father, a 34-year-old mother who is 5 months pregnant, a 4-year-old boy, and a 2-year-old girl. They have learned of a meningitis epidemic that has just begun in Chad. Assuming that the epidemic strain is covered by an available vaccine, which members of the family should be vaccinated?
A. Father and mother only
B. Father, mother, and 4-year-old boy
C. Father and the two children
D. The entire family
20. A traveller who has had no prior rabies immunization is bitten by a dog in Nepal. The traveller does not seek rabies postexposure treatment in Nepal, but presents 2 weeks after the bite. The recommended treatment at this point is to administer
A. a series of five injections of rabies vaccine on days 0, 3, 7, 14, and 28, but do not give human rabies immune globulin (HRIG) as more than 7 days have elapsed between the bite and the start of vaccine
B. nothing as more than 7 days have elapsed since the bite
C. HRIG alone since more than 7 days have elapsed since the bite
D. HRIG and begin a series of five injections of rabies vaccine on days 0, 3, 7, 14, and 28
Answer Key:
1.(C) 2.(C) 3.(D) 4.(B) 5.(A) 6.(B) 7.(C) 8.(D) 9.(C) 10.(C)
11.(B) 12.(C) 13.(D) 14.(A) 15.(D) 16.(C) 17.(A) 18.(B) 19.(D) 20.(D)
