Sample Questions

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Below are sample questions that examinees may want to review before taking the ISTM Certificate of Knowledge in Travel Medicine Exam. An international panel of travel medicine experts, representing a variety of professional disciplines, developed the questions. Each question has only one correct answer. An answer key appears on the final page of this document. Please note that the difficulty of these sample questions may not be representative of the overall difficulty of the examination.

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/mm3 (normal range 400/mm3 - 1500/mm3)?
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 Cï‚° (101.3ï‚° 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. The most common cause of death among travellers to developing countries is
A. malaria
B. motor vehicle accidents
C. drowning
D. hepatitis A

11. 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

12. Plasmodium falciparum resistance to mefloquine is found primarily in
A. sub-Saharan Africa
B. Central America
C. South America
D. Southeast Asia

13. Travellers’ diarrhea due to quinolone-resistant Campylobacter species is most common in which of the following countries?
A. Peru
B. Mexico
C. Nepal
D. Thailand

14. 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

15. 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

16. 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

17. 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 rabies vaccine, but do not give human rabies immune globulin (HRIG) as more than 7 days has elapsed between the bite and the start of the 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 injections of rabies vaccine

Sample Questions Answer key
1(C) 2(C) 3(D) 4(B) 5(A) 6(B) 7(C) 8(D) 9(C) 10(B) 11(C) 12(D) 13(D) 14(A) 15(B) 16(D) 17(D)