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Basic Pathology 2 > 14 Blood Flagellates > Flashcards

14 Blood Flagellates Flashcards

1
Q

Causative agent of leishmaniasis

A

Leishmania donovani (most important)
L major
L brasiliensis

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2
Q

Small, dark teardrop-shaped

Motile due to presence of flagella

A

Leishmania amastigotes

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3
Q

Vector of leishmaniasis

A

Sandfly

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4
Q

Sandfly

Endemic in old-world countries (Europe, Asian and African countries)

A

Plebotomus

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5
Q

Sandfly

Endemic in new-world countries (America)

A

Lutzomiya

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6
Q

Primary reservoir hosts of Leishmania

A

Dogs (L. infantum)

Humans (L. donovani, L.tropica)

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7
Q

Modes of transmission of Leishmania

A 
Blood-borne:
Blood transfusion
Wound contamination
Exposure to contaminated samples
Vertical transmission
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8
Q

Infective stage of Leishmania

A

Promastigotes

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9
Q

What ingests the promastigotes as they enter the bloodstream

A

Macrophage

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10
Q

Promastigotes in the macrophages will become ____, which will reproduce via binary fission

A

Mastigotes

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11
Q

Also known as Baghdad ulcer, Delhi boil, Bouton d’ Orient
Least severe form of leishmaniasis
Symptoms include craters and erosions

A

Cutaneous leishmaniasis (CL)

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12
Q

Most common species that cause CL

A

L. major

Others include L. tropica, L. infantum

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13
Q

Mostly seen in South America

Caused by L. braziliensis

A

Mucocutaneous leishmaniasis (MCL)

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14
Q

Skin ulcers in MCL

A

Chiclero ulcers

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15
Q

AKA Parrot’s beak or Camel nose

Massive tissue destruction of the mucus membranes of the mouth and nose

A

Espundia

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16
Q

Morbidity is higher compared to MCL and CL
Affects big area of the body, but can also be found in localized areas of the skin
Resembles lepromatous leprosy

A

Diffuse cutaneous leishmaniasis (DCL)

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17
Q

What causes DCL

A

L. aethiopica

L. mexicana

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18
Q

Symptoms of DCL

A

Disseminated and chronic skin lesions

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19
Q

Most serious form of leishmaniasis
Has more than 95% mortality
Affects visceral organs

A

Visceral Leishmaniasis (VL)

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20
Q

Etiologic agents of VL

A

L. donovani

L. chagasi

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21
Q

Double quotidian fever
Weight loss
Prominent hepatomegaly, splenomegaly
Anemia, leukopenia, thrombocytopenia

A

VL

Kala azar

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22
Q

Diagnosing leishmaniasis

A 
Direct visualization
Freeze-dried direct agglutination test
rK39 Dipstick
Latex agglutination urine test
Leishmanin (Montenegro) skin test
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23
Q

Primary confirmatory diagnosis

Gold standard for confirming leishmaniasis

A

Direct visualization

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24
Q

Direct visualization uses tissue aspirate from:

A

Spleen
Bone marrow
Lymph nodes

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25
Q

Direct visualization is unsuitable for filed use because:

A

Invasive

Low sensitivity

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26
Q

Detects antibodies

Rapid diagnostic test, hence, used in field

A

Freeze-dried direct agglutination test (DAT)

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27
Q

Based on recombinant antigen of Leishmania parasite

Being investigated for use in active case detection

A

rK39 Dipstick

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28
Q

Detects Leishmania antigens

Used among patients who have a compromised immune response

A

Latex agglutination urine test

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29
Q

Rapid diagnostic test used to detect exposure
Used for CL and MCL
Similar to an allergy test (PPD), wherein you inject an antigen and wait for delayed hypersensitvity region

A

Leismanin (Montenegro) skin test

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30
Q

Immunity against further infection can be attained

A

Leishmanization

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31
Q

Three methods of leishmanization

A

Intentional biting
Pus inoculation
Cultured promastigotes

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32
Q

Natural immunization

A

Intentional biting

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33
Q

Gets pus draining form lesion and inoculate into another person
if person is healthy enough, he will develop antibodies

A

Pus inoculation

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34
Q

Live attenuated vaccination

A

Cultured promastigotes

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35
Q

Treatment for leishmaniasis

A

Antimonate-containing drugs (Pentavalent antimony drugs):
Meglumine antimonite
Sodium antimony gluconate

36
Q

Prevention and control methods of leishmaniasis

A 
Vector control (insect repellants, insecticides, kulambo)
Reservoir control (poisoned baits)
37
Q

Opportunistic AIDS infection

A

Leishmaniasis

38
Q

New drug for treating leishmaniasis

A

Sitamaquine

Oral aminoquinolone

39
Q

Also known as Human African Trypanosomiasis or African sleeping sickness

A

African trypanosoma

40
Q

Majority of the cases of African trypanosoma come from ____

A

Sub-Saharan Africa

41
Q

Causative agents of African trypanosoma

A

Trypanosoma brucei rhodesiense
T. brucei gambiense
T. brucei brucei

42
Q

East and Southern Africa
2% of cases
Faster killer but less prevalent (more fatal because there are less cases)

A

T. brucei rhodiense

43
Q

West and Central Africa
Has the most number of cases (98%)
Slower killer than T. b. rhodesiense

A

T. b. gambiense

44
Q

Cattle disease only

A

T. b. brucei

45
Q

Vector of African trypanosoma

A

Tse-tse fly (Glossina spp)

46
Q

Reservoir hosts of African trypanosoma

A

Dogs, pigs, cattle, wild animals

47
Q

Infective stage of T. b. rhodiense

A

Metacyclic trypomastigotes

48
Q

When tsetse flies are infected via blood ingestion, trypomastigotes become ____ in the gut

A

Procyclic trypomastigotes

49
Q

Phases of African trypanosoma

A

Initial
Early
Late

50
Q

Chancre formation (Dermolytic lesion)
Pruritic lesion
Lasts for 2-3 weeks

A

Initial Phase

51
Q

A local, hard, painful lesion at the site of inoculation

A

Chancre

52
Q

Heals by itself

A piece of dead tissue that is cast off from the surface of the skin

A

Eschar

53
Q

Parasitic proliferation
Systemic
Lasts 1-6 months
S/s include relapsing fever, headache, malaise, anemia, joint and muscle pains, Winterbottom sign

A

Early phase (hemolymphatic phase)

54
Q

Enlarged posterior cervical lymph nodes

A

Winterbottom sign

55
Q

Morbidity of the disease is seen
Involvement of the CNS
S/s include apathy, behavioral changes, headaches, sleep pattern changes, convulsions, speech defects, splenomegaly, Kerandel’s sign, paralysis, progress to coma

A

Late phase (Meningoencephalitic phase)

56
Q

Deep, delayed, bilateral hyperesthesia

Exaggerated response to any stimuli, particularly pain

A

Kerandel’s sign

57
Q

Mainly an immune-mediated hypersensitivity reaction due to parasite antigens acting on RBC, cardiac tissue and brain tissue

A

African trypanosoma

58
Q

Diagnosis of African trypanosom

A

Direct visualization

Card agglutination test for trypanosome

59
Q

Gold standard
Visualizes highly motile trypomastigotes
Mainly used in the early phase
Invasive

A

Direct visualization

60
Q

Useful for screening fo T.b. gambiense
No comparable test for T. b. rhodesiense
Rapid and specific
Useful in the field setting

A

Card agglutination test for trypanosome (CATT)

61
Q

For early stage of T. b. gambiense infection

A

Pentamide

62
Q

For early stage of T. b. rhodiense infection

A

Suramin

63
Q

First line drug for late-stage disease of both forms of sleeping sickness
Removed due to toxicity and growing resistance

A

Melarsoprol

64
Q

Current first line drug for T. b. gambiense sleeping sickness patients who do not respond to melarsoprol
Ressurection drug

A

Eflornithine

65
Q

Chagas disease

Majority of the cases come from Mexico, Central America and South America

A

South American Trypanosoma

66
Q

Causative agent of Chagas disease

Has flagella

A

Trypanosoma cruzi

67
Q

Zoonotic disease that can be transmitted to humans by blood-sucking triatomine bugs

A

Chagas disease

68
Q

Infection of Chagas disease is most commonly acquried thorugh contact with ____ of an infected insect

A

Feces

69
Q

Common triatomine vector species for Chagas disease belong to genera:

A

Triatoma
Rhodnius
Panstrongylus

70
Q

Main vector for South American trypanosoma

A

Triatomine/Reduviid/Assassin bug

71
Q

Triatomine bug releases infective ______ in its feces near the site of bite wound

A

Metacyclic trypomastigotes

72
Q

Metacyclic trypomastigoes enter host’s mucosal membranes and differentiate into ______

A

Intracellular amastigotes

73
Q

Trypanosome amastigotes multiply by binary fission and differentiate into ____. which burst out and are released into bloodstream

A

Mature trypomastigotes

74
Q

If the trypomastigotes are ingested by the triatomine bug, these transform into ____ in the vector’s midgut

A

Epimastigotes

75
Q

Diagnostic stage of T. cruzi

A

Amastigotes

76
Q

Initial small furunculoid lesion at the bite site

A

Chagoma

77
Q 
Swollen palpebrae
Due to conjunctival point of entry
Painless but may be itchy on intial bite
Persist up to 2 months
Bugs bite at mucosal areas due to moisture present
A

Romana sign

78
Q

Acute phase of Chagas disease include these s/s:

A

Chagoma
Fever and lymphadenopathy
Romana sign

79
Q

Problematic phase, in which parasites are already proliferating inside the patients
Could last from months to years
Marked by fibrotic reactions

A

Indeterminate chronic phase

80
Q

Diagnostic methods for Chagas disease

A

Direct visualization
Indirect test
Imaging test

81
Q

Gold standard
Involves observation of rapid movement of live trypomastigotes
Only useful during first 2 months

A

Direct visualization

82
Q

Immunologic tests
Hemoculture in liver infusion tryptose medium
Xenodiagnosis (use of live Triatomina bugs)

A

Indirect test

83
Q

Treatment for Chagas disease

Inhibits unique enzyme trypanothione reductase

A

Nifurtimox

Benznidazole

84
Q

Treatment for cardiopathy caused by Chagas disease

A

Allopurinol, itraconazole

Heart transplants

85
Q

Preventive and control methods against Chagas disease

A

Vector control

Transfusional control

Basic Pathology 2 (8 decks)

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