20- Parasitic Infections

Question 1

May be the sole manifestation of early amebiasis

Answer 1

Chronic urticaria

Question 2

Treatment of choice for amebiasis cutis

Answer 2

Metronidazole 750mg TID x 10 days

Question 3

Common cause of vaginal pruritus with burning and frothy leukorrhea

Vaginal mucosa is bright red with pseudomembranous patches

Answer 3

Trichomoniasis

Question 4

Treatment of trichomoniasis

Answer 4

Metronidazole 2g single dose

Or 500mg BID x 7 days

Question 5

Treatment for trichomoniasis in pregnant women

Answer 5

Clotrimazole 100mg intravaginally per night x 2 weeks

Question 6

Treatment for cutaneous leishmaniasis

Answer 6

Spontaneous healing in 12-18 months

Topical: paromomycin sulfate 15% + methylbenzethonium chloride 12%
Ketoconazole cream
Cryotherapy, photodynamic therapy, laser

Systemic: immunosuppressed
Sodium antimony gluconate IM/IV 20mg/kg/day in 2 doses x 28 days

Question 7

Cutaneous ulcer
Transmitted by sandfly
Endemic in Asia minor and Mediterranean

Answer 7

Cutaneous leishmaniasis

Question 8

Mucocutaneous leishmaniasis has an initial cutaneous ulcer and develops a secondary mucosal lesions after how much time?

Answer 8

Within 5 years

Question 9

Earliest mucosal lesion in mucocutaneous leishmaniasis

Answer 9

Hyperemia of nasal septum with subsequent ulceration

Question 10

Antimony resistance is common in this type of leishmaniasis

Answer 10

Mucocutaneous

Question 11

Treatment for mucocutaneous leishmaniasis

Answer 11

Combination therapy:
Antimonials with rifampin/azithromycin

Amphotericin B

Question 12

Primary target site of leishmanial parasites in visceral leishmaniasis is

Answer 12

Reticuloendothelial system

-spleen, liver, bone marrow and lymph nodes

Question 13

Treatment for visceral leishmaniasis

Answer 13

Pentavalent antimony

Amphotericin B- resistant cases

Question 14

Evanescent erythema, erythema multiforme and edema (angioedema) are the early skin manifestations observed in

Answer 14

Trypanosomiasis

Question 15

Treatment of East African (Rhodesian) trypanosomiasis

No CNS involvement:
With CNS involvement:

Answer 15

No CNS involvement: suramin

With CNS involvement: melasoprol

Question 16

Treatment for West African (Gambian) trypanosomiasis

Answer 16

Pentamidine isethionate

Question 17

Treatment for American trypanosomiasis (Chagas disease)

Answer 17

Nifurtimox

Benznidazole

Question 18

Treatment of toxoplasmosis

Answer 18

Pyrimethamine and sulfadiazine

Question 19

Organisms enter a snail
Swimming
Attack by burrowing into skin
Transient erythematous reaction then recur after 10-15 hrs

Answer 19

Swimmers itch
Cercarial dermatitis (schistosome)

Question 20

Mild itching and papular dermatitis of feet

Urinary bladder/ intestinal inhabitation of the organisms

Fever, chills, pneumonitis, eosinophilia, petechiae, malaise, abdominal crsmps, arthritis, liver spleen involvement

Answer 20

Visceral schistosomiasis

Question 21

Treatment of schistosomiasis

Answer 21

Praziquantel 40mg/kg/day in 2 doses for 1 day

S. japonicum- 60mg/kg in 3 doses for 1 day

Question 22

Painless nodules in subcutaneous tissues

Organisms may enter general circulation and form cysts in striated muscles

Answer 22

Cysticercosis ( T.solium)

Question 23

Treatment for cysticercosis

Answer 23

Albendazole

Praziquantel

Question 24

Also known as hydatid disease
From ova-contaminated feces from an infected dog

Infestation of liver and lungs

Eosinophilia, intractable urticaria and pruritus

Answer 24

Echinococcosis

Question 25

Treatment of echinococcosis

Answer 25

Echinococcus granulosus- albendazole + percutaneous drainage Hymenolepis nana- praziquantel

Question 26

Chief symptom of pinworm infestation

Answer 26

Nocturnal pruritus ani

Question 27

Treatment of enterobiasis

Answer 27

Albendazole 400mg Mebendazole 100mg Pyrantel pamoate 11mg/kg (max 1g) Given once and repeated in 2 weeks

Question 28

Erythematous macules and papules that turn into vesicles Occurs in toe webs, soles and ankles Iron deficiency anemia, skin becomes dry and pale or yellowish Carried into circulation to the lungs—pharynx—swallowed into the small intenstine

Answer 28

Hookworm (ancylostoma, necator)

Question 29

Treatment for hookworm disease

Answer 29

Albendazole 400mg single dose Mebendazole 100mg BID x 3 days or 500mg single dose Pyrantel pamoate 11mg/kg (max 1g) OD x 3 days Prevention of contamination of soil

Question 30

Term applied to twisting linear skin lesions produced by the burrowing of larvae

Answer 30

Creeping eruption (larva migrans)

Question 31

Treatment for larva migrans

Answer 31

Ivermectin single 12mg dose and repeated the next day | Albendazole 400mg/day x 3 days

Question 32

Also called perianal larva migrans syndrome Caused by stongyloides stercoralis

Answer 32

Larva currens

Question 33

Treatment for larva currens

Answer 33

Ivermectin | Thiabendazole

Question 34

Lymphedema, hypertrophy of skin and subcutaneous tissues Enlargement and deformity of affected parts Recurrent attacks of acute lymphangitis with chills and fever

Answer 34

Elephantiasis (filariasis)

Question 35

Treatment for filariasis

Answer 35

Diethylcarbamazine x 14 days

Question 36

Usually asymptomatic, appearance of symptoms may be after 1 year Transmitted by mango fly Worm under conjunctiva, calabar swelling, eosinophilia and microfilariae in peripheral blood

Answer 36

Loiasis (loa loa)

Question 37

This sign in loiasis is usually the first one observed Painful localized subcutaneous nonpitting edema

Answer 37

Calabar swelling

Question 38

Treatment for loiasis

Answer 38

Diethylcarbamazine

Question 39

Itchy papular dermatitis localized to one extremity, may become chronic Transmitted by black fly After a time, subcutaneous nodules develop that are painful

Answer 39

Onchocerciasis

Question 40

Treatment for onchocerciasis

Answer 40

Ivermectin

Question 41

Inflict series of bites in a row “Breakfast, lunch and dinner “

Answer 41

Cimicosis (bed bug bites)

Question 42

Treatment for cimicosis (bed bug bites)

Answer 42

Permethrin impregnated bednets | Ivermectin 200ug/kg

Question 43

Treatment for pediculosis

Answer 43

Permethrin Nit combing Launder clothing 65C for 30 mins drying

Question 44

Pruritic papular lesions, excoriations and burrows Favors finger webs wrists axillar umbilicus lowe abdomen genitals buttockss Dull red nodules may appear during active period in scrotum penis or vulva

Answer 44

Scabies

Question 45

Axillae, elbow, flexures, wrists and hands and crotch are mostly affected in scabies and is collectively called

Answer 45

Circle of Hebra

Question 46

Treatment for scabies

Answer 46

Permethrin 5% cream Benzyl benzoate and 10% precipitated sulfur in white petrolatum Thoroughly rubbed and washed off 8-10h later