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III > Albert > Flashcards

Albert Flashcards

1
Q

What are protozoa?

A

Animal-like eukaryotes. Mostly free-living, some are pathogens. Prevalent in (sub)tropical regions. Can infect tissues/organs: intracellular parasites in cells, extracellular parasites in blood, intestine, urogenital system.

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2
Q

Which drugs are used for prophylaxis of malaria in areas without resistance?

A

Chloroquine or proguanil

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3
Q

Which drugs are used for prophylaxis of malaria in areas with some chloroquine resistance?

A

Proguanil + chloroquine.

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4
Q

Which drugs are used for prophylaxis of malaria in areas with chloroquine resistant P. falciparum? [3]

A
  1. mefloquine
  2. doxycycline
  3. Atovaquone-proguanil (Malarone)
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5
Q

Why is it difficult to create a malarial vaccine? [5]

A
  1. Difficult to grow enough pathogen for attenuated or killed-microbe vaccine.
  2. Natural immunity has not revealed specific antigens that provide protection.
  3. Some antigens exhibit genetic polymorphism
  4. Some antigens show temporal switching of expression - only expressed during one stage of life cycle.
  5. No good animal models for P. falciparum/vivax.
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6
Q

What are the symptoms of malaria?

A

cold stage/shivering, hot stage/fever, sweating stage. Other: headache, body aches, nausea, vomiting, weakness, enlarged spleen.

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7
Q

What are the symptoms of severe malaria?

A

Abnormal behaviour.
Shock
Liver failure, jaundice.
Swelling/rupture of spleen

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8
Q

What does the ABCD for travellers in regards to malaria represent?

A

Awareness of risk
Bite prevention
Chemoprophylaxis
Diagnosis and treatment.

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9
Q

How is malaria diagnosed?

A

Blood smears examined by microscopy: sensitive, labour intensive.
Rapid diagnostic tests: detection of antigens/enzymes. (limited sensitivity)
Other ways: PCR, antibody detection, mass spectroscopy.

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10
Q

What is the immunochromatographic technique for malarial infection diagnosis?

A
  1. Sample (buffer plus blood) is mixed with labelled detection antibodies on a nitrocellulose strip.
  2. The sample + antibody migrates by capillary action across the strip.
  3. When recognised by immobile antibodies, a dark line appears due to high concentration of detection antibody.
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11
Q

What are ACTs?

A

Artemisinin-based combination therapies.

  • rapid parasite clearance
  • rapid resolution of symptoms
  • active on blood stage of all 4 species
  • reduce gametocyte carriage and hence transmission.
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12
Q

How does ACT work?

A

It reduces gametocyte carriage and hence transmission. Active on blood stage of all 4 species.

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13
Q

What is one example of a rapid diagnostic test for malaria?

A

BinaxNow Malaria test.

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14
Q

How many classifications of protozoa are there?

A

4.

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15
Q

What are the 4 classifications of protozoa?

A

Amoeba: move by pseudopodia.
Flagellates: move via flagella.
Ciliates: have cilia.
Apicomplexa: have apical complex, all are parasitic. Plasmodium, Toxoplasma.

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16
Q

What classification of protozoa are all parasitic?

A

Apicomplexa (sporozoa) Plasmodium, Toxoplasma.

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17
Q

What protozoal disease is most common?

A

Giardiasis, intestinal infection.

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18
Q

What causes Malaria?

A

Protozoal parasites.

From the genus plasmodium. 4 species that infect humans.

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19
Q

What species of plasmodium infect humans?

A

P. falciparum: tropics, Africa + SE Asia.
P. vivax: widely distributed, main cause of malaria outside of africa.
P.ovale: tropical africa, SE asia.
P. malariae: rare.

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20
Q

What is the main cause of malaria outside of africa?

A

P. vivax.

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21
Q

What causes the more severe and common form of malaria?

A

P. falciparum.
P. vivax.
P. ovale.
P. malariae.

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22
Q

What causes the more moderate and less common form of malaria?

A 
In order of most common and most severe:
P. falciparum. 
P. vivax.
P. ovale. 
P. malariae.
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23
Q

How is malaria transmitted?

A
  1. Parasites injected within the saliva of blood-feeding female mosquitoes (anopheles sp.)
  2. Multiply in the liver, then infect RBCs.
  3. Mosquitoes the ingest parasites upon feeding on an infected host.
  4. The parasites go through a reproductive phase within the mosquito.
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24
Q

What are the mechanisms of action of the antimalarials?

A
  1. Inhibition mitochondrial metabolism: Atovaquone.
  2. Inhibition haem detoxification: chloroquine, lumefantrine, mefloquine
  3. Antifolate: proguanil, pyrimethamine, sulphadoxine.
  4. ATCs.
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25
Q

Which antimalarials inhibit haem detoxification?

A

Chloroquine
Lumefantrine
Mefloquine.

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26
Q

Which antimalarials inhibit mitochondrial metabolism?

A

Atovaquone

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27
Q

Which antimalarials are antifolate drugs?

A

Proguanil, Pyrimethamine, Sulphadoxine.

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28
Q

What are helminths?

A

Multicellular, suckers, hooks or plates for attachment. Partial life cycle in humans, tough cuticle so hard for immune system to eradicate. Blood flukes camouflage themselves by coating themselves with host molecules.

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29
Q

What helminths camouflage themselves by coating with host molecules?

A

Blood flukes.

30
Q

What is the global status of helminths?

A

Mainly rural/poor areas/overcrowded cities. Low status on public health priorities. Symptoms often mild, but parasites consume nutrients leading to malnutrition. Cattle infection: economic cost.

31
Q

What are the classes of helminths?

A
  1. nematodes (roundworms): cylindrical canal.
  2. Cestodes (tapeworms): flat, ribbon shaped, no digestive tract - nutrients absorbed through cuticle.
  3. Trematodes (flukes): leaf-shaped, blind-branched alimentary tract.
32
Q

What class of helminth is flat + ribbon shaped?

A

Cestodes (tapeworms): flat, ribbon shaped, no digestive tract - nutrients absorbed through cuticle.

33
Q

What class of helminth has a blind-branched alimentary tract?

A

Trematodes (flukes): leaf-shaped, blind-branched alimentary tract.

34
Q

What class of helminth is known as a fluke?

A

Trematodes (flukes): leaf-shaped, blind-branched alimentary tract.

35
Q

Roundworms belong to which class of helminth?

A

Nematodes (roundworms): cylindrical canal.

36
Q

Tapeworms are which class of helminth?

A

Cestodes (tapeworms): flat, ribbon shaped, no digestive tract - nutrients absorbed through cuticle.

37
Q

What is the most prevalent class of helminth?

A

Intestinal nematode infection. #2,000,000

38
Q

What are some examples of intestinal nematodes?

A

Large roundworm,

Threadworm, Hookworm, Whipworm.

39
Q

How are intestinal nematode infections spread (generally)?

A

The Fecal-oral route.

Hookworm is the exception, spread via larvae in soil penetrating skin.

40
Q

How is hookworm spread?

A

Larvae in the skin penetrate skin.

41
Q

What nematode infection is usually asymptomatic but can cause bloody diarrhoea if heavy infection occurs?

A

Whipworm.

42
Q

What nematode infection causes mild-anal itching?

A

Threadworm.

43
Q

Which nematode infection slows growth and development and can cause anaemia?

A

Hookworm. (spread through larvae in soil penetrating skin)

44
Q

What is ascariasis?

A

Infection caused by large roundworms. Adult organisms can migrate to other organs.

45
Q

What is the lifecycle of Ascariasis? (large roundworms)

A
  1. Eggs produced by females are excreted in facaes.
  2. Eggs mature in the soil (3-2 weeks)
  3. Eggs are ingested.
  4. Larvae hatch in small intestine and penetrate intestine wall.
  5. They then enter blood/lymphatic vessels: carried to liver, heart and lung; larvae grow and molt in alveoli.
  6. Coughing and swallowing brings larvae into intestines; mature into adults (live 1-2 years).
46
Q

How do ascariasis larvae enter the intestines from the lungs?

A

Coughing and swallowing.

47
Q

What are filariae?

A

Blood and tissue nematodes.

48
Q

What infection can cause enlargement of parts of the body, e.g. arms, legs, scrotum?

A

Lymphatic filariasis caused by blood and tissue nematodes. Damage to the lymphatic system causes enlargement.

49
Q

What is onchocerciasis better known as and caused by?

A

River blindness: microfilariae enter the internal tissues of the eye (except lens); causes inflammation, bleeding - leading to blindness.

50
Q

What disease does the adult Loa loa worm cause? (name is hint)

A

It travels through the subcutaneous tissues, causing inflammation in the skin and eye. Loiasis.

51
Q

What are cestodes?

A

Tapeworms: flat, ribbon shaped, no digestive tract - nutrients absorbed through cuticle.

52
Q

How do most cestode infections occur?

A

Ingestion of undercooked meat/fish and the worm then lives in the lumen of the gut.

53
Q

What happens when humans become the secondary host of a cestode?

A

Larval stages will invade tissues such as the muscle and brain.

54
Q

What helminths can live for decades in tissue or blood vessels?

A

Trematodes/flukes…

Cause progressive damage to vital organs. use snail as intermediate host - some use secondary host.

55
Q

What helminth infection uses snail as an intermediate host?

A

Trematodes, bloodflukes.

56
Q

What is schistosomiasis?

A

Caused by blood-flukes, mainly S. mansoni, S. haematobium, S. japonicum.
Main route of infection thru infected water. 2nd greatest economic impact of parasitic diseases after malaria.

57
Q

What are the symptoms of Schistosomiasis?

A

Days: rash or itchy skin (swimmers itch)
Months: fever, chills, cough, muscle aches.

58
Q

What is the main damage caused by Schistosomiasis caused by?

A

Eggs get stuck in tissues and provoke an immune response which causes organ damage and scarring. Can cause bladder cancer.

59
Q

What is the lifecycle of Schistosomiasis?

A
  1. Free-living larvae (miracidia) hatch from eggs in water, infect snail.
  2. In snail forms a larvae with a large swimming tail.
  3. The infective larvae penetrate the skin of a swimming human host
  4. They then migrate through the blood to the lung, heart and eventually liver.
  5. In the liver the worms mature and form male:female pairs that move on. (S. haematobium lives in veins around bladder)
60
Q

How are intestinal nematode/cestode infections diagnosed?

A

Eggs or larvae can be detected in faecal sample. (sometimes incidental diagnosis: e.g. coughing up or vomiting ascarids.

61
Q

How is schistosomiasis diagnosed?

A

Eggs in faecal sample or urine.

62
Q

What is a cercariae?

A

Larvae form of a schistosomiasis infection which forms in a snail, with a large tail.

63
Q

How are tissue nematode infections diagnosed?

A

Adults in the tissues (difficult) more commonly the microfilariae in the blood are detected.

64
Q

What are some drugs used to treat helminth infections?

A 
Ivermectin - filarial nematodes. 
Albendazole/mebendazole - intestinal nematodes 
Niclosamide - tapeworms. 
Piperazine - roundworms, threadworms.
Praziquantel - flukes, tapeworms.
65
Q

Why might helminths have potential as therapeutics?

A

Can survive for decades, not cleared as they are able to modulate the immune system.
Nematode infections have been shown to protect against allergic diseases: reduced skin reactivity to dust, decreased incidence of asthma.

66
Q

Elephantiasis is caused by?

A

Filarial nematodes.

67
Q

How do schistosomes normally enter the body?

A

Infective larvae that penetrate the skin of their host.

68
Q

Consumption of meat that has not been cooked properly can result in:

A

Tapeworm infection

69
Q

Intestinal helminth infections are usually detected by:

A

Eggs in faecal sample.

70
Q

What do chloroquine, lumefantrine and mefloquine all have in common? [2]

A
  1. antimalarial drugs.

2. Inhibition haem detoxification: chloroquine, lumefantrine, mefloquine

71
Q

What do proguanil, pyrimethamine and sulphadoxine all have in common? [2]

A
  1. Antimalarial drugs

2. Antifolate: proguanil, pyrimethamine, sulphadoxine.

72
Q

What is the mechanism of action of the antimalarial atovaquone?

A
  1. Inhibition mitochondrial metabolism: Atovaquone.

III (24 decks)

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