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GIR Test 1 > B5.007 Prework 2 Intestinal Protozoa > Flashcards

B5.007 Prework 2 Intestinal Protozoa Flashcards

1
Q

entamoeba histolytica

A

ameba

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2
Q

giardia intestinalis

A

flagellate

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3
Q

cryptosporidium parvum/hominis

A

gregarine

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4
Q

cyclospora cayeanensis

A

coccidia

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5
Q

trichomonas vaginalis

A

flagellate

not intestinal

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6
Q

microsporidia

A

fungus

not a protozoa

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7
Q

diagnosis of intestinal protozoa

A 
eosinophilia absent (unlike helminths)
parasite in stool: O&P exam (trophozoites and cysts)
antigen detection (stool)
molecular testing
antibody detection (least useful)
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8
Q

trichomonas vaginalis life cycle

A

no cyst phase
infects squamous epithelium of urogenital tract
1. trophozoite in vaginal and prostatic secretions in urine
2. longitudinal binary fission
3. trophozoite in vagina or orifice of urethra

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9
Q

trichomonas trophozoite appearance

A 
pear shaped/rounded
1 nucleus
5 flagella
undulating membrane
jerky motlity
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10
Q

trich transmission

A

sexual
2nd most common STI after HPV
3 million women acquire yearly
peak incidence 16-35

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11
Q

trich pathogenesis

A

parasites damage epithelial cells
increase risk of preterm birth
increases susceptibility to HIV

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12
Q

trich symptoms in women

A

persistent vaginitis
rarely asymptomatic
inflamed vaginal and cervical mucosa
petechial hemorrhage of vagina and cervix

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13
Q

trich symptoms in men

A

usually asymptomatic
dysuria
scant, nonpurulent discharge

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14
Q

diagnosis of trich

A

direct exam: wet mount, must view within 2 hr (20 min better), motile tichomonads
antigen detection
molecular detection (preferred)

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15
Q

trich treatment

A

metronidazole

treat sexual partner

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16
Q

entamoeba histolytica life cycle

A

cysts ingested
trophozoites excyst in small intestine
trophozoites adhere to colonic mucins
cysts and trophozoites present in feces

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17
Q

entamoeba cysts

A

1-4 nuclei

10-15 um

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18
Q

entamoeba trophozoites

A

directional motility
+/- ingested RBCs
1 nucleus
15-20 um

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19
Q

entamoeba transmission

A

fecal oral
endemic in regions with poor sanitation
mostly seen in travelers, immigrants, institutionalized

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20
Q

clinical manifestations of entamoeba

A 
90% asymptomatic
incubation 2-4 weeks
4-5% dysentery (blood diarrhea w mucus)
1% ameboma
1% liver abscess
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21
Q

entamoeba path

A

mucosal ulceration with little inflammatory response

flask like large intestinal ulcers extend to submucosa

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22
Q

entamoeba extraintestinal disease

A

amoebic liver abscess: 1 or more, usually right lobe, filled with necrotic tissue, few amebae present
occasional dissemination to lungs, brain, spleen
occasional invasion of perianal skin

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23
Q

entamoeba treatment and prevention

A

metronidazole (even asymptomatic)

sanitary disposal of feces

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24
Q

giardia life cycle

A

cysts ingested
trophozoites excyst in small intestine
trophozoites remain in proximal small bowel lumen
encyst in colon; cysts and trophs shed

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25
Q

giardia cyst

A

ovoid
2-4 nuclei
4 median bodies
axonemes

26
Q

giardia tophozoites

A 
pear shaped
2 nuclei
2 median bodies
8 flagella
ventral sucker
falling leaf motility
27
Q

giardia transmission

A

fecal oral

most common intestinal parasite in US

28
Q

at risk for giardia

A

travelers (tropical), childcare, institutionalized, backpackers/campers, ski resorts, men who have sex w men

29
Q

why is giardia easily acquired

A 
low infection dose (10 cysts)
environmentally hardy (resistant to chlorine, disinfectants, cold)
animal reservoirs
30
Q

incubations and durations of giardia

A

incubation 1-14 days

symptoms 1-4 weeks

31
Q

symptoms of giardia

A 
90% asymptomatic
9% sudden onset explosive diarrhea
foul smelling, greasy, floats
ad pain
bloating
abundant gas
nausea
vomiting
no fever
32
Q

chronic giardiasis

A

1% have recurrent symptoms
malabsorption
weight loss
lactose intolerance

33
Q

pathogenesis of giardia

A

malabsorption of fat and carbs
disaccharidase deficiency with lactose intolerance
damage to microvilli, inflamm infiltrate

34
Q

giardia diagnosis

A

antigen detection in stool
O&P exam (min of 3 stool)
jejunal biopsy

35
Q

giardia treatment

A

metronizadole

test close contacts

36
Q

giardia prevention

A

filter/treat water

37
Q

life cycle of cryptosporidium

A 
oocyst ingested
excyst in small intestine
sporozoites released
sporozoites invade columnar epithelial cells
mature into trophozoites
oocysts shed in feces
38
Q

crypto transmission

A

fecal oral
worldwide distribution
second most common intestinal parasite after giardia

39
Q

at risk for crypto

A

HIV+, daycare, animal contact, sexual transmission, water

40
Q

why is crypto easily acquired

A

low infectious dose (100 oocysts)

environmentally hardly- resistant to chlorine, disinfectants

41
Q

incubation and symptoms periods of crypto

A

incubation- 2-10 days

symptoms 1-2 weeks

42
Q

symptoms of crypto

A 
sudden onset explosive diarrhea
watery
self limiting
\+/- dehydration, ab pain, nausea vomiting
may be severe in immunocompromised
43
Q

crypto histopath

A

intracellular extracytoplasmic trophozoites

tiny, spherical structures beneath surface of microvilli

44
Q

direct exam of crypto

A

4-6 um
visible in stool O&P
acid fast

45
Q

diagnosis of crypto

A

OK: O&P

better: acid fast stain
best: antigen testing

46
Q

crypto treatment

A

nitazoxanide

47
Q

crypto prevention

A

enteric precautions

48
Q

cyclospora cayetanesis life cycle

A

oocyst ingested
excyst and sporozoites invade epithelial cells
excretion of unsporulated oocysts in stool

49
Q

cyclo oocyst

A

8-10 um
visible in stool O&P
acid fast

50
Q

cyclo transmission

A 
fecal oral
tropical
environmental incubation
associated with foodborne outbreak
spring/ summer
51
Q

cyclo incubation and symptoms

A

incubation 7 days

symptoms 10-12 weeks

52
Q

cyclo symptoms

A 
relapsing diarrhea
watery
self limiting
\+/- dehydration, ab pain, nausea, vomiting, fever
worse in immunocompromised
53
Q

cyclo histopath

A

parasite replicate within cytoplasm of enterocyte

54
Q

cyclo direct exam

A

8-10 um
unsporulated in stool
sporulated in environment
acid fast

55
Q

cyclo diagnosis

A

O&P
acid fast
NO antigen testing

56
Q

cyclo treatment and prevention

A

trimethoprim-sulfamethoxazole

food safety

57
Q

microsporidia overview

A

ex parasite
obligate intracellular parasitic fungi
most common human pathogens: encephalitozoon, enterocytozoon

58
Q

microsporidia life cycle

A

resistant spore with coiled polar tubule
infective sporoplasm injected into cell via tubule
mature spore ruptures cytoplasm, releasing spores

59
Q

microsporidia opportunism

A

rarely infects immunocompetent
significant in AIDS patients
-chronic diarrhea and weight loss
-dissemination to other organs

60
Q

diagnosis of microsporidia

A

microscopy- trichrome stain, 1-4 um

61
Q

microsporidia treatment

A

albendazole

GIR Test 1 (24 decks)

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