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CMBM Exam 4 Gopi > Blood parasites > Flashcards

Blood parasites Flashcards

0
Q

what Plasmodium form is found in RBCs?

A

Trophozoites

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1
Q

Malaria is caused by?

A 
Intracellular in hepatocytes and RBCs 
P vivax
P ovale 
P malariae 
P flaciparum
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2
Q

What plasmodium form is found freely in the blood?

A

Meroziotes

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3
Q

what plasmodium infects a person?

A

Sporozoites

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4
Q

where does Plasmodium go first in the body?

A

Hepatocytes

Lvier schizonts

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5
Q

What plasmodium form is picked up by mosquitos?

A

Gametocytes

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6
Q

Clinical signs of Malaria?

A

incubates about 1-2 weeks
Prodrome Flu like illness, headache, anorexia, photophobia, malaise
Classic signs: cyclic episodes of high fever, chills, rigors - from host reaction to rupture of RBCs leads to secretion of TNF and IL-1

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7
Q

what additional symptoms can occur with P. Falciparum?

A

CNS involvement or renal

merozoites are released daily so there is no cycle to chills, fever and rigor

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8
Q

What is the parasite antigen of Plasmodium that is released from lysed RBCs?

A

GPI

called glycophosphatidlylinositol

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9
Q

Most prevelent plasmodium?

A

P. Vivax

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10
Q

Hypnozoites

A

dormant form in liver of P. vivax and P ovale

can cause relapse weeks to years later

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11
Q

what is used to treat Hypnozoites?

A

Primaquine

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12
Q

P. Falciparum

A

many strains are resistant to chloroquine

replicates in erythrocytes more replication and lyse in this species

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13
Q

Falciparum infected RBCs

A

express pfEMP-1 this binds to ICAM-1 on endothelial cells leading to RBC blockage of small vessels
this blocks blood supply to organs leading to organ damage - severe damage in kidneys, CNS and placenta
lysis leads to accumulation of toxic hemoglobin breakdown products

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14
Q

What are severe manifestations of P. Falciparum?

A

cerebral malaria
Blackwater fever - renal damage, lysed blood cells in urine
maternal and fetal death in pregnancy

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15
Q

what does the P falciparium gametocyte look like on a blood smear?

A

a banana!

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16
Q

Treatment of malaria?

A

for Chloroquine resistant P falciparum - Mefloquine, Quinine + doxycycline or clindamycin or Atovaquone+proguanil (Malarone)
for Chloroquine sensitive P falciparum and P malariae - Chloroquine
for P vivax and P ovale - Chloroquine plus primaquine

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17
Q

Malaria chemoprophylaxis

A

everything you typically use to treat except for areas where there is chloroquine resistance P falciparum, you dont need to include Clindamycin

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18
Q

Babesia Microti

A 
protozoan-sporozoan 
found in US - coastal NE region 
Vector: ticks - Lxodes dammini 
Reservoir: Mice, adults feed on deer 
replicates in RBCs 
Humans are incidental hosts
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19
Q

Pathogenesis of Babesiosis

A

replicates in erythrocytes
RBC lysis releases merozoites
1-4 week incubation period
fever, chills, headache, fatigue, weakness
leads to Hemolytic anemia and rarely renal failure
recovery in 2-4 weeks

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20
Q

Treatment of Babesiosis?

A

Clindamycin plus quinine
or
Atovaquone plus azithromycin

21
Q

Trypanosoma Cruzi

A 
flagellated protozoan 
causes Chagas' disease 
vector: Triatomid bugs 
Reservoir: armadillos, rodents, dogs 
Endemic in central and south america
22
Q

Clinical signs of Chagas’ disease: Acute phase

A

asymptomatic or present with fever, anorexia, lymphadenopathy, mild hepatosplenomegaly, myocarditis
Chagoma
Romanas sign
resolve in weeks to months into an asymptomatic chronic form of the disease

23
Q

Chagoma

A

nodular lesion at the site of inoculation

caused by Trypanosoma Cruzi

24
Q

Romana’s sign

A

chagoma near eye

unilateral periocular swelling

25
Q

Clinical signs of Chagas’ disease: Chronic

A

replicates in various cell types - especially cardiac myocytes and tissues macrophages
develop after years-decades
can lead to megaesophagus or megacolon as result of nerve damage
Cardiomyopathy - parasite growth in and damage to cardiac myocytes
Complications can be fatal

26
Q

Cardiomyopathy in Chagas’ disease

A

heart develops conduction disturbances, becomes enlarged leading to heart failure
antigenic mimic also plays role in chronic cardiac disease - parasite antigen mimics heart muscle antigen, immune reacts to parasite and then eventually to heart muscle
see mononuclear infiltration into the heart

27
Q

Treament of Chaga’s disease

A

drugs available from the CDC

tissue damage from chronic infection is not reversible

28
Q

African sleeping sickness caused by

A

Trypanosoma Brucei

29
Q

Trypanosoma Brucei

A

vector: Tsetse fly
Reservoir: wild antelope
causes african sleeping sickness

30
Q

Pathogenesis of Sleeping sickness

A

replicates in blood and lymphatics
fever, lymphadenopathy, pruritus
enters CNS weeks to months after bite
altered mental state and sensory disorders
difficulty walking and talking
Somnolence (deep deep sleep) coma and death

31
Q

Treat Sleeping sickness with?

A

Suramin for blood and lymphatic stages

Malarsoprol for CNS disease

32
Q

Schistosoma

A

blood flukes

Trematodes

33
Q

Schistosomiasis

A

chronic infection and organ damage
Intermediate host - fresh water snails - sporocyst develops followed by cercaria, this form is released from the snail and burrows through the skin of human host -this leads to adults (in blood vessels)- lay eggs and eggs hatched into Miracidium after being released. this form infects snails

34
Q

Schistosoma Haematobium

A

adults in vessels of bladder
eggs migrate through bladder wall
released in urine

35
Q

Schistosoma Mansoni and S. Japonicum

A

adults in venous plexis of intestine
eggs migrate through intestine and liver
released in stool

36
Q

Clinical signs of Schistosomiasis

A

allergic dermatitis with cercarial penetration through skin
Katayama fever: acute (4-6 wks after infection) fever, cough, abdominal pain, urticarial (hives) rash, hepatosplenomegaly due to immune reaction to egg production
chronic illness: due to inflammatory response to eggs - Granulomatous lesions interfere with organ function - see liver damage, urinary obstruction, pyelonephritis, bladder cancer

37
Q

Schistosomiasis - eggs

A

eggs are very antigenic

body forms granulomas (type IV) causes organ damage

38
Q

Katayama fever

A

Schistosomiasis
fever, cough, abdominal pain, urticarial rash, hepatosplenomegaly
due to immune reaction to eggs

39
Q

Chronic Schistosomiasis

A

leads to Granulomatous lesions that interfere with organ function
liver damage - mansoni, japonicum
Urinary obstruction, pyelonophritis, bladder cancer - haematobium

40
Q

ID S. Heamoatobium by

A

looking in urine and finding lemon shaped eggs (pointy at both ends)

41
Q

Treat Schistomiasis with?

A

Praziquantel

42
Q

Filariasis diseases caused by

A

Wuchereria bancrifti
Brugia malayi
Onchocera volvulus
Loa loa

43
Q

Lymphatic filariasis

A

Elephantiasis
caused by Wuckereria bancrifti and Brugia malayi
parasite blocks lymph drainage

44
Q

River blindness

A

Onchocercosis
caused by Onchocera volvulus
vector: black flies - like to lay eggs in rivers

45
Q

Clinical signs of Onchocerosis

A

due to inflammatory response to microfilariae
Skin - nodules, de-pigmentation, thickening, intense itching
blindness due to inflammation as microfilariae migrate through eye

46
Q

Treat Onchocerosis?

A

surgical removal of nodules containing adult worms

Ivermectin

47
Q

Prophylaxis of Onchocerosis?

A

Ivermectin and diethylacarbanizine

48
Q

Loiasis

A

caused by Loa Loa

transmitted by Chrysops (deer fly also called mango fly)

49
Q

Loiasis

A

adult worms live in connective tissue under the skin and between fascial layers overlying somatic muscles
adults migrate frequently, pass briefly across the surface of eye, leading to eye congestion, itching, pain and light sensitivity
no permanent damage to eye

CMBM Exam 4 Gopi (10 decks)

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