Clinical Parasitology Flashcards
What are the chronic stage symptoms of Giardia lamblia?
Steatorrhea Weight loss Malaise Low grade fever Failure to thrive syndrome
What is the pathogenesis of Trichomonas vaginalis?
Inflammation of vaginal mucosa after several days of inoculation
4-28 days after inoculation, it will degenerate and de-squamify the vaginal epithelium followed by leukocytic inflammation
**The trophozoites cannot live without close association to vaginal, urethral, or prostatic tissues
What is the pathogenesis of Chilomastix mesnili?
Ingestion of cyst from contaminated food or water → cyst goes to stomach → small intestine → cecum; it will excyst (to merge from a cyst) → trophozoite replicates and encysts → excretion via feces
**only the cyst will survive in the environment
What are the acute stage symptoms of Giardia lamblia?
Diarrhea Abdominal pain Excessive flatus Bloating Nausea Anorexia
Enumerate the four tests on how we diagnose Giardia lamblia and their important notes
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Demonstration of trophozoite in feces
- 3 stool exams on alternate days
- Note falling-leaf motility of trophozoites
-
Duodeno-jejunal aspirate
- For cases wherein parasite is not seen on stools
- Higher percentage of positive findings
-
Enterotest/Entero string test
- Gelatin capsule with nylon string on px’s cheek
- Removed after 4-6 hours and fluid is examined
-
Direct fluorescent antibody assay
- Gold standard
- Highest sensitivity and specificity
What are the treatment options for Giardia lamblia? Determine first line drug and drug for resistant cases
Metronidazole - first line drug
Tinidazole
Albendazole
Nitazoxanide - for drug resistant cases
What is the shape of the Chilomastix mesnili trophozoite?
10 um pear-shaped due to spiral groove
What are the acute stage symptoms of Trichomonas vaginalis?
Greenish/Yellow vaginal secretions
Irritation
Itchiness
Burning sensation
How do we prevent Chilomastix mesnili?
Improved sanitation and personal hygiene
What is the epidemiology of Giardia lamblia?
Giardia lamblia is widely distributed with high prevalence in areas with poor sanitation and hygiene practices, overcrowding, and homosexual practice. It can also be foodborne or waterborne.
What is the phylum, subphylum, class, and order of oral and intestinal flagellates?
Phylum: Sarcomastigophora
Subphylum: Mastigophora
Class: Zoomastigophora
Order: Trichomonadida (Trichomonas), Retortamonadida (Chilomastix), Diplomonadida (Giardia lambia)
What are the chronic stage symptoms of Trichomonas vaginalis?
Secretion no longer purulent
Increase in epithelial cells
Mixed bacterial flora
Females: inflammation of vaginal mucosa, vaginal discharge, vulvitis, dysuria, post-partum endometritis, secondary bacterial infection of urogenital tract
Males: recurring urethritis; prostatitis (most common complication); latent and symptomatic
What is the diagnostic stage of Giardia lamblia?
Trophozoite
Cyst
How do we prevent and control Trichomonas vaginalis?
Limit number of sexual partners, proper use of protection, simultaneous tx of sexual partners
What is the habitat of Trichomonas hominis trophozoite?
Cecum
How can we transmit Trichomonas tenax?
Kissing
Use of common eating and drinking utensils
Droplet spray
What is the diagnostic feature for Chilomastix mesnili?
Spiral groove
How do we prevent and control Giardia lamblia?
Proper sanitary disposal of human excreta
What is the shape and dimensions of Trichomonas vaginalis trophozoite?
7-23 um pyriform/tear drop shape
What is the shape and dimensions of the Giardia lamblia cyst?
8-10 um by 7-10 um double-walled ovoid/football shape
What is the shape and dimensions of the Giardia lamblia trophozoite?
9-12 um by 5-15 um bilaterally symmetrical pyriform/teardrop shape
These flagellates have a prevalence of less than 1% in the Philippines
Trichomonas hominis
Trichomonas tenax
What is the shape and dimensions of the Trichomonas hominis trophozoite?
7-13 um pyriform shape
How long is the incubation period of Giardia lamblia?
1-4 weeks with 9 days average
