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BSMT 2 > Clinical Parasitology > Flashcards

Clinical Parasitology Flashcards

1
Q

What are the chronic stage symptoms of Giardia lamblia?

A 
Steatorrhea
Weight loss
Malaise
Low grade fever
Failure to thrive syndrome
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2
Q

What is the pathogenesis of Trichomonas vaginalis?

A

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

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3
Q

What is the pathogenesis of Chilomastix mesnili?

A

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

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4
Q

What are the acute stage symptoms of Giardia lamblia?

A 
Diarrhea
Abdominal pain
Excessive flatus
Bloating
Nausea
Anorexia
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5
Q

Enumerate the four tests on how we diagnose Giardia lamblia and their important notes

A
  1. Demonstration of trophozoite in feces
    • 3 stool exams on alternate days
    • Note falling-leaf motility of trophozoites
  2. Duodeno-jejunal aspirate
    • For cases wherein parasite is not seen on stools
    • Higher percentage of positive findings
  3. Enterotest/Entero string test
    • Gelatin capsule with nylon string on px’s cheek
    • Removed after 4-6 hours and fluid is examined
  4. Direct fluorescent antibody assay
    • Gold standard
    • Highest sensitivity and specificity
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6
Q

What are the treatment options for Giardia lamblia? Determine first line drug and drug for resistant cases

A

Metronidazole - first line drug
Tinidazole
Albendazole
Nitazoxanide - for drug resistant cases

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7
Q

What is the shape of the Chilomastix mesnili trophozoite?

A

10 um pear-shaped due to spiral groove

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8
Q

What are the acute stage symptoms of Trichomonas vaginalis?

A

Greenish/Yellow vaginal secretions
Irritation
Itchiness
Burning sensation

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9
Q

How do we prevent Chilomastix mesnili?

A

Improved sanitation and personal hygiene

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10
Q

What is the epidemiology of Giardia lamblia?

A

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.

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11
Q

What is the phylum, subphylum, class, and order of oral and intestinal flagellates?

A

Phylum: Sarcomastigophora
Subphylum: Mastigophora
Class: Zoomastigophora
Order: Trichomonadida (Trichomonas), Retortamonadida (Chilomastix), Diplomonadida (Giardia lambia)

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12
Q

What are the chronic stage symptoms of Trichomonas vaginalis?

A

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

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13
Q

What is the diagnostic stage of Giardia lamblia?

A

Trophozoite

Cyst

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14
Q

How do we prevent and control Trichomonas vaginalis?

A

Limit number of sexual partners, proper use of protection, simultaneous tx of sexual partners

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15
Q

What is the habitat of Trichomonas hominis trophozoite?

A

Cecum

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16
Q

How can we transmit Trichomonas tenax?

A

Kissing
Use of common eating and drinking utensils
Droplet spray

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17
Q

What is the diagnostic feature for Chilomastix mesnili?

A

Spiral groove

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18
Q

How do we prevent and control Giardia lamblia?

A

Proper sanitary disposal of human excreta

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19
Q

What is the shape and dimensions of Trichomonas vaginalis trophozoite?

A

7-23 um pyriform/tear drop shape

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20
Q

What is the shape and dimensions of the Giardia lamblia cyst?

A

8-10 um by 7-10 um double-walled ovoid/football shape

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21
Q

What is the shape and dimensions of the Giardia lamblia trophozoite?

A

9-12 um by 5-15 um bilaterally symmetrical pyriform/teardrop shape

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22
Q

These flagellates have a prevalence of less than 1% in the Philippines

A

Trichomonas hominis

Trichomonas tenax

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23
Q

What is the shape and dimensions of the Trichomonas hominis trophozoite?

A

7-13 um pyriform shape

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24
Q

How long is the incubation period of Giardia lamblia?

A

1-4 weeks with 9 days average

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25
Q

How do we diagnose Trichomonas tenax?

A

Swabbing tartar between teeth
Gingival margin or tonsillar crypts viewed on wet mount or stained slides
Pulmonary trichomoniasis of CPD px (probably via aspiration)

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26
Q

How long does the undulating membrane of Trichomonas vaginalis trophozoite extend?

A

1/2

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27
Q

How long does the undulating membrane of Trichomonas hominis trophozoite extend?

A

Entire body with free trail on posterior end

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28
Q

What is the shape of the Chilomastix mesnili cyst?

A

Lemon/Pear shape with knob-like protuberance

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29
Q

What is the infective stage of Chilomastix mesnili?

A

Cyst stage

30
Q

How long does the cytostome of Chilomastix mesnili cyst extend?

A

Whole body

31
Q

It is the smallest Trichomonas specie

A

Trichomonas tenax

32
Q

What is the shape and dimensions of Trichomonas tenax trophozoite?

A

5-12 um pyriform shape

33
Q

How long does the undulating membrane of Trichomonas tenax trophozoite extend?

A

1/2 to 2/3

34
Q

What is the treatment option for Chilomastix mesnili?

A

No tx indicated

35
Q

What are the pathogenic flagellates?

A

Giardia lamblia

Trichomonas vaginalis

36
Q

What is the non-life threatening disease caused by Giardia lamblia?

A

Giardiasis

37
Q

What are the non-pathogenic flagellates?

A

Trichomonas hominis
Trichomonas tenax
Chilomastix mesnili

38
Q

How can one become infected with Giardia lamblia cysts?

A

Infection through ingestion of quadrinucleated cyst from contaminated food and water

39
Q

It is the most commonly diagnosed intestinal parasite in the US

A

Giardia lamblia

40
Q

What are the habitats of Giardia lamblia?

A

Duodenum
Jejunum
Upper ileum

41
Q

What is the infective stage of Giardia lamblia?

A

Mature cyst or quadrinucleated cyst

42
Q

Enumerate the life cycle of Giardia lamblia

A

Ingestion of quadrinucleated cyst via food/water → cyst passes through stomach → cyst develops into trophozoites in the duodenum → trophozoites actively multiply and attach to intestinal walls via sucking discs → microvilli flattens resulting in mechanical irritation and deficiency of digestive enzymes → trophozoites may then be seen in jejunum → feces enters colon and dehydrates → parasites will encyst (be incapsulated) → mature cysts are excreted and ingested by susceptible host

43
Q

What is the diagnostic stage of Chilomastix mesnili?

A

Trophozoite stage

Cyst stage

44
Q

What is the habitat of Chilomastix mesnili?

A

Cecum

45
Q

What flagellate is transmitted sexually?

A

Trichomonas vaginalis

46
Q

How does Giardia lamblia divide?

A

Longitudinal binary fission

47
Q

What side of the Giardia lamblia trophozoite has an adhesive disc?

A

Ventral side (concave)

48
Q

How do we diagnose Chilomastix mesnili?

A

Demonstration of cyst or trophozoite in feces

49
Q

How many nuclei do young and mature Giardia lamblia cysts have?

A

Young: 2 nuclei
Mature: 4 nuclei

50
Q

Who discovered Giardia lamblia?

A

Antoine van Leeuwenhoek (1871)

51
Q

What flagellate and its stage is described as having a falling leaf motility?

A

Trophozoite stage of Giardia lamblia

52
Q

What is the other name for the cyst stage?

A

Quadrinucleated cyst

53
Q

How many pairs of flagella do Giardia lamblia trophozoites have?

A

4 pairs

54
Q

Who discovered Trichomonas vaginalis in 1836?

A

Donne

55
Q

What are the habitats of Trichomonas vaginalis?

A

Male: urogenital tract
Female: vagina

56
Q

How many flagella are there in Trichomonas vaginalis trophozoite?

A

4 anterior flagella

1 embedded flagella in undulating membrane

57
Q

How does Trichomonas vaginalis multiply?

A

Longitudinal binary fission

58
Q

What specie of Trichomonas will not invade the mucosa?

A

Trichomonas vaginalis

59
Q

It is the quickest and most inexpensive way to diagnose trichomoniasis, but the sensitivity of this technique is low at 60 to 70%

A

Saline preparation of vaginal fluid

60
Q

How do we describe the motility of Trichomonas hominis trophozoite?

A

Rapid jerky

61
Q

What is the gold standard of diagnosing trichomoniasis? How many days does it take to finish it?

A

Culture (2-5 days)

62
Q

What are the treatment options for Trichomonas vaginalis? Determine first line drug

A

Metronidazole - first line drug
Tinidazole
Concomitant tx of sexual partners to prevent reinfection

63
Q

What is the epidemiology of Trichomonas vaginalis?

A

Occurs worldwide and higher prevalence on child-bearing aged women

64
Q

How can Trichomonas hominis trophozoite be transmitted?

A

Contaminated foods and drink

65
Q

How can we diagnose Trichomonas hominis trophozoite?

A

Demonstration of trophozoite in stools

66
Q

What is the habitat of Trichomonas tenax?

A

Oral cavity

67
Q

How long does the cleft-shaped cytostome of Chilomastix mesnili trophozoite extend?

A

1/2

68
Q

What is the movement of Chilomastix mesnili trophozoite?

A

Boring, spiral forward motion

69
Q

This Trichomonas specie is resistant to heat and can survive for several hours in drinking water

A

Trichomonas tenax

70
Q

What is the appearance of the cytostomal fibril of Chilomastix mesnili cyst?

A

Shepherd’s crook appearance

BSMT 2 (3 decks)

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