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Block G -- Infection > Dr. Libman -- Parasitology 1: Protozoa > Flashcards

Dr. Libman -- Parasitology 1: Protozoa Flashcards

1
Q

5 protozoa that affect the intestine

A
  1. Entamoeba histolytica
  2. Giardia
  3. Isospora
  4. Cryptosporidium
  5. Cyclospora
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2
Q

5 protozoa that have a systemic effect

A
  1. Malaria
  2. Babesia
  3. Toxoplasma
  4. Leishmania
  5. Trypanosoma
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3
Q

2 divisions of parasites

A

Unicellular (protozoa)

Multicellular (helminthes)

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4
Q

3 types of helminthes

A
  1. Nematodes
  2. Cestodes
  3. Trematodes
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5
Q

4 nematodes that affect the intestine

A
  1. Strongyloides
  2. Ascaris
  3. Tricharis
  4. Hookworm
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6
Q

2 nematodes that have a systemic effect

A
  1. Filaria
  2. Toxocara
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7
Q

Cestodes that affect the intestine

A

Tapeworms

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8
Q

2 cestodes that have a systemic effect

A
  1. Hydatid cysts
  2. Cysticercosis
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9
Q

Trematodes that affect the intestine

A

Intestinal flukes

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10
Q

2 trematodes that have a systemic effect

A
  1. Schistosoma
  2. Liver flukes
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11
Q

Definition of protozoa that differentiates it from bacteria and viruses

A

“Eukaryote” as it has genetic material encased in a nuclear membrane

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12
Q

Define trophozoite

A

Any stage in a protozoan’s life cycle which can ingest food. In practice, also refers to the motile form

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13
Q

Define a cyst

A

The non-motile form which is protected by a distinct membrane or cyst well. This is the infective stage of the parasite

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14
Q

Define excystation

A

The process of emergence of the trophozoite from the cyst

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15
Q

Define pseudopod

A

Temporary cytoplasmic processes at the surface of the trophozoite

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16
Q

3rd leading cause of parasitic death in the world

A

Entamoeba histolytica (amoebiasis)

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17
Q

4 stages of amoebiasis

A
  1. Asymptomatic carrier state
  2. Acute amoebic dysentery
  3. Amoebic liver abscess
  4. Amoeboma
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18
Q

Presentation of amoebic dysentery (3)

A
  • Blood, mucousy diarrhea
  • Fever
  • Abdominal pain
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19
Q

4 ways to diagnose amoebic dysentery

A
  • Amoebic (hematophagous trophozoites) in stool
  • Mixed WBCs in stool
  • Patchy inflammation seen on colonoscopy
  • Stool PCR or antigen capture
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20
Q

Presentation of amoebic liver abscess (3)

A
  • Persisting fever
  • RUQ or epigastric pain and/or shoulder pain
  • Rarely diarrhea
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21
Q

5 ways to diagnose amoebic liver abscess

A
  1. Ultrasound
  2. Raised WBC
  3. Serology
  4. Aspirate microscopy
  5. Response to metronidazole 750 TID
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22
Q

Drug for tissue entamoeba histolytica

A

Metronidazole

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23
Q

2 drugs for bowel lumen entamoeba histolytica

A
  • Diiodochlorhydroxyquin (aka Iodoquinol, Diodoquin)
  • Diloxanide furoate (Furamide)
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24
Q

Only source of entamoeba histolytica

A

Humans

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25
Q

*Entamoeba histolytica *transmission

A

Fecal-oral (poop the eggs and then eat the eggs)

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26
Q

Most commonly diagnosed enteric parasite in US/Canada

A

Giardia lamblia

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27
Q

Effect of *giardia lamblia *on intestinal wall

A
  • Villus atrophy
  • Crypt hyperplasia
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28
Q

Transmission of giardia

A

Fecal oral; zoonotic (most mammals, esp. beaver)

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29
Q

7 symptoms of giardiasis

A
  1. Diarrhea
  2. Flatulence
  3. Abdominal cramps
  4. Decreased appetite
  5. + weight loss
  6. + nausea
  7. NO fever

Basically, upper GI symptoms (colitis very unlikely dDx)

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30
Q

Signs of giardiasis

A

Mild abdominal tenderness

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31
Q

4 laboratory findings of giardiasis

A
  • No leukocytes in stool
  • No mucous in stool
  • Giardia cysts/trophs intermittent in stool
  • Girdia cysts/trophs in duodenal aspirate
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32
Q

Define anchovy paste and when you can find it

A

Aspirate of liver amoebic liver abscess

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33
Q

6 treatments for giardia

A
  1. Metronidazole 250 - 750 mg TID x 7 - 10 days
  2. Tinidazole
  3. Nitazoxanide
  4. Paromomycin
  5. Quinacrine (atabrine)
  6. Furazolidone
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34
Q

What is Cryptosporidium parvum an important cause of

A

Self-limited foodborne diarrhea worldwide

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35
Q

2 methods of transmission of cryptosporidium

A
  1. Zoonosis (bovine)
  2. Fecal-oral (i.e. by contamination of municipal water)
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36
Q

Location of cryptosporidium in body

A

Small intestine epithelial cell membrane

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37
Q

Type of life cycle that cryptosporidium has

A

Apicomplexa

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38
Q

2 clinical findings of cryptosporidium

A
  • Diarrhea 2 - 3 weeks (chronic in AIDS)
  • Cholecystitis
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39
Q

Taxonomy of cyclospora cayetanensis

A

Apicomplexa

40
Q

Epidemiology of cyclospora cayetensis (3 points)

A
  • Travellers to tropics (esp. Nepal, Americas)
  • Raspberries
  • Basil from Guatemala and Mexico
41
Q

Location of cyclospora cayetanensis in body

A

Small intestine epithelial cells

42
Q

Clinical presentation of cyclospora cayetanensis

A

Prolonged diarrhea (2 - 6 weeks)

43
Q

Cyclospora cayetanensis treatment

A

Septra

44
Q

Treatment for cryptosporidium

A
  • HIV-neg = nitazoxanide optional
  • HIV-pos = HAART!
45
Q

4 intestinal protozoa for which we stain with hematoxylin

A
  1. E. histolytica
  2. Giardia
  3. D. fragilis
  4. Isospora
46
Q

2 intestinal protozoa for which we stain using modified Ziehl-Neelsen

A
  1. Cryptosporidium
  2. Cyclospora
47
Q

Intestinal protozoa for which we stain with trichrome

A

Microsporidium

48
Q

Giardia taxonomy

A

Mastigophora

49
Q

Trichomonas vaginalis taxonomy

A

Mastigophora

50
Q

Trichomonas vaginalis transmission

A
  • Human reservoir
  • Urogenital tract, sexual transmission
51
Q

Biology of Trichomonas vaginalis

A

Inflammation of vaginal and urethral epithelium

52
Q

Clinical presentation of Trichomonas vaginalis (5)

A
  1. Asymptomatic
  2. Foul per vagina discharge
  3. Dyspareunia
  4. Adbominal cramps
  5. Pre-term birth
53
Q

Treatment of Trichomonas vaginalis

A

Metronidazole

54
Q

Taxonomy of toxoplasma gondii

A

Apicomplexa

55
Q

Definitive host of toxoplasma gondii

A

Cat

56
Q

Define definitive host

A

A host in which the parasite reaches maturity and, if possible, reproduces sexually

57
Q

Define reservoir host

A

Can harbour a pathogen indefinitely with no ill effects. A single reservoir host may be reinfected several times

58
Q

Define secondary or intermediate host

A

A host that harbors the parasite only for a short transition period, during which (usually) some developmental stage is completed

59
Q

Reservoir form of toxoplasma gondii and where is it is found

A

Cyst (bradyzoite) in many animals and birds

60
Q

3 modes of transmission of toxoplasmosis

A
  1. Fecal oral from cat
  2. Oral (raw meat)
  3. Transplacental during acute infection
61
Q

4 clinical forms of toxoplasmosis

A
  1. Lymphadenopathic/acute
  2. Ocular
  3. Neonatal
  4. In immunocompromised host
62
Q

3 signs and symptoms of lymphadenopathic toxoplasmosis

A
  1. Fever
  2. Lymphadenopathy
  3. Fatigue
63
Q

Duration of lymphadenopathic toxoplasmosis

A

1 - 4 weeks

64
Q

2 sources of lymphadenopathic toxoplasmosis

A
  1. Raw meat
  2. Kitty litter
65
Q

2 signs and symptoms of ocular toxoplasmosis

A
  1. Decreased vision
  2. Retinal lesions on retinoscopy
66
Q

3 sources of ocular toxoplasmosis

A
  1. Intrauterine infection
  2. Raw meat
  3. Kitty litter
67
Q

Signs and symptoms of neonatal toxoplasmosis

A

Mother has lymphadenopathic toxoplasmosis (fever, nodes and/or fatigue)

68
Q

Trend of transmission risk of neonatal toxoplasmosis in pregnancy

A

Increases with duration of pregnancy

69
Q

Trend of sequelae severity of neonatal toxoplasmosis relative to the duration of pregnancy

A

Decreases with duration of pregnancy (i.e. if infected earlier, more severe)

70
Q

3 treatments for toxoplasmosis

A
  1. Pyrimethamine po 200 mg for 1 day THEN 100 mg od for 4 weeks
  2. Sulfadiazine po 4 mg od for 4 weeks
  3. Folinic acid po 5 mg for 4 weeks
71
Q

Taxonomy of leishmania

A

Mastigophora

72
Q

Taxonomy of trypanosoma

A

Mastigophora

73
Q

3 forms of leishmania

A
  1. Cutaneous
  2. Mucocutaneous
  3. Visceral
74
Q

2 forms of trypanosoma

A
  1. African sleeping sickness
  2. South American Chagas disease
75
Q

Type of transmission pathway taken by hemoflagellates (trypanosoma and leishmania)

A

Zoonotic (man and livestock)

76
Q

3 basic morphologic stages of trypanosoma and leishmania

A
  1. Motile promastigote
  2. Trypomastigote
  3. Immotile amastigote
77
Q

2 distinguishing features of trypanosoma and leishmania

A
  • Kinetoplast
  • Flagellum
78
Q

Definitive host of leishmania

A

Human

79
Q

Leishmania vector

A

Sandfly

80
Q

Leishmania reservoir

A

Dog, gerbil

81
Q

4 methods of diagnosis and for which types of hemoflagellates they cover

A
  1. Biopsy
    • Granuloma
    • Impression smear stain –> amastigotes
  2. Aspirate and stain = amastigotes
  3. Aspirate culture = promastigotes
  4. Aspirate or biopsy
    • PCR
82
Q

2 types of leishmania responsible for the cutaneous form

A
  • L. tropica
  • L. major
83
Q

2 types of leishmania responsible for mucocutaneous leishmaniasis

A
  • L. (V.) braziliensis complex
  • L. (L.) mexicana complex
84
Q

2 types of leishmania responsible for visceral leishmaniasis

A
  • L. infantum
  • L. donovani
85
Q

5 relatively common clinical manifestations of visceral leishmaniasis

A
  • Fever
  • Hepatomegaly
  • Splenomegaly
  • Cough
  • Lymphadenopathy (inguinal, axillary, post-cervical)
86
Q

3 rare clinical manifestations of viscerla leishmaniasis

A
  • Nephrotic syndrome
  • Symptomless generalized lymphadenopathy
  • Mucocutaneous lesions in Africa
87
Q

6 treatments for visceral leishmaniasis

A
  1. Liquid nitrogen
  2. Ketoconazole/fluconazole
  3. Pentostam (sodium antimony gluconate) IV
  4. Amphotericin B IV
  5. Liposomal Ampho B
  6. Miltefosine po
88
Q

Distribution of trypanosomiasis in sub-Saharan Africa

A
  • West = gambiense
  • East = rhodesiense
89
Q

Difference between the gambiense and rhodesiense types of trypanosoma brucei

A
  • Rhodesiense = more virulent
  • Gambiense = more chronic
90
Q

Typical vector for trypanosoma

A

Tsetse fly

91
Q

Reservoir for East African trypanosomiasis

A

Bush buck

92
Q

3 types of clinical findings associated with Africna trypanosomiasis

A
  1. Chancre (painless ulceration)
  2. Parasitemia
  3. Organ-specific symptoms
93
Q

7 symptoms related to parasitemia due to African trypanosomiasis

A
  1. Periodic fever
  2. Headache
  3. Joint and muscle pain
  4. Lymphadenopathy
  5. Weight loss
  6. Pruritis
  7. Anemia
94
Q

4 edema-related symptoms of African trypanosomiasis

A
  1. Peripheral
  2. Ascites
  3. Pulmonary
  4. Pericardial
95
Q

3 cardiac symptoms of African trypanosomiasis

A
  1. ECG changes
  2. CHF
  3. Cardiac distension
96
Q

2 GI symptoms of African trypanosomiasis

A
  1. Diarrhea
  2. Anorexia
97
Q

4 neurologic symptoms of African trypanosomiasis

A
  1. Focal neurologic defects
  2. Confusion
  3. Lethargy
  4. Coma

Block G -- Infection (23 decks)

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