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FA - Micro - Parasitology Flashcards

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0
Q

Giardiasis - Transmission?

A

Cysts in water.

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1
Q

Giardiasis - Features?

A
  1. Bloating
  2. Flatulence
  3. Foul-smelling
  4. Fatty diarrhea (often seen in campers/hikers)
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2
Q

Giardiasis - Diagnosis?

A

Trophozoites OR cysts in stool.

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3
Q

Giardiasis - Treatment?

A

Metronidazole.

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4
Q

Amebiasis - Features?

A
  1. Bloody diarrhea (dysentery)
  2. Liver abscess (“Anchovy paste” exudate)
  3. RUQ pain (histology shows flask-shaped ulcer if submucosal abscess of colon ruptures).
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5
Q

Amebiasis - Transmission?

A

Cysts in water.

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6
Q

Amebiasis - Diagnosis?

A

Serology and/or trophozoites (with RBCs in the cytoplasm) OR cysts (with up to 4 nuclei) in stool.

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7
Q

Amebiasis - Treatment?

A
  1. Metronidazole

2. Iodoquinol for asymptomatic CYST passers.

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8
Q

Cryptosporidium - Features?

A 
Severe diarrhea in AIDS.
Mild disease (watery diarrhea) in immunocompetent.
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9
Q

Cryptosporidium - Transmission?

A

Oocysts in water.

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10
Q

Cryptosporidium - Diagnosis?

A

Oocysts on acid-fast stain.

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11
Q

Cryptosporidium treatment?

A
  1. Prevention (by filtering city water supplies).

2. NITAZOXANIDE in immunocompetent hosts.

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12
Q

T.gondii - causes?

A

Reactivation in AIDS ==> Brain abscess seen as ring-enhancing brain lesions on MRI.

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13
Q

Congenital toxo - classical triad?

A
  1. Chorioretinitis
  2. Hydrocephalus
  3. Intracranial calcifications
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14
Q

T.gondii - transmission?

A
  1. Cysts in meat (MC).
  2. Oocysts in cat feces.
  3. Crosses placenta (pregnant women should avoid cats).
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15
Q

T.gondii - diagnosis?

A

Serology or biopsy (tachyzoites).

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16
Q

Toxo - Treatment?

A

Sulfadiazine + pyrimethamine.

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17
Q

Naegleria fowleri - causes?

A

Rapidly fatal meningoencephalitis.

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18
Q

N.fowleri - transmission?

A
  1. Swimming in freshwater lakes .

2. Enters via cribriform plate.

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19
Q

N.fowleri - diagnosis?

A

Amoebas in spinal fluid.

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20
Q

N.fowleri treatment?

A

Amphotericin B has been effective for a few survivors.

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21
Q

T.brucei - causes?

A

African sleeping sickness.

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22
Q

African sleeping sickness - features?

A
  1. Enlarged lymph nodes
  2. Recurring fever (due to ANTIGENIC VARIATION)
  3. Somnolence
  4. Coma
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23
Q

T.brucei - Transmission?

A

Tsetse fly - a painful bite.

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24
Q

T.brucei - diagnosis?

A

TRYPOMASTIGOTE in blood smear.

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25
Q

T.brucei - Treatment?

A
  1. Suramin ==> Blood-borne disease.

2. Melarsoprol ==> CNS penetration.

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26
Q

Malaria - Features?

A
  1. Fever
  2. Headache
  3. Anemia
  4. Splenomegaly
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27
Q

P.vivax/ovale - Features?

A

48h-cycle - tertian; includes fever on 1st day and 3rd day, thus fevers are actually 48h apart.

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28
Q

P.vivax/ovale - Dormant form?

A

Hypnozoites in liver.

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29
Q

P.falciparum - features?

A
  1. Severe
  2. Irregular fever patterns
  3. Parasitized RBCs occlude capillaries in brain (cerebral malaria), kidney, lungs.
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30
Q

P.malariae - cycle?

A

72h - quartan.

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31
Q

Plasmodium - transmission?

A

Mosquito (Anopheles).

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32
Q

Plasmodium - diagnosis?

A

Blood smear:

  1. Trophozoite ring form within RBC.
  2. Schizont containing merozoites.
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33
Q

Plasmodium - treatment?

A
  1. Begin with chloroquine, which blocks PLASMODIUM HEME POLYMERASE.
  2. If resistant - use mefloquine or atovaquone/proguanil.
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34
Q

Plasmodium - Life-threatening - treatment?

A
  1. IV quinidine (test for G6PD).

2. ARTESUNATE.

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35
Q

P.vivax/ovale treatment?

A

Add primaquine for hypnozoite (test for G6PD).

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36
Q

Babesiosis - features?

A
  1. Fever

2. Hemolytic anemia

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37
Q

Babesiosis - where?

A

Predominantly in northeastern US.

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38
Q

Babesiosis - special risk?

A

Asplenia –> Incr. risk for severe disease.

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39
Q

Babesia - Transmission?

A

Ixodes tick (same as B.burgdorferi) - often coinfection.

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40
Q

Babesia - diagnosis?

A
  1. Blood smear: Ring form - Maltese cross.

2. PCR.

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41
Q

Babesiosis - Treatment?

A

Atovaquone + Azithro

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42
Q

T.cruzi - causes?

A

Chagas

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43
Q

Chagas - features?

A
  1. DCM + APICAL ATROPHY.
  2. Megacolon
  3. Megaesophagus
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44
Q

T.cruzi - where?

A

Predominantly in South America.

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45
Q

T.cruzi - transmission?

A
  1. Reduviid bug - “kissing bug”
  2. Feces
  3. Deposited in a painless bite (much like a kiss)
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46
Q

T.cruzi - diagnosis?

A

TRYPOMASTIGOTE in blood smear.

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47
Q

T.cruzi - treatment?

A
  1. Benznidazole

2. Nifurtimox

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48
Q

L.donovani - causes?

A

Visceral leishmaniasis (kala-azar).

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49
Q

Visceral leishmaniasis - features?

A
  1. Spiking fevers
  2. HSM
  3. Pancytopenia
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50
Q

L.donovani - transmission?

A

Sand fly

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51
Q

L.donovani - diagnosis?

A

Macrophages containing AMASTIGOTES.

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52
Q

L.donovani - treatment?

A
  1. Amphotericin B.

2. Sodium STIBOGLUCONATE.

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53
Q

T.vaginalis - causes?

A

Vaginitis.

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54
Q

T.vaginalis - not to be confused with?

A

G.vaginalis - gram variable bacterium associated with bacterial vaginosis.

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55
Q

T.vaginalis - Transmission?

A

Sexual (CANNOT EXIST OUTSIDE human because it cannot form cysts).

56
Q

T.vaginalis - diagnosis?

A

Trophozoites (motile) on wet mount. “Strawberry cervix”.

57
Q

T.vaginalis - treatment?

A

Metronidazole for patient and partner (prophylaxis).

58
Q

Enterobius vermicularis (pinworm) - transmission?

A

Fecal-oral

59
Q

E.vermicularis (pinworm) - causes?

A

Intestinal infection causing ANAL PRURITUS (diagnosed via SCOTCH TAPE TEST).

60
Q

E.vermicularis (pinworm) - treatment?

A

Bendazoles (because worms are bendy).

61
Q

Ascaris lumbricoides (giant roundworm) - transmission?

A

Fecal-oral ==> eggs visible in feces under microscope.

62
Q

Ascaris lumbricoides (giant roundworm) - disease?

A

Intestinal infection ==> Possible OBSTRUCTION at ileocecal valve.

63
Q

Ascaris lumbricoides (giant roundworm) - treatment?

A

Bendazoles.

64
Q

Strongyloides stercoralis - transmission?

A

Larvae in soil penetrate the skin.

65
Q

Strongyloides stercoralis - disease?

A

Intestinal infection causing:

  1. Vomiting
  2. Diarrhea
  3. Epigastric pain (may be peptic ulcer-like)
66
Q

Strongyloides stercoralis - treatment?

A

Ivermectin or bendazoles.

67
Q

Ancylostoma duodenale, Necator americanus (hookworms) - transmission?

A

Larvae penetrate skin.

68
Q

Ancylostoma duodenale, Necator americanus (hookworms) - disease?

A

Intestinal infection causing:

Anemia –> Sucking blood from intestinal walls.

69
Q

Ancylostoma duodenale, Necator americanus (hookworms) - treatment?

A

Bendazoles or pyrantel pamoate.

70
Q

Onchocerca volvulus - transmission?

A

Female blackfly bite.

71
Q

Onchocerca volvulus - Disease?

A
  1. Skin changes.
  2. Loss of ELASTIC FIBERS.
  3. River blindness.
    ==> Black flies + Black skin nodules + Black sight.
    ==> ALLERGIC REACTION TO MICROFILARIA possible.
72
Q

Onchocerca volvulus - treatment?

A

Ivermectin (IVERmectin for rIVER blindness).

73
Q

Loa loa - transmission?

A
  1. Deer fly.
  2. Horse fly.
  3. Mango fly.
74
Q

Loa loa - disease?

A
  1. Swelling in skin.

2. Worm in conjunctiva.

75
Q

Loa loa - treatment?

A

Diethylcarbamazine.

76
Q

Wuchereria bancrofti - transmission?

A

Female mosquito

77
Q

Wuchereria bancrofti - disease?

A

Elephantiasis:
Worms invade lymph nodes and cause inflammation ==> Can block the lymphatic vessels.
==> Takes 9 MONTHS-1 YEAR after bite to become symptomatic.

78
Q

Wuchereria bancrofti - treatment?

A

Diethylcarbamazine.

79
Q

Toxocara canis - transmission?

A

Fecal-oral

80
Q

Toxocara canis - disease?

A

Visceral larva migrans.

81
Q

Toxocara canis - treatment?

A

Bendazoles.

82
Q

Nemotodes (roundworms):

A

A. INTESTINAL:

  1. E.vermicularis
  2. Ascaris lumbricoides
  3. Strongyloides stercoralis
  4. Ancylostoma duodenale, Necator americanus
  5. Trichinella spiralis.

B. TISSUE:

  1. Onchocerca volvulus
  2. Loa loa
  3. Wucheria bancrofti
  4. Toxocara canis
83
Q

Nematode routes of infection - ingested?

A
  1. Enterobius
  2. Ascaris
  3. Toxocara
  4. Trichinella.
84
Q

Nematode route of infection - Cutaneous?

A
  1. Strongyloides
  2. Ancylostoma
  3. Necator
85
Q

Nematode routes of infection - Bites?

A
  1. Loa loa
  2. Onchocerca volvulus
  3. Wuchereria bancrofti
86
Q

Cestodes?

A
  1. Taenia solium
  2. Diphyllobothrium latum
  3. Echinococcus granulosus
87
Q

Taenia solium - transmission?

A
  1. Ingestion of larvae encysted in undercooked pork ==> Intestinal tapeworm.
  2. Ingestion of eggs contaminated with human feces ==> Cysticercosis, neurocysticercosis.
88
Q

Taenia solium - disease?

A
  1. Intestinal tapeworm

2. Cysticercosis, neurocysticercosis

89
Q

Taenia solium - intestinal infection treatment?

A

Praziquantel.

90
Q

Taenia solium - cysticercosis, neurocysticercosis treatment?

A
  1. Praziquantel

2. Albendazole for neurocysticercosis

91
Q

Diphyllobothrium latum - transmission?

A

Ingestion of larvae from raw freshwater fish.

92
Q

Diphyllobothrium latum - disease?

A

VitB12 def. (tapeworm competes for B12 in intestine) –> MEGALOBLASTIC Anemia.

93
Q

Diphyllobothrium latum - treatment?

A

Praziquantel.

94
Q

Echinococcus granulosus - transmission?

A

Ingestion of eggs from dog feces.

==> SHEEP are INTERMEDIATE HOST.

95
Q

Echinococcus granulosus - disease?

A

Hydatid cysts in liver –> causing anaphylaxis if antigens released (surgeons preinject with ETHANOL or HYPERTONIC SALINE to kill cysts before removal).

96
Q

Echinococcus granulosus - treatment?

A

Albendazole.

97
Q

Trematodes (flukes) ?

A
  1. Schistosoma

2. Clonorchis sinensis

98
Q

Schistosoma -transmission?

A

Snails are host - cercariae penetrate skin of humans.

99
Q

Schistosoma - disease?

A
  1. Liver and spleen ENLARGEMENT, fibrosis, inflammation.

2. Chronic infection with S.haematobium can lead to SCC of the bladder (painless hematuria) + PULMONARY HTN.

100
Q

Schistosoma - treatment?

A

Praziquantel

101
Q

Clonorchis sinensis - transmission?

A

Undercooked fish

102
Q

Clonorchis sinensis - disease?

A
  1. Biliary tract inflammation –> pigmented gallstones.

2. Associated with cholangiocarcinoma!

103
Q

Clonorchis sinensis treatment?

A

Praziquantel.

104
Q

Biliary tract disease

Cholangiocarcinoma

A

Clonorchis sinensis

105
Q

Brain cysts

Seizures

A

Taenia solium (NEUROcysticercosis)

106
Q

Hematuria

Bladder SCC

A

Schistosoma haematobium

107
Q

Liver (hydatid) cysts

A

Echinococcus granulosus

108
Q

Microcytic anemia

A

Ancylostoma, Necator

109
Q

Perianal pruritus

A

Enterobius

110
Q

Portal HTN

A

Schistosoma mansonii, Schistosoma japonicum

111
Q

VitB12 def

A

Diphyllobothrium latum.

112
Q

2 Ectoparasites:

A
  1. Scabies (Sarcoptes scabiei).

2. Lice (Pediculus humanus/Phthirus pubis).

113
Q

Scabies (Sarcoptes scabiei) - Mites that …?

A
  1. Burrow into the STRATUM CORNEUM ==> Cause PRURITUS.

2. Causes serpiginous burrows (lines) in webspace of hands and feet.

114
Q

Scabies (Sarcoptes scabiei) - Common in …?

A
  1. Children.

2. Crowded populations (jails, nursing homes).

115
Q

Scabies (Sarcoptes scabiei) - Transmission through …?

A

Fomites.

116
Q

Scabies (Sarcoptes scabiei) - Tx:

A
  1. Permethrin cream.
  2. Washing/drying ALL CLOTHING/BEDDING.
  3. Treat close contacts.
117
Q

Lice (Pediculus humanus/Phthirus pubis):

A

BLOOD-SUCKING insects that prefer to live on CLOTHING.

118
Q

Lice (Pediculus humanus/Phthirus pubis) - Cause …?

A
  1. INTENSE PRURITUS.

2. Pink macules + Papules commonly in intertriginous regions.

119
Q

Lice (Pediculus humanus/Phthirus pubis) - Can transmit:

A
  1. Rickettsia prowazekii (typhus).
  2. Borrelia recurrentis (relapsing fever).
  3. Bartonella quintana (trench fever).
120
Q

Lice (Pediculus humanus/Phthirus pubis) - Tx:

A
  1. Pyrethroids.
  2. Malathion.
  3. Ivermectin lotion.
  4. Nit combing.
121
Q

Children with head lice can be treated at …?

A

HOME without interrupting school.

122
Q

Myalgias + Periorbital edema:

A

T.spiralis.

123
Q

Schistosoma mansonii - Morphology:

A

Egg with LATERAL SPINE.

124
Q

S.haematobium - Morphology:

A

Egg with TERMINAL SPINE.

125
Q

VISCERAL larva migrans (Toxocara canis) - Pathogenesis:

A
  1. Nematodes migrate to BLOOD through intestinal wall causing inflammation and damage.
  2. Organs frequently affected include:
    A. HEART (myocarditis).
    B. LIVER.
    C. CNS (Seizures + coma).
126
Q

Trichinella spiralis - Disease:

A

Intestinal infection.

==> Larvae enter bloodstream and encyst in STRIATED muscle ==> Inflammation of muscle.

127
Q

Trichinosis:

A
  1. Fever.
  2. Vomiting.
  3. Nausea.
  4. Periorbital edema.
  5. Myalgia.
128
Q

T.spiralis - Transmission:

A

Fecal-oral ==> Undercooked meat (ESPECIALLY PORK).

129
Q

T.spiralis - Tx:

A

Bendazoles.

130
Q

Immune response to helminths:

A

Eosinophils act by HSR I + HRS II in responding to helminths.

131
Q

Immune response to helminths - HSR I:

A

Neutralization of histamine and LTs.

132
Q

Immune response to helminths - HSR II:

A

Eosinophils attach to surface of helminths via IgE + Release cytotoxins (eg MAJOR BASIC PROTEIN) contained in their granules.

133
Q

Vaginitis:

A
  1. Foul-smelling + Greenish discharge.

2. Itching + Burning.

134
Q

Cutaneous leishmaniasis:

A

SKIN ULCERS.

135
Q

T.cruzi - Characteristic of acute stage:

A

ROMANA SIGN ==> Unilateral periorbital swelling.

136
Q

Malaria - Diagnosis of P.vivax/ovale?

A

Red granules (SCHUFFNER STIPPLING) throughout RBC cytoplasm seen with P.vivax/ovale.

137
Q

2 subspecies of T.brucei:

A
  1. Trypanosoma brucei rhodesiense.

2. Trypanosoma brucei gambiense.

Microbiology (46 decks)

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