Fungi/Parasites/Protzoa/Nematodes/Tapeworms/Flukes Flashcards
1
Q
histoplasmosis
A
- Mississippi and Ohio River valleys
- ovoid cells within macrophages (smaller than RBC)
- found in bird/bat droppings, soil
2
Q
blastomycosis
A
- Mississippi River and Central America
- inflammatory lung disease that can disseminate to skin and bone
- forms granulomatous nodules
- broad-based budding (same size as RBC)
3
Q
coccidiomycosis
A
- southwest US, California
- causes pneumonia and meningitis, can disseminate to bone and skin
- inc rate after earthquakes
- spherule (much larger than RBC) filled with endospores
4
Q
paracoccidiomycosis
A
- Latin America
- budding yeast with “captains wheel” formation
- much larger than RBC
5
Q
tinea versicolor
A
- Malassezia furfr
- hyper/hypopigmented patches
- “spaghetti and meatballs”
- treat with topical miconzazole, selenium sulfide (selsun)
6
Q
other tineae
A
- caused by dermatophytes (microsporum, trichophyton, epidermophyton)
7
Q
candida albicans
A
- thrush, diaper rash, endocarditis in IV drug useres, disseminated candidiasis and chronic mucocutaneous candidiasis
- treat with topical azole for vaginal, fluconazole or capsofungin for oral/esopheageal, fluconazole, amphotericin B or capsofungin for systemic
- nystatin for kids with oral thrush
- T cells prevent superficial candida, Neutrophils prevent hematogenous spread
8
Q
aspergillus fumigatus
A
- invasive aspergillosis (immunocompromised and CGD)
- allergic bronchopulmonary aspergillosis (ABPA) associated with asthma and CF –> bronchiectasis and eosinophilia
- some species live on peanuts/soybeans and produce aflatoxins –> HCC
- septate hyphae that branch at acute angles
9
Q
cryptococcus neoformans
A
- cryptococcal meninigitis
- heavily encapsulated yeast
- soil and pigeon droppings
- Sabouraud agar, india ink stain
- latex agglutination test detects polysaccharide capsular antigen (one of its virulence factors) and is more specific
- “soap bubble” lesions in brain
- treat with amphotericin B + flucytosine for meningitis, fluconazole for ppx
10
Q
mucor and rhizopus spp
A
mucormycosis
- affects diabetics and leukemia pts
- penetrate cribriform plate and enter brain
- rhinocerebral, frontal lobe abscesses
- headache, facial pain, black necrotic eschar on face
- diagnose with mucosal biopsy and treat with amphotericin B
- irrecular, broad, nonseptate hyphae branching at wide angles
11
Q
pneumocystic jirovecii
A
- causes PCP
- inhaled yeast
- diffuse, bilateral CXR appearance
- yeast forms on methenamine silver stain of lung tissue
- TMP/SMX, pentamidine, dapsone, atovaquone
- start ppx when CD4 < 200
12
Q
sporothrix schenckii
A
- sporotrichosis
- dimorphic, cigar-shaped budding yeast that lives on vegetation
- spores traumatically introduced to skin via thorns, causing a local pustule or ulcer with nodules along draining lymphatics
- little systemic illness
- treat with itraconazole or K iodide
13
Q
giardia lamblia
A
- foul smelling fatty diarrhea in campers/hikers
- transmitted by cysts in the water
- diagnose with trophozites in stool
- metronidazole
14
Q
entameoba histolytica
A
- bloody diarrhea, liver abscess, RUQ pain (flask shaped ulcer if submucosal abscess of colon ruptures)
- transmitted by cysts in water
- diagnose with serology or trophozoites/cysts in stool
- metronidazole
15
Q
cryptosporidium
A
- severe diarrhea in AIDS, mild in immune competent
- transmission through oocysts in water
- diagnose with oocysts on acid-fast stain
- prevent with water filters and give nitazoxanide in imunocompetent hosts
16
Q
toxoplasma gondii
A
- ring enhancing brain abscess in HIV
- congenital: chorioretinitis, hydrocephalus, intracranial calcifications
- transmitted through cysts in meet or oocysts in cat feces
- diagnose with serology, biopsy
- treat with sulfadiazene + pyrimethamine
17
Q
naegleria fowleri
A
- rapidly fatal meningoencephalitis
- swimming in freshwater (Nalgene with fresh water)
- diagnosis with amoebas in spinal fluid
- amphotericin B if they survive
18
Q
trypanosoma brucei
A
- african sleeping sickness- enlarged lymph nodes, recurring fever, somnolence, coma
- transmitted by tsetse fly, painful bite
- diagnose with blood smear
- treat with suramin for blood born or melarsoprol for CNS
19
Q
plasmodium
A
- malaria: fever, headache, anemia, splenomegaly
- p. vivax/ovale - 42 hour cycle (fever 1st/3rd day), dormany form (hypnozoite) in the liver
- p. falciparum - severe, irregular fever patterns, parasitized RBCs occlude capillaries in brain, kidney snad lungs
- p. malariae - 72 hour cycle
- transmitted by anopheles mosquito
- diagnosis based on blood smear, trophozite ring form within RBC
- treat with chloroquine or mefloquine/atovaquone for resistant, add primaquine for vivax/ovale
20
Q
babesia
A
babesiosis: fever and hemolytic anemia, predominantly NE US, asplenia inc risk of severe disease
- ixodes tick transmits disease
- diagnose with blood smear, ring form or maltese cross
21
Q
trypanosoma cruzi
A
- chagas disease - dilated cardiomyopathy, megacolon, megaesophagus (parasymp denervation), predominantly in South America
- trasmitted by reduviid bug feces deposited in painless bite
- diagnose on blood smear
- treat with benznidazole or nifurtimox
22
Q
leishmania donovani
A
visceral leishmaniasis: spiking fevers, HSmegaly, pancytopenia
- transmitted by sandfly
- diagnose wtih macrophages containing amastigotes
- treat with amphotericin B, sodium stibogluconate
23
Q
trichomonas vaginalis
A
- vaginitis, foul smelling with greenish discharge
- sexual transmission
- diagnose with motile trophozites on wet mount, “strawberry cervix”
- treat with metronidazole for pt and partner
24
Q
enterobius vermicularis (pinworm)
A
T: fecal-oral
disease: intestinal infection causing anal pruritis (scotch tape test)
- treat with bendazoles or pamoate
25
Q
ascaris lumbircoides (giant roundworm)
A
fecal-oral, eggs can be seen in feces
- causes intestinal infection
- treat with bendazoles or pyrantel pamoate
26
Q
strongyloides stercoralis
A
- larvae in soil penetrate the skin
- causes intestinal infection with vomiting, diarrhea, epigastric pain (peptic ulcer like)
- treat with ivermectin or albendazole
27
Q
ancylostoma duodenale, necator americanus (hookworm)
A
- larvae penetrate skin
- intestinal infection causes anemia
- bendazoles or pyrantel pamoate
28
Q
onchocerca volvulus
A
- transmitted by female blackfly bite
- hyperpigmented skin and river blindness
- treat with ivermectin
29
Q
loa loa
A
- transmitted by deer fly, horse fly, mango fly
- swelling in skin, worm in conjunctiva
- treat with diethylcarbamazine
30
Q
wuchereria bancrofti
A
- transmitted by female mosquito
- blocks lymphatic vessels - elephantiasis
- treat with diethylcarbamazine
31
Q
toxocara canis
A
- fecal-oral
- visceral larva migrans
- treat with albendazole or mebendazole
32
Q
nematodes route of infection
A
- ingestion: EAT (enterobius, ascaris, toxocara)
- cutaneous: SAN (strongyloides, ancylostoma, necator)
- bite : LOW (loa loa, onchocerca volvulus, wuchereria bancrofti)
33
Q
taenia solium
A
- ingestion of larvae encysted in undercooked pork and ingestion of eggs
- disease causes intestinal infection or cystercercosis, neurocystercercosis
- treat with praziquantel, albendazole for neuro
34
Q
diphyllobothrium latum
A
- ingestion of larvae from raw freshwater fish
- disease - vit B12 deficiency –> anemia
- treat with praziquantel
35
Q
echinococcus granulosus
A
- ingestion of eggs from dog feces
- hyatid cysts in the liver, causing anaphylaxis if antigens are released
- treat with albendazole
36
Q
schistosoma
A
- snails are host, cercariae penetrate skin of humans
- liver and spleen granulomas, fibrosis and inflammation
- squamous cell carcinoma of the bladder
- treat with praziquantel
37
Q
clonorchis sinensis
A
- undercooked fish
- biliary tract inflammation –> pigmented gallstones
associated with cholangiocarcinoma - treat with praziquantel
