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STEP 1 Microbiology > GI/urinary parasites > Flashcards

GI/urinary parasites Flashcards

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1
Q

Giardia- morphology

A

Trophozoite, flagellated, with ventral sucking discs

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2
Q

Giardia- transmission

A

Fecal-oral transmission; travelers/campers ingest cysts from contaminated water in endemic areas

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3
Q

Giardia- presentation

A

Foul-smelling steatorrhea, weight loss/malabsorption

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4
Q

Which vitamins may become deficient due to giardia?

A

A, D, E, K (bleeding!), due to fat malabsorption

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5
Q

Giardia- diagnosis

A
  • Trophozoites in stool O&P (cysts may also be visible)

- ELISA stool antigen test

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6
Q

Giardia- treatment

A

Metronidazole

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7
Q

Entamoeba histolytica- presentation

A
  • Flask-shaped ulcerations in colon (intestinal amebiasis)
  • Inflammatory diarrhea
  • Amoebic liver abscess (right lobe; RUQ pain; “anchovy paste” consistency)
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8
Q

Entamoeba histolytica- diagnosis

A
  • Trophozoites containing endocytosed RBCs/cysts on stool O&P
  • ELISA antigen test of stool/serum
  • Serology for anti-Entamoeba antibodies
  • Flash-shaped ulcerations on intestinal biopsy
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9
Q

Entamoeba histolytica- treatment

A

Metronidazole

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10
Q

Entamoeba histolytica- lifecycle

A

Cysts are ingested (fecal-oral via contaminated water, eating ass); trophozoites invade colon, enter the portal system, and spread to the liver

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11
Q

Entamoeba histolytica- treatment

A
  • Metronidazole

- Luminal agents (Paramycin, iodoquinol)

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12
Q

Is surgery necessary for liver masses in Entamoeba histolytica?

A

No

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13
Q

Is surgery necessary for liver masses in Echinococcus?

A

Yes

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14
Q

Is surgery necessary for liver masses in Echinococcus?

A

Yes

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15
Q

Cryptosporidium- morphology

A

Unicellular, partially acid-fast organisms

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16
Q

Cryptosporidium- transmission

A

Immunocompromised/AIDS patients, people who swim in dirty water, campers, people who work with animals; fecal-oral ingestion of oocysts; resistant to chlorination

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17
Q

Cryptosporidium- presentation

A

Severe diarrhea in AIDS/immunocompromised patients; mild watery diarrhea in immunocompetent individuals; usually affects small intestine but may cause colitis

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18
Q

Why does Cryptosoridium cyst appear multifaceted?

A

Bundle of four sporozoites

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19
Q

Cryptosporidium- treatment

A
  • Nitazoxanide

- Spiramycin (macrolide; not approved in USA)

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20
Q

Schistosoma mansoni- morphology

A
  • Trematode

- Large, lateral spine

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21
Q

Schistosoma japonicum- morphology

A
  • Trematode

- Small spine

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22
Q

Schistosoma hematobium- morphology

A
  • Trematode

- Large, terminal spine

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23
Q

Schistosoma mansoni- presentation

A
  • Swimmer’s itch where larvae penetrate the skin
  • Resides in mesenteric veins
  • Portal hypertension, leading to GI hemorrhage, abdominal pain, and jaundice/cirrhosis
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24
Q

Schistosoma japonicum- presentation

A
  • Swimmer’s itch where larvae penetrate the skin
  • Resides in mesenteric veins
  • Portal hypertension, leading to GI hemorrhage, abdominal pain, and jaundice/cirrhosis
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25
Q

Schistosoma hematobium- presentation

A
  • Swimmer’s itch where larvae penetrate the skin
  • Resides in the bladder
  • Hematuria
  • Bladder cancer
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26
Q

What is the intermediate host of Schistosoma?

A

Snails

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27
Q

Schistosoma- treatment

A

Praziquantel

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28
Q

Schistosoma- treatment

A

Praziquantel

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29
Q

Clonorchis sinensis- morphology

A
  • Trematode

- Operculated eggs

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30
Q

Clonorchis sinensis- transmission

A

Larvae from snail hosts are transferred to fish. Humans ingest cysted larvae in uncooked fish.

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31
Q

Clonorchis sinensis- treatment

A

Praziquantel

32
Q

Clonorchis sinensis- diagnosis

A

Operculated eggs on stool O&P

33
Q

What is the intermediate host of Clonorchis sinensis?

A

Snails

34
Q

Clonorchis sinensis- presentation

A

“Liver fluke”;Reside in biliary tract, causing biliary tract fibrosis, pigmented gallstones, and cholangiocarcinoma

35
Q

Paragonimus westermani- type of parasite

A

Trematode

36
Q

Paragonimus westermani- presentation

A

“Lung fluke”; causing chronic cough with bloody sputum

37
Q

Paragonimus westermani- transmission

A

Consumption of raw/undercooked crab meat with larvae

38
Q

Paragonimus westermani

A

Praziquantel

39
Q

Taenia solium- transmission

A

Intermediate host is pig

40
Q

Taenia saginata- transmission

A

Intermediate host is cattle

41
Q

Taenia solium- diagnosis

A

Cestode with proglottid head on stool O&P

42
Q

Taenia saginata-

A

Cestode

43
Q

Taenia- presentation

A
  • Taeniasis from ingesting cysts (GI problems, malabsorption)
  • Neurocysticercosis from ingestion of eggs (seizures and hydrocephalus)
44
Q

Taenia- treatment

A
  • Praziquantel for taeniasis

- Praziquantel + albendazole for neurocysticercosis

45
Q

Diphyllobothrium latum- diagnosis

A

Cestode with proglottid segments on stool O&P

46
Q

Diphyllobothrium latum- presentation

A
  • “Fish tapeworm”; resides in small intestine and causes diarrhea, associated with B12 deficiency and magaloblastic anemia
  • Longest tapeworm
47
Q

Diphyllobothrium latum- treatment

A

Praziquantel or niclosamide

48
Q

Ecchinococcus granulosus- transmission

A
  • Cestode
  • Sheep are intermediate hosts.
  • Dogs are definitive hosts.
  • Humans are incidental hosts from ingestion of eggs (fecal-oral route)
49
Q

Ecchinococcus granulosus- treatment

A

Surgical removal of cysts, with prior injection of ethanol/hypertonic saline into cysts to kill cells and prevent anaphylaxis

50
Q

Ecchinococcus granulosus- presentation

A
  • Hydatid cysts in the liver (looks like slow growing tumor; eggshell calcifications on CT)
  • Anaphylaxis and acute abdomen if hydatid cysts rupture
  • Hooks in sputum if cysts rupture in lungs
  • Eosinophilia may be observed (all helminths)
51
Q

Enterobius vermicularis- diagnosis

A

Nematode; Scotch tape shows eggs deposited at night

52
Q

Enterobius vermicularis- transmission

A

Female worms migrate to anus at night to lay eggs; spread by fecal-oral route (scratching itchy anus causes reinfection)

53
Q

Enterobius vermicularis- presentation

A

Itchy anus

54
Q

Ecchinococcus granulosus- treatment

A

Pyrantel pamoate or albendazole

55
Q

Acyclostoma duodenale- transmission

A

Common in southern US; larvae penetrate skin of sole of feet and go to lungs, ascend bronchial tree, are coughed and swallowed, and mature into adults in the small intestine

56
Q

Necator americanus- transmission

A

Common in southern US; larvae penetrate skin of sole of feet and go to lungs, ascend bronchial tree, are coughed and swallowed, and mature into adults in the small intestine

57
Q

Acyclostoma duodenale- presentation

A

Iron deficiency anemia

58
Q

Acyclostoma duodenale- diagnosis

A

Eggs in stool, high eosinophil count

59
Q

Necator americanus- presentation

A

Iron deficiency anemia

60
Q

Necator americanus- diagnosis

A

Eggs in stool, high eosinophil count

61
Q

Necator americanus- treatment

A

Pyrantel pamoate (choice) or albendazole

62
Q

Acyclostoma duodenale-

A

Pyrantel pamoate (choice) or albendazole

63
Q

Ascaris lumbricoides- transmission

A

Eggs in contaminated food/water; eggs hatch in small intestine, and larvae migrate into bloodstream into the lungs, where they ascend the bronchial tree, are coughed and swallowed, and mature into adults in the small intestine

64
Q

Ascaris lumbricoides- presentation

A
  • Respiratory symptoms

- GI obstruction (especially at ileocecal valve)

65
Q

Ascaris lumbricoides- diagnosis

A
  • Eggs in stool

- Eosinophilia

66
Q

Ascaris lumbricoides- treatment

A

Albendazole

67
Q

Albendazole- MOA

A

Cause microtubule dysfunction and immobilize worms

68
Q

What complication can happen with albendazole?

A

Intestinal obstruction due to immotile worms

69
Q

Alternative to albendazole in pregnant women

A

Pyrantel pamoate

70
Q

Strongyloides stercoralis- diagnosis

A
  • Larvae in the stool (eggs do not exit!)

- Eosinophilia

71
Q

Strongyloides stercoralis- transmission

A

Larvae penetrate skin of sole of feet and go to lungs, ascend bronchial tree, are coughed and swallowed, and mature into adults in the small intestine. Autoinfection by laying eggs in the intestinal tract, which then penetrate the wall and enter the bloodstream.

72
Q

Strongyloides stercoralis- treatment

A
  • Albendazole

- Ivermectin

73
Q

Trichinella spiralis- type of parasite

A

Nematode (intestinal)

74
Q

Trichinella spiralis- presentation

A

Fever, vomiting, and periorbital edema, severe myalgias (larvae form cysts within striated muscle)

75
Q

Trichinella spiralis- transmission

A

Ingestion of cysts from undercooked meat (especially pork or bear)

76
Q

Trichinella spiralis- treatment

A

Albendazole

STEP 1 Microbiology (22 decks)

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