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STEP 1 Microbiology > GI/urinary parasites > Flashcards

GI/urinary parasites Flashcards

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
Schistosoma hematobium- presentation
- Swimmer's itch where larvae penetrate the skin - Resides in the bladder - Hematuria - Bladder cancer
26
What is the intermediate host of Schistosoma?
Snails
27
Schistosoma- treatment
Praziquantel
28
Schistosoma- treatment
Praziquantel
29
Clonorchis sinensis- morphology
- Trematode | - Operculated eggs
30
Clonorchis sinensis- transmission
Larvae from snail hosts are transferred to fish. Humans ingest cysted larvae in uncooked fish.
31
Clonorchis sinensis- treatment
Praziquantel
32
Clonorchis sinensis- diagnosis
Operculated eggs on stool O&P
33
What is the intermediate host of Clonorchis sinensis?
Snails
34
Clonorchis sinensis- presentation
"Liver fluke";Reside in biliary tract, causing biliary tract fibrosis, pigmented gallstones, and cholangiocarcinoma
35
Paragonimus westermani- type of parasite
Trematode
36
Paragonimus westermani- presentation
"Lung fluke"; causing chronic cough with bloody sputum
37
Paragonimus westermani- transmission
Consumption of raw/undercooked crab meat with larvae
38
Paragonimus westermani
Praziquantel
39
Taenia solium- transmission
Intermediate host is pig
40
Taenia saginata- transmission
Intermediate host is cattle
41
Taenia solium- diagnosis
Cestode with proglottid head on stool O&P
42
Taenia saginata-
Cestode
43
Taenia- presentation
- Taeniasis from ingesting cysts (GI problems, malabsorption) - Neurocysticercosis from ingestion of eggs (seizures and hydrocephalus)
44
Taenia- treatment
- Praziquantel for taeniasis | - Praziquantel + albendazole for neurocysticercosis
45
Diphyllobothrium latum- diagnosis
Cestode with proglottid segments on stool O&P
46
Diphyllobothrium latum- presentation
- "Fish tapeworm"; resides in small intestine and causes diarrhea, associated with B12 deficiency and magaloblastic anemia - Longest tapeworm
47
Diphyllobothrium latum- treatment
Praziquantel or niclosamide
48
Ecchinococcus granulosus- transmission
- Cestode - Sheep are intermediate hosts. - Dogs are definitive hosts. - Humans are incidental hosts from ingestion of eggs (fecal-oral route)
49
Ecchinococcus granulosus- treatment
Surgical removal of cysts, with prior injection of ethanol/hypertonic saline into cysts to kill cells and prevent anaphylaxis
50
Ecchinococcus granulosus- presentation
- 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
Enterobius vermicularis- diagnosis
Nematode; Scotch tape shows eggs deposited at night
52
Enterobius vermicularis- transmission
Female worms migrate to anus at night to lay eggs; spread by fecal-oral route (scratching itchy anus causes reinfection)
53
Enterobius vermicularis- presentation
Itchy anus
54
Ecchinococcus granulosus- treatment
Pyrantel pamoate or albendazole
55
Acyclostoma duodenale- transmission
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
Necator americanus- transmission
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
Acyclostoma duodenale- presentation
Iron deficiency anemia
58
Acyclostoma duodenale- diagnosis
Eggs in stool, high eosinophil count
59
Necator americanus- presentation
Iron deficiency anemia
60
Necator americanus- diagnosis
Eggs in stool, high eosinophil count
61
Necator americanus- treatment
Pyrantel pamoate (choice) or albendazole
62
Acyclostoma duodenale-
Pyrantel pamoate (choice) or albendazole
63
Ascaris lumbricoides- transmission
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
Ascaris lumbricoides- presentation
- Respiratory symptoms | - GI obstruction (especially at ileocecal valve)
65
Ascaris lumbricoides- diagnosis
- Eggs in stool | - Eosinophilia
66
Ascaris lumbricoides- treatment
Albendazole
67
Albendazole- MOA
Cause microtubule dysfunction and immobilize worms
68
What complication can happen with albendazole?
Intestinal obstruction due to immotile worms
69
Alternative to albendazole in pregnant women
Pyrantel pamoate
70
Strongyloides stercoralis- diagnosis
- Larvae in the stool (eggs do not exit!) | - Eosinophilia
71
Strongyloides stercoralis- transmission
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
Strongyloides stercoralis- treatment
- Albendazole | - Ivermectin
73
Trichinella spiralis- type of parasite
Nematode (intestinal)
74
Trichinella spiralis- presentation
Fever, vomiting, and periorbital edema, severe myalgias (larvae form cysts within striated muscle)
75
Trichinella spiralis- transmission
Ingestion of cysts from undercooked meat (especially pork or bear)
76
Trichinella spiralis- treatment
Albendazole

STEP 1 Microbiology (22 decks)

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