Giardiasis Flashcards

1
Q

Life cycle: What is responsible for signs and symptoms of Giardia?

A

Trophs attach to the surface lining cells and cause symptoms

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2
Q

Life cycle: What part of the cyst is most important in transmission

A

Cysts have an outer wall to protect them

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3
Q

Life cycle: What is Excystation?

A

Step 1 Release of parasite from cyst in the small intestine

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4
Q

Life cycle: Each cyst releases how many parasites?

A

Each cyst releases 2 trophs

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5
Q

Life cycle: What is Encystation?

A

formation of cyst from trophs; with giardia smooth wall cyst can contain 2 trophs

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6
Q

Clinical: Describe the clinical manifestations of Giardia

A
  • Acute diarrhea x 7-10 days, watery, foul-smelling (Concern with dehydration in children)
  • Incubation period is 7-10 days
  • Abdominal discomfort
    Chronic diarrhea =/- malabsorption, weight loss
    Asymptomatic “infection can occur”
    Occasional lactase deficiency with or after infection (important to avoid dairy, as it will prolong symptoms)
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7
Q

Describe the Epidemiology of Giardia

A
HIGHLY CONTAGIOUS  (infection spreads with only 10 or more cysts)
 - Fecal oral (person to person)
 - Day care (person to person)
 - Sex practice (person to person)
 - Water
 - Foodborne (after fecal contamination)
Traveller's Diarrhea
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8
Q

Describe the Diagnosis of Giardia

A

Giardia stool antigen (most cost effective) polyclonal or monoclonal antibody against cyst or trophozoite antigens is used, whether with an immunoflourscent antibody test or ELISA

  • useful to dx or r/o giardia
  • Ab or ELISA (highly specific/sensitive test)
  • Fecal leukocytes (WBC) absent (no inflammation)
  • Duodenal aspirate and/or biopsy or “string test:
  • Stool for O & P (ova and parasite exam) can be negative even with infection. Organisms can be shed intermittently
  • No serologic test available
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9
Q

Describe the Treatment of Giardia

A

TINIDAZOLE (DOC - drug of choice)

  • single dosing
  • avoid dairy 1 month
  • also: metronidazole (was DOC, still used)
  • empiric therapy for presumed giardiasis in very selective patients= diarrhea for longer than 3 weeks or lab w/u negative but patient “at risk” by hx
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10
Q

Explain prevention of Giardia

A
  • proper handling/treatment of water (chlorination)
  • hand washing
  • avoid oral-anal
  • campers: boil/treat H2O w/ chlorine/iodine
    - small volume personal water filter
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11
Q

How can we prevent this disease?

A
  1. Proper handling & treatment of water
  2. Good personal hygiene
  3. Campers & travelers to filter/boil water
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12
Q

What are Trophozoites?

A
  • The active form that grows and replicates by binary fission
  • Protozoan enteric flagellate. Single cell protozoa
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