Hemoflagellates Flashcards
1
Q
Four stages of development
A
Leishmania
Leptomonad
Crithidia
Trypanosome
2
Q
A.k.a. Amastigote stage
A
LEISHMANIA
3
Q
Promastigote stage
A
LEPTOMONAD
4
Q
Inner portion of the flagellum that is actually extend from the blepharoplast to the surface of the body
A
Axoneme
5
Q
Epimastigote stage
A
CRITHIDIA
6
Q
● Trypanomastigote stage
A
TRYPANOSOME
7
Q
Stage: Reduce d when it
comes to size and does not have any flagellu m
A
Amastigote
8
Q
Common name of amastigote
A
Leishmania form
9
Q
Stage: The flagellum is anterior place and away from the cell body
A
Promastigote
10
Q
Promastigote common name
A
Leptomonad form
11
Q
stage: nucleus
is almost
centrally
located;
located
in the
anterior
part of
the
parasite
A
Epimastigote
12
Q
common name of epimastigote
A
Crithidial form
13
Q
Stage: Connected with
short angionating
membrane
A
Epimastigote
14
Q
TRYPANOSOMA BRUCEI GAMBIENSE disease
A
West african sleeping sickness (97%)
mild african sleeping sickness
gambian trypanosomiasis
15
Q
Stage: Flagella in the center of organism
A
Epimastigote
16
Q
stage: Connected with
long angionating
membrane
A
Trypomastigote
17
Q
stage: Flagella originates at posterior end
of the organism
A
Trypomastigote
18
Q
Trypomastigote common name
A
Trypanoso
mal form
19
Q
TRYPANOSOMA BRUCEI RHODESIENSE DISEASE
A
East african sleeping sickness
20
Q
TRYPANOSOMA BRUCEI GAMBIENSE GEOGRAPHIC DISTRIBUTION
A
Central and West Africa
21
Q
TRYPANOSOMA BRUCEI RHODESIENSE EPIDEMIOLOGICALLY RELEVANT ANIMAL/RESERVOIr
A
Domestic Cattles
22
Q
TRYPANOSOMA BRUCEI GAMBIENSE main reservoir
A
● Human
● They can also be found in animals including the primates
23
Q
TRYPANOSOMA BRUCEI RHODESIENSE
VECTOR
A
Glossina Species (Tsetse fly)
Glossina palpalis
GLossina morsitans
24
Q
T.cruzi disease
A
Chaga’s disease
American Trypanosomiasis
25
TRYPANOSOMA BRUCEI GAMBIENSE VECTOR
Glossina Species (Tsetse fly)
Glossina palpalis
Glossina tachinoides
26
T.cruzi vector
Kissing bug or Assassin bug
Tritoma or Reduviidae
27
TRYPANOSOMA BRUCEI RHODESIENSE GEOGRAPHIC DISTRIBUTION
East and South Africa
28
alternatively known as sleepiness or
drowsiness; state of a strong desire to sleep or sleeping for
unusually long periods of time.
Somnolence-
29
chaga diseas discoverer
Carlos Ribeiro Justiniano Chagas
30
Disease Named from the Brazilian physician and researcher
who discovered chaga’s disease on 1609
Chaga’s disease
31
● Cyclical fever with a seeming remission
● Fever-free interval of at least two weeks
EPISODIC FEVER- RECURRENT FEVER
32
● Disease of the lymph nodes in which there are abnormal size
or consistency
● Lymphadenopathy of inflammatory types specifically, the
most common type is lymphadenitis producing swelling or
enlarged lymph nodes.
LYMPHADENOPATHY/ ADENOPATHY
33
enlargement of the posterior cervical
lymph nodes.
Winterbottom ‘s sign-
34
GAMBIAN TRYPANOSOMIASIS ● Systemic phase:
episodic (lasting from 1-6 days followed by
an asymptomatic period lasting several weeks)
35
earliest sign of Gambian Trypanosomiasis
● Characterized by hard painful lesion at the site of insect bite
CHANCRE
36
GAMBIAN TRYPANOSOMIASIS
● Incubation period:
14 days
37
vector of T.cruzi
Triatomid Bug
Kissing bug
Assassin bug
38
T.cruzi main habitat
Reticuloendothelial cells
Central nervous System
39
Gambian trypanosomiasis CNS symptomes:
Takes years to develop
40
Rhodesian trypanosomiasis CNS manifestations
develop 3-6 months
41
Usually appear 48 hours after the tsetse bite
TRYPANOSOMAL CHANCRE
42
changes around the eyes usually
characterized by swelling
ROMANAS SIGN
● Periorbital changes-
43
usually start at the end of the first year or beginning of the
second year
CHRONIC SLEEPING SICKNESS
44
itchy, painful inflammatory reaction at the site of the insect bite
● The chancre is actually uninjured (hardened) red or purple
nodule
● The nodule would usually measure 2-5 cm in diameter which
is accompanied by enlarge lymphs
TRYPANOSOMAL CHANCRE
45
Begins with local lesion (chagoma)
● Marked local edema within the region of the eye or within the
conjunctival sac
ROMANAS SIGN
46
usually seen in the early phase of African
trypanosomiasis specifically Trypanosoma brucei
rhodesiense and Trypanosoma brucei gambiense
Winterbottom’s sign
47
○ CNS invasion
○ Increased metal dullness & opathy
○ Tremors, hyperesthesia (abnormal increase
sensitivity to stimuli of any of the senses),
somnolence
CHRONIC SLEEPING SICKNESS
48
- commonly known as African
sleeping sickness
Trypanosoma brucei gambiense
49
inflammation of the mesenteric lymph
nodes or glands found in the abdomen
Adenitis- PATHOLOGY: CHAGA’S DISEASE
50
slightly painful reddish nodule at the site of
inoculation of the reduviid bug. This bug transmits the chaga’s
disease.(initial lesion)
Chagoma PATHOLOGY: CHAGA’S DISEASE
51
he esophagus and the
colon will already be involved in chronic cases
Esophagial or colonic involvement PATHOLOGY: CHAGA’S DISEASE
52
disease of the heart muscle that makes it
harder for the heart to pump blood to the rest of the body. It
can lead to heart failure.
Cardiomyopathy- PATHOLOGY: CHAGA’S DISEASE
53
Pre-orbital soft tissue and lymphoid swelling that
occurs when T. cruzi causes chaga’s disease
enters the conjunctiva of the eye.
Romanas sign
54
vector of T.cruzi
Reduviid bug
55
host of T.cruzi
Dasypus novencinctus
Opossums (Dildelphis species
56
unilateral conjunctivitis and orbital edema (if
portal of entry is the upper face or eye)
Romanas sign PATHOLOGY: CHAGA’S DISEAS
57
This is breeding of a clean bugs in
laboratories then after 2-3 weeks, their guts will be dissected
to determine the metacyclic trypanosomes.
Xenodiagnosis
58
- There is an abnormal increase in the
amount of lymphocytes in the cerebrospinal fluid. Thus,
lumbar tap is used for CSF then observed under the
microscope if there is an increase amount of lymphocytes in
CSF. It also measures increased protein content.
Lymphatic pleocytosis
59
L. braz disease
Espundia or MCL, Chiclero’s ulcer or New World
cutaneous leishmaniasis
60
L.trop vector
Phlebotomus spp. (sandfly)
P.papatasii
P.sargenti
61
LEISHMANIA TROPICA disease
Oriental sore or Old World Cutaneous
Leishmaniasis
62
L.bra: In the mid cut of the sandfly the amastigote would develop to
___ which would replicate profusely. These are
internally transmitted to the skin of the person bitten by the
sandfly
promastigote
63
L.bra vector
Phlebotomus spp. (sandfly)
64
nvolves the liver, spleen, and the bone marrow
VISCERAL LEISHMANIASIS
65
They are usually ingested by sandflies and these sandflies
usually feed near the skin lesions
LEISHMANIA BRAZILIENSIS
66
The morphology and life cycle of Leishmania tropica
resembles that of
Leishmania donovani
67
L bra: The ____ are present in the skin within large
mononuclear cells inside the neutrophils inside capillary
endothelial cells and also free in the tissues
Amastigote
68
is the most severe and fatal of Leishmaniasis
Kala-azar
69
causative agen of visceral leishmaniasis
Leishmania donovani
70
nvolves the skin at the site of the sandfly or site of the sandfly
bite specifically caused by Leishmania tropica , Leishmania
mexicana, and Leishmania major
CUTANEOUS LEISHMANIASIS
71
deepening skin pigmentation:
: Kala azar or balck sickness
72
LEISHMANIA DONOVANI
Disease
Kala-azar (dumdum fever) or VLM (Visceral
Leishmaniasis
73
Involves mucus membrane of the mouth and the nose
MUCOCUTANEOUS LEISHMANIASIS
74
CAUSATIVE AGENT: MUCOCUTANEOUS LEISHMANIASIS
Leishmania braziliensis
75
vector of L.dovo
Phlebotomus spp. (sandfly)
76
black spots or skin hemorrhages, its presence is due
to thrombocytopenia which is a condition having a low blood
platelet
Purpura LEISHMANIA DONOVANI
77
In India, where the domestic sandfly vector Phlebotomus
argentipes'' usually solely on humans and people appear to
be a rare only reservoir
LEISHMANIA DONOVANI
78
Associated with poor nutrition desperate poverty
LEISHMANIA DONOVANI
79
The lesions typically evolve to papules to nodular
plaques and even up to ulcerative lesions a raised
borders and central depression which actually covered in scabs some lesions can even persists
as nodules
LEISHMANIA TROPICA
80
In general Cutaneous leishmaniasis causes skin lesions
which can persist for months and sometimes even years after
the exposure but occasionally first appear years later for
example the context of trauma, immunosuppression or if the
patient is immunocompromised
LEISHMANIA TROPICA
81
Early Lesion of Espundia
LEISHMANIA BRAZILIENSIS
82
83
Other term of Espundia:
Mucosal leishmaniasis
84
NOVY-NICOLLE-MACNEAL (NNN) Incubation at
28 deg cel
for 1-4 weeks
85
Refers to a metastatic sequelae of the new world cutaneous
infection which results from dissemination or the spread of
parasites from the skin to the naso oropharyngeal mucosa
LEISHMANIA BRAZILIENSIS
86
Deformity and severe case affecting the nasopharyngeal area
LEISHMANIA BRAZILIENSIS
87
NNN medium
Schneider`s insect culture medium
88
Supplemented by the addition of 30% heat
inactivated fetal bovine serum plus penicillin and
100 um streptomycin, final concentration is per ml
NNN
89
Shown to be simple to use in diagnosis and
management of visceral leishmaniasis, it is
specially valuable because small lumbers of
parasites can be detected using the schneiders
insect medium during the treatment
NNN
90
Isolate Leishmania Donovani specifically the promastigote
NNN
91
Tool determining the degree of exposure and
immunity to the parasite
LEISHMANIN (MONTENEGRO) TEST
92
TEST: Inactive visceral leishmaniasis the test is always
almost negative and a positive result usually
appears 2-24 months after clinical recovery
LEISHMANIN (MONTENEGRO) TEST
93
This test has no rule in the diagnosis when it
comes to acute disease
LEISHMANIN (MONTENEGRO) TEST
94
There is a intradermal injection of antigen or
cultured promastigotes
LEISHMANIN (MONTENEGRO) TEST
Tool determining the deg
95
A diagnostic test where a small tube-shaped piece of skin and
some other tissue underneath are removed using a sharp
cutting tool
Done anywhere on the body but usually the preferred site is
the arm because it is fleshy
The tissue is then examined under a microscope
For Cutaneous Leishmaniasi
PUNCH BIOPSY
96
Diagnosis of Visceral Leishmaniasis
SPLENIC PUNCTURE
97
The method of choice for staging Trypanosoma
brucei gambiense and Trypanosoma brucei
rhodesiense when it comes to the assessment of
neurological infection
ILIAC CREST PUNCTURE OF THE BONE MARROW
98
Performed by microscopic examination of the CSF
that is collected by lumbar puncture on a we preparation looking for motile trypomastigote and
white blood cell
ILIAC CREST PUNCTURE OF THE BONE MARROW
99
Large amount of IgG: Kala-azar patient
Albumin/globulin ratio is reversed
FORMO-GEL TEST
100
has long been
considered a procedure which might be helpful in differential
diagnosis of splenomegaly in cases of Visceral leishmaniasis
However, it is difficult to perform and there may be
complications in the performance of
SPLENIC PUNCTURE
101
. Not
100% safe
SPLENIC PUNCTURE
102
Detect the greatly increased serum proteins in visceral
leishmaniasis
FORMO-GEL TES
103
This indicates a high protein proportion of globulins
FORMO-GEL TEST
104
Addition of 1 drop of 30% formalin in 1 mL serum with rapid
and complete coagulation indicating a positive reaction
There is the formation of gel after 20 minutes standing at room
temperature
FORMO-GEL TEST
105
1. DIRECT EVIDENCE
i. Microscopy
ii. Culture
106
2. INDIRECT EVIDENCES
i. Non-specific test
ii. Animal inoculation - like xenodiagnosis
iii. Leishmania skin or montenegro test
iv. Detection of antigen
v. detection of antibody
vi. Blood picture - peripheral blood smear as basis or
reference
107
MICROSCOPIC OBSERVATION Presence of kinetoplasts would distinguish
Toxoplasma
gondii and Microsporum capsula.
108
Aspirates ARE FIXED IN
methanol and stained with Giemsa
109
medium for monophasic media
Schneider's Drosophila medium
o Grace's insect medium
(Both mediums are insect medium)
110
medium for state only
1. MONOPHASIC MEDIA
111
medium; Usually contain a medium both solid and liquid state in a
single bottle
2. BIPHASIC MEDIUM
112
medium: Uses mainly for minimizing contamination and spread of
infection
BIPHASIC MEDIUM
113
One ml of patient's serum is mixed with a drop of 40%
formaldehyde, shaken and kept at room temperature
NAPIER'S ALDEHYDE TEST (FORMOL GEL TEST)
114
biphasic mediums ?
o Novy MacNeal Nicolle (NNN) medium
o Brain Heart Infusion agar medium
(Specialized medium with special component)
115
Positive reaction: gellification and opacification of the test
serum
NAPIER'S ALDEHYDE TEST (FORMOL GEL TEST)
116
This is an obsolete clinical test of uncertain diagnostic
validity/value
CHOPRA'S ANTIMONY TEST
117
Patients with disease of 3-4 months or more give positive
reaction
)
NAPIER'S ALDEHYDE TEST (FORMOL GEL TEST)
118
CHOPRA'S ANTIMONY TEST Positive test
Formation of profuse flocculant precipitate
119
Material from patient is injected intraperitoneally in hamster or
mice and later parasite is recovered from the animal.
Sometimes it has ethical issues because of the use of the
mice
ANIMAL INOCULATION
120
To 1-2ml of patient serum in test tube, few drops of 4% urea
stibamine solution is added
4% antimony solution is added to dilute serum from patients
with visceral leishmaniasis or other forms of splenomegaly
CHOPRA'S ANTIMONY TEST
121
Very sensitive method but takes long time
ANIMAL INOCULATION
122
test Negative in kalaazar
LEISHMANIA SKIN OR MONTENEGRO TEST
123
This is a skin test for Montenegro test
LEISHMANIA SKIN OR MONTENEGRO TEST
124
Positive result is indicated by induration and erythema of 5mm
or more after 48-72 hours
LEISHMANIA SKIN OR MONTENEGRO TEST
125
Condition in which there is a lower number of RBC, WBC and
platelets in the body (meaning low RBC, WBC and platelet
count)
This would usually occur when there is a problem with the
blood forming stem cells in the bone marrow
In cases of leishmaniasis, this is differently alters
erythropoiesis in the bone marrow and the spleen, causing
low blood counts
PANCYTOPENIA
Condition i
126
LEISHMANIA SKIN OR MONTENEGRO TEST: stage of development that is used for
intradermal injection
Promastigote Stage
127
in leishmaniasis ESR is elevated or decreased
elevated
128
Although specific life cycle may vary, all the organisms in
these two genera ___ and ___ involves
some combination of the 4 morphologic forms
(Trypanosomes and Leishmania)
129
It has a 2 contractile vacuole
BALANTIDIUM COLI
130
primary
diagnostic For leishmania,
it is the amastigote
131
So, the transmission of all hemoflagellates is via the bite of
the
arthropod vector (either the sunfly, red feed bug or tsetse
fly)
132
primary
diagnostic For trypanosome
, it is the trypomastigote
■ With the exception of the Trypanosoma
Cruzi where amastigotes are usually
found
133
vector: Phlebotomus
papatasii
Phlebotomus
sergenti
Leishmania tropica
134
Habitat : Endothelial cells of
the infected skin
capillaries and
within the
cytoplasm of large
phagocytic
monocytes
Leishmania tropica
135
habitat: Endothelial cells of the
reticuloendothelial
system: liver, spleen,
bone marrow, and
visceral lymph nodes
and fixed tissue
macrophage
Leishmania donovani
136
habitat: Mucocutaneous
junctions, particularly the
nasal septum, mouth,
and pharynx
Leishmania braziliensis
137
Vecctor: Phlebotomus
argentipes
Leishmania donovani
138
Laboratory
diagnosis
: Skin scrapings
(Wright’s or
Giemsa stain)
▪ Impression
smears or tissue
sections
prepared from
active lesions;
biopsies should
be obtained
from elevated,
inflamed
margins of the
lesion
Leishmania tropica
139
vectore: Phlebotomus peruensis
Phlebotomus verrucarum
Leishmania braziliensis
140
lab diag: ▪ Puncture of the
ulcerated part
▪ Demonstration of the
parasite from smears
prepared from lesion
scrapings (particularly
in the edge)
Leishmania braziliensis
141
Pathology: Localized
cutaneous
infection which
gives rise to a
macule, then a
papule, a raised
lesion with
depressed
ulcerated center
Leishmania tropica
142
pathology: Splenomegaly
associated with
severe anemia
Leishmania donovani
143
Disease: Visceral leishmaniasis,
Kala-azar fever, Dumdum fever, Death
fever, tropical
splenomegaly
Leishmania donovani
144
pathology: Primary lesion is similar to
that of Leishmania
tropica except the ulcer
produced is a weeping
lesion without a granular
base
Leishmania braziliensis
145
Infective stage of all Leishmania spp
Promastigotes
(released via bite
of a sand fly
146
Genus Trypanosoma:
Exists in two forms
✓ Epimastigote
✓ Trypomastigote
147
Clinical disease: Old world
cutaneous
leishmaniasis,
locally known as
Oriental sore, Delhi
boil, Aleppo
button, Forest yaws
Baghdad or Jericho
boil
L.trop
148
lab diag: ▪ Blood smear
▪ Lymph node
aspirate
▪ Bone marrow
puncture
Leishmania donovan
149
disease: american or
Mucocutaneous
leishmaniasis, Espundia,
Uta, Chiclero ulcer,
Nasopharyngeal
leishmaniasis, New world
cutaneous leishmaniasis
L.bra
150
151
manifestations: ▪ Monocytosis and
neutropenia with
granulocytopenia
▪ Infection of the
bone marrow
▪ Headache
▪ Undulant fever
▪ Hepatosplenomeg
aly
▪ Black fever
L.dov
152
Coma state develops, commonly known as
sleeping sickness”; Trypanosoma brucei rhodesiense and Trypanosoma brucei gambiens
153
154
Characterized by an acute phase in which peripheral blood and lymph
nodes are invaded, followed by a chronic phase in which the central
nervous system is invaded, resulting in meningoencephalitis
A. Trypanosoma brucei rhodesiense and Trypanosoma brucei gambiense
155
156
157
158
159
160
161
