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Neoplasia Block > IID Blood and Tissue Parasites & ClDx clin manif of hemat disease > Flashcards

IID Blood and Tissue Parasites & ClDx clin manif of hemat disease Flashcards

1
Q

Iron deficiency anemia sx

A

sx rel to decreased O2 carryign capacity of blood bc less iron, esp older pts, consider colon, pale eyes, blood in stool, constipation or change in stool (left sided colon cancer), high platelet count, low blood cell vol, TIBC tot iron binding cap high, ferriton and iron low means IRON DEFICIENCY, but if TIBC is also low then anemia from other chronic disease

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2
Q

Iron def pap smear

A

small cells (microcytic) rbcs smaller than lympho
hypo-chromatic aka PALE RBCs
poikolicytosis aka diff size/shape of RBC

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3
Q

Predisposing factors to iron def

A

loss of iron from menses etc, colon polyp blood loss, colon cancer causes anemia, pencil thin stool L side colon lesion, diet (not enough red meat, vegetarian)

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4
Q

Screening in Iron def

A

barium enema- white area in colon
apple core lesions-L sided obstruction is sx
screening colonoscopy at age 50 etc

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5
Q

Vitamin C deficiency sx

A 
bleeding gums
bruises
petechiae red dots
LOW HEMOGLOBIN LVL
SPLIT CORKSCREW HAIR
WEAKNESS from hypotension etc
anemia (need vit C as cofactor for bone marrow production with all cell lines)
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6
Q

Vitamin C def on smear

A

Blue RBCs (recticulocyte), a few of the RBCs are a bit bluish, bc vit C cant help with marrow production

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7
Q

Predisposing factor of Vit C def

A

malnutrition (diet)

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8
Q

What does vit C def cause (disease)?
what mech is vit C impt for?
vit C px?

A
  • vit C def is SCURVY
  • vit C impt for cross linking collagen and is a cofactor for prolyl and lysly hydroxylases
  • nutritional defs often overlooked
  • vit C def may dev within a month and be fatal
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9
Q

Vitamin B12 def sx

A

long duration confusion
walking problems (ataxic gait/unsteady)
Paraesthesias (loos of posn/vibration)
Romberg- loss of proprioception
Absent bilateral DTR (deep tendon reflex)
High mean corpusc vol (many causes eg alc)
Elevated METHYLMALONIC ACID (conversion of this acid needs b12 as cofactor)
NOT from ab’s to intrinsic factor

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10
Q

What is vitamin b12 cofactor for

A

Converting methylmalonic acid

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11
Q

Advanced cases of b12 def can cause

A

leukopenia, thrombocytopenia

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12
Q

Vitamin B12 deficiencies on histology smear

A

HYPER-SEGMENTED NEUTROPHILS
Polychromasia (diff colored cells)
Macrocytic RBCs (large RBCs)
blue discorloration not fully mature cells

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13
Q

Predisposing factors to vitamin b12 def

A

Inadequate absorption of nutrients, can cause pernicious anemia (eg automimm ab’s against intrinsic factor)
OR
Right colonectomy–missing site of B12 absorption (terminal ileum), or gastric bypass surgery

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14
Q

How to treat vitamin b12 def

A

Replenish Vitamin b12 through injection or sublingual

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15
Q

Which deficiency has high mean corpuscular volume?

A

Vitamin B12!

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16
Q

Malaria spp and mosquito type

A

Anopheles

Plasmodium falicparum, ovale, and vivax (last 2 are liver)

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17
Q

Malaria pathology

A

sporozoites from mosq saliva inj into host, virus enters liver cells, after 7-10 days liver cells lyse and rel infectious merozoites into bloodstresm, which enter RBC and dev into schizonts, some meroz dev into gametocytes to be taken up by another mosq

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18
Q

Malaria pathology in vivox/ovale

A

can form hypnozoites in liver

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19
Q

Toxins/clin features in malaria

A

FEVER

cytoadhrence to endothelium

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20
Q

Histo of malaria

dx

A 
thicc smears to find parasites in RBCs
thin smear to find spp 
may be ring form as torophozoite early on
diff as meorozoite (stippling)
Dx with RDT
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21
Q

Prophylactic tx (3)

A

Chloroquine if u dont have res (color queen)
doxy (but sun sens)
mefloquine for long time travelers (fly queen w luggage)

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22
Q

Tx for malaria

A

Artemesinian combo tx (ACT) used worldwide for falciparum (artist painting near scary false mask warrior)
IV artesunate
Malarone (atavaquone&proguinil) (Atova vampire queen w iguana), and COARTAM
Quinine/doxy (dining queen)

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23
Q

Plasmodium falciparum
(false mask guy)
sx

A 
7 d incub
Africa etc
RBC lysis (RBC headdress)
Irreg feverchills (irreg toga)
Severe, v high mortality 
CNS, pulm edema (gold lung plates), renal failure (renal rings), etc bc RBCs occlude brain, kidney and lungs
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24
Q

P falciparum histo

A

2 red dots on slides

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25
Q

P vivax & P ovale

Sx etc

A

Hypnozoites (hypnosis warrior) in liver (liver shield)
48 hr fever/chills (days 1, 3)
Spleen enlargement (spleen spot on cow) (can enlarge too much)

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26
Q

What should you treat P vivax (india)/ ovale(W africa) with, and what is important to be careful of?

A

Tx with primaquine! (primal queen blocking hypnosis)

Be careful of GPDH deficiency

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27
Q

Plasmodium malariae

A

fever chills every 72 hr (days 1 and 4) (quartile buttons 1 and 4 red)
renal failure

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28
Q

Traveler’s malaria

A

can be from any spp
@ least 10 days incub
no spec sx (ask pt if traveled!), jaundice late (liver spot), normal ish labs but INCREASED total bili and LDH

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29
Q

Why does malaria avoid heterozygous SS pts

A

bc spleen clears sickled rbcs before virus can burst, less cytoadherence, but homozygotes can still die
(same w thalassemias)

30
Q

Babesia
vector
sx

A

“vampire babes”
ioxdes tick (same as lyme, robin), wooded areas, blood transfusion, placenta, NE
asymp unless IC (microtic less severe, divergens more)
Malaria like sx
Sudden severe hemolysis (broken RBC windows)
splenectomy pt (hole in shirt in spleen area)

31
Q

Babesia histo

dx

A 
Maltese cross (cross in sketchy) and ring formation seen together
Dx: malaria like sx but didnt travel to malaria area, smear, pcr, fluor ab, etc etc
32
Q

Tx

A

Atovaquone & azithromycin
(atova vampire queen w crows for macrolides)
(can also have quinine and clindamycin)

33
Q

KINETOPLASTIDS

spp

A 
diff bugs
long orgs
no good tx bc non oral and have sxe
Trypanosom
Leishmania
34
Q

3 types of trypanosoma

A

T gambiense
T rhodesiense
T cruzi

35
Q

Trypanosoma cruzi
disease
transmission and bug
location

A 
"cruizin thru che's gas"
causes CHAGAS disease
from reduviid/triatomine kissing bug
poor housing conds
S america
bug defacates on skin, scratching
36
Q

T cruzi

Acute, indeterminate, and chronic phase

A

Unilateral PUFFY EYE (chagoma/romana’s sign)
most asymp except kids

indet: 10-30 yr latency
chronic: organomegaly, cardiomegaly (saddle bag shaped like heart), megacolon (large gas pump), megaesophagus (snake w big throat)

37
Q

T cruzi tx

A

NiFURtimox (fur boots on woman)
BENZnidazole
(CRUIZIN in my BENZ with my FUR coat on)

38
Q

T gambiense
dis
transm

A

TSETSE FLY
W african sleeping sickness
rural, poor
(“prince bruce to the rescue”)

39
Q

Trypanosoma gambiense sx

A 
slow dev of wasting, coma, convulsions, etcetc
OCCIPITAL ADENOPATHY (pearl necklace)
40
Q

T gambiense Tx

A

EFLORNITHINE (IV) (think flowers)

suramin serum and melarsoprol soap if CNS (“i SURe am MELLow when im sleeping”)

41
Q

T rhodesiense
pop
animal
etc

A

E africa sleeping sickness
tsetse
males, hunters

42
Q

T rhod sx

A

acute febrile, rash w circular large lesion

facial edema, helaptosplenomegaly, adenopathy, CNS/ CSF, cardiac/renal,

43
Q

Leishmania
trans
area

A 
SAND FLY ("desert mania")
Lutz-new world, phleb-old world
44
Q

Leishmania
sx
forms

A

skin lesions (primary form) (painless raised border, looks like syphilis but not in genital)
good Th1 immune resp, self healing
new world: new-WET, old-DRY

  • mucocutaneous
    visceral: dissem of macros sys, poor th2 resp, high mortality, guy w black rash
45
Q

Leishmania tx

A

sodium stibogluconate (steak t-bone offering)

46
Q

Ancylostoma braziliensis

A

DOG/CAT HOOKWORM (larva on ground enters skin)

larva migrans dis w inflam

47
Q

A braziliensis sx

A

Cutaneous- vvv itchy
prurutic, serpiginous (wavy margins) parasite trying to find dog/cat intestines
toddler in sandbox etc

48
Q

Ancylostoma braziliensis tx

A

Oral IVERMECTIN to kill worm

topical thiabenz

49
Q

Toxocara canis/catis

A

ROUNDWORM in dogs/cats (“wolfman in screamatodes III)

puppies or kids ingest egg

50
Q

T canis sx

A

visceral-sys inflam from worm crawling, fever etc
EOSINOPHILIA (pink marbles), allergy, diarr etc
-ocular, larva in retina, can cause blindness (wearing mask

51
Q

T canis Tx (and dx)

A

dx pcr

TX: ALBENDAZOLE (bendy chairs on wolf man)

52
Q

Baylisascaris procyonis

A

RACOON ROUNDWORM, have to kill racoon poop with flamethrower

53
Q

B procyonis sx

A

V SEVERE
enceph, brain/eye
no good tx, high mortality etc

54
Q

Filaria (nematodes)

A

infx has swimming egg stage and adult stage
immune resp
LOW: (loa loa, onchocerca, wuchereria)

55
Q

Wuchereria bancrofti

A

Brugian spp
adults in lymphatics
peaks at midnight, trans by mosquitos

56
Q

W bancrofti sx

A

asympt

early: usual, retrograde lymphangitis

late sympt phase: chronic edema, elephantitis (MC hammer pants), hydrocele, DLA (skin), nodules/plaques

57
Q

Wuchereria dx and tx

A

rapid ag detection

tx: DEC (diet and carb zine)
Ivermectin
Penicillin for DLA immed
Doxy to tx wolbachia that lives in filaria

58
Q

Onchocerca volvulus

A

Filarial onchocerciasis causing RIVER BLINDNESS

trans by black flies, painful bite, skin, africa

59
Q

O volvulus sx

A

skin disease w nodules in lower extremities and butt, eye disease w worm causing blindness (fly covering eye)
black flies black skin black nodules black sight

60
Q

Onchocercia dx tx

A

dx skin snips, dec patch test not used much bc systemic mazzoti
rxn: can cause sepsis like sx from ag storm, blindness/death
Tx: IVERMECTIN, dec

61
Q

Loa Loa (fliaria loiasis)

A 
EYE WORM
adults in subcut tissue
microfilaria in blood
peaks in morning 
trans by chrysops fly
62
Q

Loa loa sx

A

asymp
allergic, CALABAR SWELLING, non painful
eye worm, non inflam, no perm dmg

63
Q

Loa loa tx

A

DEC (blue guy also reading diet and carb zine)

64
Q

Pt in NE area shows malaria like sx– which microbe?

A

babesia! (microti LESS severe than divergens)

65
Q

Oozing nonpainful ulcer with firm raised edges and cetnral crator– which microbe?

A

Leishmania! (cutaneous)

66
Q

Inflamed rash on buttocks w squiggly line

and disease process

A

maybe onchocerca volvulus filaria, cutaneous larva migrans, DOG HOOKWORM, dog poops egg, egg hatches into larva, larva finds human host, worm tries to find dog intestines but cant cross bloodstream so wiggles around and causes inflam

67
Q

What is an example of a sx Wuchereria bancrofti may cause?

A

elephantiasis (eg of scrotum) (MC hammer pants), OBSTRUCTS LYMPHATICS (ruffles on armpits)

68
Q

What do you use to treat issue in girl with chronic slow lymphedema of leg?

A

WUCHERIA BANCROFTI

tx with PENICILLIN

69
Q

loa loa sx and dx?

A

swelling blotchy rash, cellulitis etc

Giemsa stain blood smear

70
Q

What is a ulcer with firm raised edges and central crater (oozy, nonpainful) called?

A

swollen epitrochlear node (FOREARM LYMPH NODE)

in cutaneous leishmania

Neoplasia Block (16 decks)

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