L5: Antihelminthics and Antiprotozoals (non-malarial) Flashcards

1
Q

Which of the following causes the most common helminth infection in the USA?
A. Entamoeba histolytica (amebiasis)
B. Enterobius vermicularis (pin worm)
C. Ascaris lumbricoides (round worm)
D. Necator americanus (hookworm)

A

B. Enterobius vermicularis (pin worm)

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2
Q

Mebenazole and Albendazole can be used to treat helminth infections caused by:
A. hook worm
B. round worm
C. pin worm
C. amebiasis

A

C. pin worm

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3
Q

True or False: Pyrantel pamoate is most common drug used to treat helminth infections caused by pinworms

A

True

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4
Q

True or False: Pinworm treatment is only effective if when patient adheres to rigid standards of personal hygeine

A

True

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5
Q

Perianal pruritis and presence of eggs or worms is a symptom of which type of helminth infection?
A. Pin worm
B. Round worm
C. Earth worm
D. Fungus

A

A. Pin worm

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6
Q

Which of the following is a specialized parasite that exclusively infects Homo sapiens?
A. Entamoeba histolytica (amebiasis)
B. Enterobius vermicularis (pin worm)
C. Ascaris lumbricoides (round worm)
D. Necator americanus (hookworm)

A

C. Ascaris lumbricoides (round worm)

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7
Q

Abdominal pain, insomnia, and eggs in feces suggests a helminth infection caused by which parasite?
A. Entamoeba histolytica (amebiasis)
B. Enterobius vermicularis (pin worm)
C. Ascaris lumbricoides (round worm)
D. Necator americanus (hookworm)

A

C. Ascaris lumbricoides (round worm)

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8
Q

True or False: One can acquire enterobius vermicularis (pinworm) or Ascaris lumbricoides via: fecal-oral route

A

True

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9
Q

True or False: Night soil can cause pinworm eggs

A

False - night soil can be source of round worm eggs

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10
Q

What two drugs treat asymptomatic/mild roundworm helminth infections?
A. Mebendazole / Albendazole
B. Pyrantel pamoate / Albendazole

A

A. Mebendazole / Albendazole

  • Ivermectin as alternative
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11
Q

Why is pyrantel pamoate used to treat heavy roundworm infections?

A

Reduces wandering and causes worm paralysis

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12
Q

Ivermectin is the preferred therapy for treatment of:
A. pinworms
B. roundworm
C. hookworm

A

C. hookworm

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13
Q

Anemia and eggs/worms in feces suggests infection by:
A. pinworms
B. roundworm
C. hookworm

A

C. hookworm

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14
Q

N. americanus is the predominant species of ____, which travelers to the tropics are more apt to be infected by:
A. pinworms
B. roundworm
C. hookworm

A

C. hookworm

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15
Q

True or False: Roundworms attach to the intestinal mucosa using the ventral tooth to lacterate host tissue

A

True

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16
Q

A patient has anemia. Which parasite most likely infected them?

A

Hookworm

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17
Q

A small child was playing outside with friends during the summer. Over the next few weeks, patient begins complaining of tiredness, dizziness, and looks pallid. Results indicate that patient has a hookworm infection. What is the source of this infection?

A

Direct skin contact / oral ingestion

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18
Q

Which of the following drugs is used to treat “creeping eruptions” that are seen in hookworm infections?
A. Albendazole
B. Mebendazole
C. Pyrantel pamoate
D. Ivermectin

A

A. Albendazole

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19
Q

Taenia solium is the ___ tapeworm while Taenia saginata is the ___ tapeworm

A

Taenia solium
Taenia saginata

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20
Q

A patient has abdominal pain, upset GI, loss of appetite, diarrhea, and the presence of eggs/proglottids in the feces. What type of infection to they likely have?
A. Pin worm
B. Round worm
C. Tape worm
D. Hook worm

A

C. Tape worm
(pork or beef)

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21
Q

Neurocysticercosis (in the CNS) and
cysticercosis (in visceral organs)
can arise due to infection by:
A. T. saginata (beef tapeworm)
B. T. solium (pork tapeworm)
C. Pin worm

A

B. T. solium (pork tapeworm)

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22
Q

True or False: T. saginata larvae can penetrate small bowel and become encysted in visceral organs, causing neuro/cysticercosis

A

False - this occurs with T. solium (pork tapeworm

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23
Q

True or False: A seizure may suggests cysticercosis

A

True

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24
Q

Which drug is used to treat T. saginata (beef tapeworm)?

A

Praziquantel

25
Q

Treatment of T. solium (pork tapeworm) with Praziquantel can cause disintergration of gravid segments of T. solium, which can result in release of embryos from eggs and cysticercocis. How do you avoid this?

A

Mg Sulgate is administered 2 hrs after treatment with Praziquantel

  • Exam stool 5 weeks after tx to ensure no infection
26
Q

How do you treat neurocysticercosis?
- for inflammation?
- acts on scolex?
- systemic drug, acts on cysts in tissue?

A

1) Dexa - Inflammation
2) Albenazole - acts on cysts in tissues, systemic
3) Praziquantel - acts on scolex

27
Q

True or False: Albendazole has more systemic effects, while mebendazole has less

A

True

28
Q

What account for the systemic anti-helminthic activity of albendazole?

A

Albenazole is metabolized in the liver to an active metabolite

29
Q

True or False: Albendazole is metabolized to inactive metabolite, which is effective against GI (luminal) parasites

A

False - Mebendazole is metabolized to inactive metabolite, which is effective against GI (luminal) parasites

30
Q

Which two drugs for helminth infections bind with high affinity to b-tubulin to inhibit microtubule polymerization and MT-dependent glucose uptake on surface of parasite

A

Mebendazole and Albendazole

31
Q

Which drugs can cause increased in liver enzymes and cause leukopenia?
A. Mebendazole
B. Albendazole
C. Pyrantel pamotate

A

A. Mebendazole
B. Albendazole

32
Q

Which drug for helminths infections works via: paralysis due to activation of cholinergic nicotinic receptors in nematode muscle cells, causing depolarizing NM blockade?

A

Pyrantel pamotate

33
Q

____ _____: a broad spectrum agent that is effective against a variety of GI nematodes (round worm, pin worm, and hookworm)

____: Broad spectrum drug with activity against shistosomes (trematodes) and well as tapeworms (cestodes)

A

Pyrantel pamotate
(similar to succinylcholine)

Praziquantel

34
Q

___ works by inducing CONTRACTION and PARALYSIS of musculature of the worms by causing an increased in ca+ ion influx.

Note: with tapeworms, the drug causes the suckers to be dislodged
A. Praziquantel
B. Pyrantel pamotate
C. Mebendazole
D Albendazole

A

A. Praziquantel

35
Q

Which drug used for treatment of helminth infections belongs to pregnancy Cat B and therefore has no risk based on animal studies?
A. Praziquantel
B. Pyrantel pamotate
C. Mebendazole
D Albendazole

A

A. Praziquantel

36
Q

___: oral and topical preparation for off-label use of hookworms, round worms (A. lumbricoides) and head lice

A

Ivermectin

37
Q

True or False: Praziquantel causes PARALYSIS by activation of GLUTAMATE-GATED Cl- channels, leading to hyper-polarization with increasing intracellular Cl-

A

False - this is the MOA for Ivermectin

38
Q

True or False: Ivermectin can be used in patients with impaired BBB

A

False - it cannot be used. If it is, it can cross BBB and interact with GABA-R

39
Q

True or False: Ivermectin has high affinity for GABA-R and channels

A

False - does not have high affinity for those

40
Q

___ is the only effective way to treat protozoal infections

A

Chemo

41
Q

True or False: Protozoal infections are more prominent in the immunocompromiised, elderly, very young, HIV/AIDS pts, and chemotherapy

A

True

42
Q

What is the primary source of protozoal infections?

A

Consumption of contaminated drinking water

43
Q

Abdominal cramping, vomiting, and blood diarrhea suggests which type of protozoal infection?
A. Amebiasis
B. Giardiasis
C. Trichomoniasis

A

A. Amebiasis

44
Q

True or False: Advanced stages of Giardiasis infection can lead to: parasite spreading into the liver and causing liver abscess

A

False - advanced stages of Amebiasis infection can lead to: parasite spreading into the liver and causing liver abscess

45
Q

Which type of therapy is more effective against the trophozoite stage of the amebiasis?

A

Drug

46
Q

True or False: Both Amebiasis and Giardiasis exist in an active trophozite and dormant cyst form

A

True

47
Q

What two drugs are used to treat asymptomatic carriers of amebiasis?

A

1) Iodoquinol
2) Paromomycin

48
Q

Metronidazole, followed by Iodoquinol or Paromomycin is used to treat symptomatic _____
A. Amebiasis
B. Giardiasis
C. Trichomonis

A

A. Amebiasis

  • symptomatic: GI symptoms; amebic liver abscess
49
Q

True or False: Giardiasis almost exists as a parasite

A

True

50
Q

Which two drugs treat giardias?

A

1) Metronidazole
2) Nitazoxanide

51
Q

Which drug is used to treat Trichomoniasis?

A

Metronidazole

52
Q

In ______, oocytes are consumed that form sporozoites in the GI tract.

A

Cryptosporidiosis

53
Q

How does one commonly become infected with Crytosporidium paravum?

A

Pools and waterparks

54
Q

Which two drugs treat Cryptosporidiosis?

A

1) Nitazoxanide
2) Paromomycin

55
Q

Which drug for protozoal infections has a N group that gets reduced in anaerobic bacteria, then binds to DNA to inhibit synthesis or cause DNA damage in anaerobes?

A

Metronidazole (Flagyl)

56
Q

Which drug for protozoal infections can have DDI with ETOH?

A

Metronidazole (Flagyl)

57
Q

True or False: Iodoquinol contains iodine, which may cause enhance or increased hyperthyroidism

A

True

58
Q

Which of the following drugs used to treat protozoal infections inhibits protein synthesis via binding to the 30S ribosomal subunit AND has potential for nephrotoxicity?
A. Iodoquinol
B. Metronidazole (Flagyl)
C. Nitazoxanide
D. Paromomycin

A

D. Paromomycin

59
Q

____ is a drug used for treating protozoal infections, via interfering with anaerobic energy by inhibiting pyruvate:ferredoxin 2-oxidoreductase enzyme dependent electron transfer (which is important for anaerobic energy metabolism in cyrptosporidium, giardia, etc.)
A. Iodoquinol
B. Metronidazole (Flagyl)
C. Nitazoxanide
D. Paromomycin

A

C. Nitazoxanide