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Medical Parasitology - Markell and Voges > Lecture 02 - Sarcodina & Mastigophora > Flashcards

Lecture 02 - Sarcodina & Mastigophora Flashcards

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USMLE® Step 1 flashcards
1
Q

Naegleria fowleri: General Characteristics

A 
in sweat warm water and wet grounds
37c non-nutrition agar
Termophil (until 45degrees)
Mostly in youngsters
Forms:
1. Trohozoite: only in tissue, active form, 1 nucleus and nucleolus, can transform to both
2. Flagellate: when in foodless places
3. Cyst: round with filled pores, 1 nucleus and bug nucleolus
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2
Q

Naegleria fowleri: Pathogenesis

A 
From ethmoid to olfactory bulbs
Necrosis of white and grey matter
Meningitis (PAM: primary amoebic meningoencephalopathy)
Limited to brain
2-3 days to 2 weeks incubation
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3
Q

Naegleria fowleri: Diagnostic Tests

A

1.Biopsy/Autopsy: trophozoites in tissue
2.LP: flagellated in 37c
11 days incubation in 37c

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4
Q

Naegleria fowleri: Treatment

A

No definitive treatment
Amphotericin B: intravenous/intraspinal
+
Tetracycline/miconazole/rifampin

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5
Q

Acanthamoeba: General Characteristics

A 
Resistant to temperature, pH, osmolarity changes
Can transform to both forms in environmental changer
25c non-nutrition agar
Trophozoite:
Acanaceous 
Common in environment 
Cyst:
Sinuate inner wall
Strong (30-40 years)
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6
Q

Acanthamoeba: Pathogenesis

A

Granulomatosis Amebic Encephalopathy(GAE)
In biopsy/autopsy both forms are seen
3 weeks incubation faster if immunocompromised

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7
Q

Acanthamoeba: Diagnostic Lab Tests

A 
Encephalic: 
1.CSF giesma coloring
2.biochemistry: increased lymphocytes, neutrophils, protein
Cutaneous:
1.incubation in non-food agar
2.PCR
3.immunocytochemical
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8
Q

Acanthamoeba: Pathogenesis Factors

A
  1. MBP: connection to surfaces + phagocytosis
  2. Toxins
  3. pH, temperature, osmolarity resistance
  4. Hydrolytic enzymes
  5. Morphology (Acantopudia)
  6. Drug resistance
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9
Q

Acanthamoeba: Disease Forms

A
  1. Cutaneous: mostly in immunocompromised
  2. Encephalic: GAE
  3. Pulmonary: mostly in immunocompromised
  4. چشمي: chronic amebic kertitis
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10
Q

Acanthamoeba: Encephalic Clinical Findings

A 
Headache
Dizziness
Nausea
Neck stiffness: similar to meningitis
Necrosis
Hemorrhage
Edema
Multiple ضايعات in midbrain, brain stem, مخچه
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11
Q

Acanthamoeba: Treatment

A

Encephalic/Keratitis:
propamidine isethionate + dibromopropamidine isethionate
Cutaneous:
5 fluorocytosine (5FC)
Corticosteroids –> diffision of parasite
No drug is effective on both cyst and trophozoite –> remission
Keratitis is treated better

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12
Q

Balamuthia

A

Encephalic (GBE), Cutaneous, Pulmonary Granulation
Spider-like movement
Nutrition agar

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13
Q

Mastigophora: General Characteristics

A 
In great intestine except gingivalis and giardia
Flagella
Belpharolast
Longitudinal division
In 1.body cavities 2.tissues
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14
Q

Dientamoeba fragilis: General Characteristics

A 
Binuclear
Broken nucleolus (unlike amoeba)
No cyst(like tricomunas)
Connection between nuclei when dividing
Sensitive trophozoite --> Transmission egg of askaris/pinworm
Mucosal diarrhea
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15
Q

Dientamoeba fragilis: Pathology

A

Mucosal diarrhea

Use diarrhea inducer to test

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16
Q

Dientamoeba fragilis: Treatment

A

Metronidazole
Paramomycin
Diiodohydroxyquin
Clioquinol

17
Q

Chilomastix mesnili

A

Trophozoite:
Nucleus, necleolus, cytostome, flagella
Cyst:
Nucleus, residue of flagella and cytostome

18
Q

Giardia lamblia: General Characteristics

A 
Duodenum
Heterogene 
Zoonotic
Mostly dangerous in children 4-11
7-10 days cycle in body (oral-fecal)
Strong cyst against Cl
Trophozoite:
8*flagella
Binuclear
Parabasal body
Median body
Ventral disks
Cyst:
Binuclear then tetranuclear--> trophozoite
19
Q

Giardia lamblia: Pathogenesis

A
  1. Ventral disk covers the intestinal surface–> malnutrition(fat, vitamins) –> children if prolonged –> brain underdevelopment
  2. Bile salts degeneration
  3. Toxin: Intestinal disorders
  4. Nutritional competition: carbohydrates
  5. chole cystitis
20
Q

Giardia lamblia: Effective Factors

A
  1. Stomach pH
  2. immunocompromision: specially IgA
  3. malnutrition
  4. A blood type
  5. cysts eaten
21
Q

Giardia lamblia: Clinical Findings

A 
Nausea
Stinking stool: fat
Burp
Steatorrhea
Milky Diarrhea
9-11% eosinophils
Eye disorders(uncommon): Uveithis
22
Q

Giardia lamblia: Diagnostic Lab Tests

A 
1.parasitology: 
Diarrhea stool test
Normal stool (cyst passer) test: formalin ether + centrifuge
 String test
2.immunology:
IFA/ELISA unusable
Ag finding in stool
3.PCR
23
Q

Giardia lamblia: Treatment

A

Metronidazole: 250mg - 2-3 times daily - a week or 2g - daily - 3 days
Chloroquinol
Albendazole: a doze(2 pills) daily - 3 days
Mebendazole
Quinacrine: if drug resistant for its neurological after effects

Children:
Furazolidone (75%) a small spoon every 6 hours

Pregnant:
Paramomycin –> no improvement –> Metronidazole/oronodazole

Medical Parasitology - Markell and Voges (5 decks)

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