Lecture Flashcards
Protozoa Categories
Intestinal
Blood and Tissue Apicomplexa
Flagellates
Free-Living
Helminths Categories
Nematodes (Roundworms)
Trematodes (Flukes)
Cestodes (Tapeworms)
Nematodes (roundworms) Categories
Intestinal
Tissue
Filarial
Cestodes (tapeworms) Catgories
Tissue
Intestinal Protozoa - species
Giardia Microsporidium Cryptosporidium Cyclospora Cysytoisospora D. fragilis B. hominis E. histolytica E. dispar B. coli
Blood and tissue Apicomplexa Protozoa - species
Palsmodium
Babesia
Toxoplasma
Flagellates (Protozoa) - Species
Leishmania
Trypanosoma
Trichomonas
Free-living (Protozoa) - species
Acanthamoeba
Balmuthia
Naeglaeria
Intestinal Nematodes (roundworms) - Species
Ascaris lumbricoides (round) Trichuris trichuria (whip) Enterobius vermicularis (pin) Ancylostoma duodenale (hook) Necator americanus (hook) Cappillaria philippinensis Strongyloides stercoralis Anisakis
Tissue Nematodes (roundworms) - Species
Angiostrongylus (rat) Gnathostoma Dracunculus (guinea pig) Trichinella (pig, bear) Toxocara (cat, dog) Bayliscaris (raccoon)
Filarial Nematodes (roundworms) - Species
Wuchereria bancrofti Brugia malayi Loa loa Onchocerca volulus Mansonella
Trematodes (flukes) - Species
Schistosoma (skin)
Fasciola (sheep, watercress)
Clonorchis (fish, watercress)
Paragonimus (crabs, crayfish)
Tissue Cestodes (tapeworms) - Species
Taenia solium (pig) Taenia saginata (cow) Diphyllobotherium latum (fish) Hymenolopsis nana (arthropods) Hymenolopsis diminuta (arthropods) Echinococcus (dog, cat)
Suggested number of stools and time frame for O&P
3 stools over 10 days
Two stages of intestinal protozoa
Trophozoite phase (active growing stage) Cyst stage (dormant org)
E. histolytica/dispar troph characteristic morphologic features
Size: 12-60um Karyosome: Central, small, compact Chromatin: Fine, granular, evenly distributed Cytoplasm: Granular, with bacteria Other: Look for RBCs=hitsolytica
E. hartmanni troph characteristic morphologic features
Looks like E. histolytica but smaller, 5-12um (E. hitso is 12-60um)
E. coli troph characteristic morphologic features
Size: 15-50um
Karyosome: Large, diffuse, eccentric
Chromatin: Clumpy, uneven
Cytoplasm: Vacuolated, with bacteria and yeast
Ioamoeba butschlii troph characteristic morphologic features
Size: 8-20um
Karyosome: klarge, “basket” shaped
Other: Nuclear halo
E. histolytica/dispar cyst characteristic morphologic features
Size: 10-20um
# Nuclei: 4
Chromatoid bodies: Rounded ends
Other: very refractile
E. coli cyst characteristic morphologic features
Size: 10-35um
# Nuclei: 8
Chromatoid bodies: Splintered ends
Other: distorted
Ioamoeba butschlii cyst characteristic morphologic features
Other: Glycogen vacuole
E. histolytica - Clinical presentation, incubation, Transmission
Clin: bloody diarrhea, asymptomatic, malaise
Incubation: 1 wk to months
trans: Ingestion of cysts from food/H2O, sexual transmission
B. coli - Clinical presentation, incubation, Transmission
Clin: Mild colitis, asympt, diarrhea, can be sim. to amoebic dysentery
Incubation: days to weeks
Transmission: Ingestions of cysts from food/H2O, pig reservoir
G. lamblia - Clinical presentation, incubation, Transmission
Clin: Foul smelling diarrhea, mucous filled stool, no blood, abdominal pains, can be asympt
Incubation: 10 days (1-4 weeks)
Transmission: Ingestion of cysts from food/H2O
D. fragilis - Clinical presentation, incubation, Transmission
Clin: Asymptomatic
Incubation: days to weeks
Transmission: Ingestion of trophs (no cyst forms). Transmitted via helminth eggs
Cryptosporidium - Clinical presentation, Transmission/Onset, Treatment
Clin: Acute gastroenteritis
Trans/Onset: 1 wk to months
Treat: Self limiting
Cyclospora cayetanensis - Clinical presentation, Transmission/Onset, Treatment
Clin: Small intestine infection, low grade fever, malaise to GI symptoms
Trans/Onset: Ingestion of oocyst from contaminated food/H2O. Oocysts RESISTANT to chlorine
Treat: Trim/Sulfa
Cystoisospora belli - Clinical presentation, Transmission/Onset, Treatment
Clin: “Travelers diarrhea”, severe in immunocomp. (extraintestinal)
Trans/Onset: Ingestion of oocyst from raw/undercooked food
Treat: trim/sulfa
Sarcocystis - Clinical presentation, Transmission/Onset, Treatment
Clin: Intestinal or muscular infection
Trans/Onset: Ingestion of infected meat
Treat: Supportive care
Modified Acid-Fast Positive Intestinal Protozoa
Cryptosporidium
Cyclospora cayetanensis
Cystoisospora belli
Sarcocystis
Roundworm - Name and Clinical
Name: Ascaris lumbricoides
Clinical: Worm burden, pneumonitis, small bowel obstruction, ectopic liver/pancreas
Roundworm - Lab Diagnosis
Eggs or worms in stool O&P
Roundworm - Transmission and Rx
Trans: Ingestion of emryonated eggs
Rx: Mebendazole, Albendazole
Pin worm - Name and Clinical
Name: Enterobius vermicularis
Clinical: Pruritus ani, weight loss, abd pain, ectopic genital tract
Pin worm - Lab Diagnosis
Eggs in stool, SCOTCH TAPE TEST
Pin worm - Transmission and Rx
Trans: Direct ingestion of eggs from perianal region
Rx: Mebendazole, albendazole
Hookworm - Name and Clinical
Name: Necator americanus, Ancylostoma duodenale
Clinical: Pruitic rash “ground itch” at site of entry, pneumonitis, intestinal
Hookworm - Lab Diagnosis
Eggs in stool, larvae rare but can hatch them from the eggs
Hookworm - Transmission and Rx
Trans: Direct skin penetration of active filariform larvae
Rx: Mabendazole, albendazole, Iron supplement
Strogyloides - Name and Clinical
Name: Strongyloides stercoralis
Clinical: “Larva currens” rash, pulmonary “loeffler’s syndrome”, intestinal, hyperinfection
Strongy - Lab Diagnosis
Larvae on stool, rarely eggs, Migration plate!, serology
Strongy - Transmission and Rx
Trans: Direct skin penetration of active filariform larvae
Rx: Ivermectin
Whipworm - Name and Clinical
Name: Trichuris trichuria
Clinical: Mild gastrointestinal symptoms, rectal prolapse
Whipworm - Lab diagnosis
Eggs in stool
Whipworm - Transmission and Rx
Trans: Ingestion of embyonated eggs
Rx: Mabendazole, albendazole
How to differentiate Strongy from Hookworm?
Strongy has a short buccal cavity and a large genital promordium (short and sexy)
How to differentiate the species of Hookworm?
Must be larvae and compare mouths, also geography:
Ancylostoma has teeth (old world)
Necator has cutting plates (new world)
Faciolopsis buski - organ infected, geography, transmission
Site: Intestinal and liver
Geo: Asia, India
Trans: Pig
Fasciola hepatica - organ infected, geography, transmission
Site: Intestinal and liver
Geo: Worldwide
Trans: water plants
Clonorchis sinesis - organ infected, geography, transmission
Site: Liver
Geo: Far east
Trans: Freshwater fish
Opsithorchis species - organ infected, geography, transmission
Site: Liver
Geo: Thailand, Europe
Trans: Freshwater fish
Paragonimus westermani - organ infected, geography, transmission
Site: Lung
Geo: Far east, Africa, South america
Trans: Crabs, crayfish
Paragonimus kelcottii - organ infected, geography, transmission
Site: Lung
Geo: Mid-west USA
Trans: Crabs, crayfish
Schistosoma mansoni - organ infected, geography, transmission
Site: Veins (intestine)
Geo: S. america, Caribbean, Africa, Middle East
Trans: Skin penetration in water
Schistosoma japonicum - organ infected, geography, transmission
Site: Veins (intestine)
Geo: Asia
Trans: Skin penetration in water
Schistosoma haematobium - organ infected, geography, transmission
Site: Veins (bladder)
Geo: Africa, Middleeast
Trans: Skin penetration in water
Schistosoma intercalatum - organ infected, geography, transmission, features
Site: Veins (rectum)
Geo: W. Africa
Trans: Skin penetration in water
Feat: longer terminal spine than S. haematobium
Schistosoma mekongi - organ infected, geography, transmission, features
Site: Veins
Geo: Cambodia, Laos
Trans: skin penetration, dog reservoir
Features: no spine
Plasmodium species (5)
P. falciparum P. vivax P. ovale P. malariae P. knowlesi
Areas with choloroquine resistance in P. falciparum
Caribbean, Central america