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Lecture Flashcards

1
Q

Protozoa Categories

A

Intestinal
Blood and Tissue Apicomplexa
Flagellates
Free-Living

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2
Q

Helminths Categories

A

Nematodes (Roundworms)
Trematodes (Flukes)
Cestodes (Tapeworms)

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3
Q

Nematodes (roundworms) Categories

A

Intestinal
Tissue
Filarial

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4
Q

Cestodes (tapeworms) Catgories

A

Tissue

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5
Q

Intestinal Protozoa - species

A 
Giardia
Microsporidium
Cryptosporidium
Cyclospora
Cysytoisospora
D. fragilis
B. hominis
E. histolytica
E. dispar
B. coli
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6
Q

Blood and tissue Apicomplexa Protozoa - species

A

Palsmodium
Babesia
Toxoplasma

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7
Q

Flagellates (Protozoa) - Species

A

Leishmania
Trypanosoma
Trichomonas

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8
Q

Free-living (Protozoa) - species

A

Acanthamoeba
Balmuthia
Naeglaeria

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9
Q

Intestinal Nematodes (roundworms) - Species

A 
Ascaris lumbricoides (round)
Trichuris trichuria (whip)
Enterobius vermicularis (pin)
Ancylostoma duodenale (hook)
Necator americanus (hook)
Cappillaria philippinensis
Strongyloides stercoralis
Anisakis
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10
Q

Tissue Nematodes (roundworms) - Species

A 
Angiostrongylus (rat)
Gnathostoma
Dracunculus (guinea pig)
Trichinella (pig, bear)
Toxocara (cat, dog)
Bayliscaris (raccoon)
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11
Q

Filarial Nematodes (roundworms) - Species

A 
Wuchereria bancrofti
Brugia malayi
Loa loa
Onchocerca volulus
Mansonella
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12
Q

Trematodes (flukes) - Species

A

Schistosoma (skin)
Fasciola (sheep, watercress)
Clonorchis (fish, watercress)
Paragonimus (crabs, crayfish)

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13
Q

Tissue Cestodes (tapeworms) - Species

A 
Taenia solium (pig)
Taenia saginata (cow)
Diphyllobotherium latum (fish)
Hymenolopsis nana (arthropods)
Hymenolopsis diminuta (arthropods)
Echinococcus (dog, cat)
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14
Q

Suggested number of stools and time frame for O&P

A

3 stools over 10 days

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15
Q

Two stages of intestinal protozoa

A 
Trophozoite phase (active growing stage)
Cyst stage (dormant org)
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16
Q

E. histolytica/dispar troph characteristic morphologic features

A 
Size: 12-60um
Karyosome: Central, small, compact
Chromatin: Fine, granular, evenly distributed
Cytoplasm: Granular, with bacteria
Other: Look for RBCs=hitsolytica
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17
Q

E. hartmanni troph characteristic morphologic features

A

Looks like E. histolytica but smaller, 5-12um (E. hitso is 12-60um)

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18
Q

E. coli troph characteristic morphologic features

A

Size: 15-50um
Karyosome: Large, diffuse, eccentric
Chromatin: Clumpy, uneven
Cytoplasm: Vacuolated, with bacteria and yeast

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19
Q

Ioamoeba butschlii troph characteristic morphologic features

A

Size: 8-20um
Karyosome: klarge, “basket” shaped
Other: Nuclear halo

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20
Q

E. histolytica/dispar cyst characteristic morphologic features

A

Size: 10-20um
# Nuclei: 4
Chromatoid bodies: Rounded ends
Other: very refractile

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21
Q

E. coli cyst characteristic morphologic features

A

Size: 10-35um
# Nuclei: 8
Chromatoid bodies: Splintered ends
Other: distorted

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22
Q

Ioamoeba butschlii cyst characteristic morphologic features

A

Other: Glycogen vacuole

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23
Q

E. histolytica - Clinical presentation, incubation, Transmission

A

Clin: bloody diarrhea, asymptomatic, malaise
Incubation: 1 wk to months
trans: Ingestion of cysts from food/H2O, sexual transmission

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24
Q

B. coli - Clinical presentation, incubation, Transmission

A

Clin: Mild colitis, asympt, diarrhea, can be sim. to amoebic dysentery
Incubation: days to weeks
Transmission: Ingestions of cysts from food/H2O, pig reservoir

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25
Q

G. lamblia - Clinical presentation, incubation, Transmission

A

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

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26
Q

D. fragilis - Clinical presentation, incubation, Transmission

A

Clin: Asymptomatic
Incubation: days to weeks
Transmission: Ingestion of trophs (no cyst forms). Transmitted via helminth eggs

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27
Q

Cryptosporidium - Clinical presentation, Transmission/Onset, Treatment

A

Clin: Acute gastroenteritis
Trans/Onset: 1 wk to months
Treat: Self limiting

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28
Q

Cyclospora cayetanensis - Clinical presentation, Transmission/Onset, Treatment

A

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

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29
Q

Cystoisospora belli - Clinical presentation, Transmission/Onset, Treatment

A

Clin: “Travelers diarrhea”, severe in immunocomp. (extraintestinal)
Trans/Onset: Ingestion of oocyst from raw/undercooked food
Treat: trim/sulfa

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30
Q

Sarcocystis - Clinical presentation, Transmission/Onset, Treatment

A

Clin: Intestinal or muscular infection
Trans/Onset: Ingestion of infected meat
Treat: Supportive care

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31
Q

Modified Acid-Fast Positive Intestinal Protozoa

A

Cryptosporidium
Cyclospora cayetanensis
Cystoisospora belli
Sarcocystis

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32
Q

Roundworm - Name and Clinical

A

Name: Ascaris lumbricoides
Clinical: Worm burden, pneumonitis, small bowel obstruction, ectopic liver/pancreas

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33
Q

Roundworm - Lab Diagnosis

A

Eggs or worms in stool O&P

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34
Q

Roundworm - Transmission and Rx

A

Trans: Ingestion of emryonated eggs
Rx: Mebendazole, Albendazole

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35
Q

Pin worm - Name and Clinical

A

Name: Enterobius vermicularis
Clinical: Pruritus ani, weight loss, abd pain, ectopic genital tract

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36
Q

Pin worm - Lab Diagnosis

A

Eggs in stool, SCOTCH TAPE TEST

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37
Q

Pin worm - Transmission and Rx

A

Trans: Direct ingestion of eggs from perianal region
Rx: Mebendazole, albendazole

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38
Q

Hookworm - Name and Clinical

A

Name: Necator americanus, Ancylostoma duodenale
Clinical: Pruitic rash “ground itch” at site of entry, pneumonitis, intestinal

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39
Q

Hookworm - Lab Diagnosis

A

Eggs in stool, larvae rare but can hatch them from the eggs

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40
Q

Hookworm - Transmission and Rx

A

Trans: Direct skin penetration of active filariform larvae
Rx: Mabendazole, albendazole, Iron supplement

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41
Q

Strogyloides - Name and Clinical

A

Name: Strongyloides stercoralis
Clinical: “Larva currens” rash, pulmonary “loeffler’s syndrome”, intestinal, hyperinfection

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42
Q

Strongy - Lab Diagnosis

A

Larvae on stool, rarely eggs, Migration plate!, serology

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43
Q

Strongy - Transmission and Rx

A

Trans: Direct skin penetration of active filariform larvae
Rx: Ivermectin

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44
Q

Whipworm - Name and Clinical

A

Name: Trichuris trichuria
Clinical: Mild gastrointestinal symptoms, rectal prolapse

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45
Q

Whipworm - Lab diagnosis

A

Eggs in stool

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46
Q

Whipworm - Transmission and Rx

A

Trans: Ingestion of embyonated eggs
Rx: Mabendazole, albendazole

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47
Q

How to differentiate Strongy from Hookworm?

A

Strongy has a short buccal cavity and a large genital promordium (short and sexy)

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48
Q

How to differentiate the species of Hookworm?

A

Must be larvae and compare mouths, also geography:
Ancylostoma has teeth (old world)
Necator has cutting plates (new world)

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49
Q

Faciolopsis buski - organ infected, geography, transmission

A

Site: Intestinal and liver
Geo: Asia, India
Trans: Pig

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50
Q

Fasciola hepatica - organ infected, geography, transmission

A

Site: Intestinal and liver
Geo: Worldwide
Trans: water plants

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51
Q

Clonorchis sinesis - organ infected, geography, transmission

A

Site: Liver
Geo: Far east
Trans: Freshwater fish

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52
Q

Opsithorchis species - organ infected, geography, transmission

A

Site: Liver
Geo: Thailand, Europe
Trans: Freshwater fish

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53
Q

Paragonimus westermani - organ infected, geography, transmission

A

Site: Lung
Geo: Far east, Africa, South america
Trans: Crabs, crayfish

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54
Q

Paragonimus kelcottii - organ infected, geography, transmission

A

Site: Lung
Geo: Mid-west USA
Trans: Crabs, crayfish

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55
Q

Schistosoma mansoni - organ infected, geography, transmission

A

Site: Veins (intestine)
Geo: S. america, Caribbean, Africa, Middle East
Trans: Skin penetration in water

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56
Q

Schistosoma japonicum - organ infected, geography, transmission

A

Site: Veins (intestine)
Geo: Asia
Trans: Skin penetration in water

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57
Q

Schistosoma haematobium - organ infected, geography, transmission

A

Site: Veins (bladder)
Geo: Africa, Middleeast
Trans: Skin penetration in water

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58
Q

Schistosoma intercalatum - organ infected, geography, transmission, features

A

Site: Veins (rectum)
Geo: W. Africa
Trans: Skin penetration in water
Feat: longer terminal spine than S. haematobium

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59
Q

Schistosoma mekongi - organ infected, geography, transmission, features

A

Site: Veins
Geo: Cambodia, Laos
Trans: skin penetration, dog reservoir
Features: no spine

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60
Q

Plasmodium species (5)

A 
P. falciparum
P. vivax
P. ovale
P. malariae
P. knowlesi
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61
Q

Areas with choloroquine resistance in P. falciparum

A

Caribbean, Central america

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62
Q

P. falciparum - RBCs (age and size), Stages seen, features, schizonts/gametocytes, periodicity

A 
RBCs: any, normal
Stages: rings and gametocytes
Feats: multiple rings, delicate chromatin, 2 dots (headphones), applique
Schi/Gams: Banana shaped gametocyte
Period: 36-48 hrs
63
Q

P. vivax - RBCs (age and size), Stages seen, features, schizonts/gametocytes, periodicity

A 
RBCs: young, bigger
Stages: all
Feats: Schuffner's dots, ameboid cells
Schi/Gams: 12-24 schizonts
Period: 48 hrs
64
Q

P. ovale - RBCs (age and size), Stages seen, features, schizonts/gametocytes, periodicity

A 
RBCs: young, normal to big
Stages: all
Feats: Schuffner's dots, fimbrionated cell edge
Sci/Gams: 8-12 schizonts
Period: 48 hrs
65
Q

P. malariae - RBCs (age and size), Stages seen, features, schizonts/gametocytes, periodicity

A 
RBCs: old, small to normal
Stages: all
Feats: banding troph form
Schi/Gams: 6-12 in daisy head
Period: 72 hrs
66
Q

P. knowlesi - RBCs (age and size), Stages seen, features, schizonts/gametocytes, periodicity

A 
RBCs: any, normal
Stages: all
Feats: multiple rings, 2 chromatin dots (headphones)
Schi/Gams: 10-16 schizonts
Period: 36-48 hrs
67
Q

Plasmodium species with late liver stages and what that causes

A

P. vivax and P. ovale, causes relapse, need to treat for longer and with primiquine

68
Q

Four clinical forms of leishmaniasis

A

Cutaneous, visceral, mucocutaneous, Disseminated

69
Q

Diagnosis of leishmaniasis by stain and acceptable specimens

A

Geimsa stain, biopsy, blood, bone marrow

70
Q

Features of Leishmania on stain, what it can be confused with

A 
Intracellular organisms (amastigotes), can be confused with Histoplasma
Look for KINETOPLAST
71
Q

Media used to culture Lesihmania

A

Novy-MacNeal-Nicolle (NNN) medium

72
Q

L. donovani - Disease and specimen type

A

Disease: all 4
Spec: bone marrow, spleen, skin and/or mucosal macrophage

73
Q

L. infantum.chagasi - Disease and specimen type

A

Disease: visceral
Spec: bone marrow, spleen

74
Q

L. tropica - Disease and specimen type

A

Disease: cutaneous
Spec: skin macrophage

75
Q

L. major - Disease and specimen type

A

Disease: cutaneous
Spec: skin macrophage

76
Q

L. braziliensis - Disease and specimen type

A

Disease: cutaneous, mucocutaneous
Spec: skin and/or mucosal macrophage

77
Q

L. mexicana - Disease and specimen type

A

Disease: cutaneous, mucocutaneous, diffuse cutaneous
Spec: skin macrophage

78
Q

L. panamensis - Disease and specimen type

A

Disease: cuntaneous
Spec: skin macrophage

79
Q

Three Trypanosoma species

A

T. cruzi
T. brucei rhodesiense
T. bruci gambiense

80
Q

T. cruzi - Disease, vector, geography

A

Dis: Chaga’s disease
Vect: Reduvid bug
Geo: S. america

81
Q

T. brucei rhodesiense - Disease, vector, geography

A

Dis: ACUTE, african sleeping sickness, myocarditis
Vect: Tse Tse fly
Geo: E. africa

82
Q

T. brucei gambiense - Disease, vector, geography

A

Dis: CHRONIC, african sleeping sickness, CNS meningitis
Vect: Tse Tse fly
Geo: W. aftrica

83
Q

Diagnosis of Trypanosomes and specimen types

A

Diagnosis: Serology (at CDC) or ELISA for blood donors, SMEAR
Spec: Blood, CSF and chancre (T. brucei), lymph node aspirate, tissue

84
Q

Lab diagnosis of Trichomonas vaginalis

A

Wet mount of vaginal secretions or urethral discharge, must see movement of trophs (distinguish from PMNs), pouch culture, waived rapid tests, PCR

85
Q

What is the primary clinical presentation of infection with free living amoeba?

A

Primary amoebic meningoencephalitis

86
Q

Lab diagnosis of infection with free living amoeba

A

Primarily clinical, PCR, EM, culture on to plate with E.coli lawn (see tracts as amoeba move and eat bacteria)

87
Q

Brugia malayi - Disease, vector, periodicity

A

Dis: Elephantitis
Vect: Mosquito (Mansonia and Aedes)
Period: 9-10PM

88
Q

Loa loa - Disease, vector, periodicity

A

Dis: Eye worm
Vect: Deep fly
Period: Midday

89
Q

Wuchereria bancrofti - Disease, vector, periodicity

A

Dis: Elephantitis
Vect: Mosquito (Culex, Anopheles, Ades, Mansoina)
Period: 9-10PM

90
Q

Onchocerca volvulus - Disease, vector, periodicity

A

Dis: River blindness
Vect: Black fly
No periodicity

91
Q

Mansonella perstans - Disease, vector, periodicity, geography

A

Dis: Blood infection
Vector: Midge
No periodicity
Geo: Africa, South America

92
Q

Mansonella streptocerca - Disease, vector, periodicity, geography

A

Dis: Blood infection
Vector: Midge
No periodicity
Geo: Africa

93
Q

Mansonella ozzardi - Disease, vector, periodicity, geography

A

Dis: Blood infection
Vector: Midge
No periodicity
Geo: South and Central America

94
Q

Gnathostoma - definitive host, intermediate host, disease, Dx

A

Def host: Dogs, cats
Int host: Cyclops
Dis: visceral, creeping eruptions
Dx: larvae on histopath

95
Q

Angiostrongylus - definitive host, intermediate host, disease, Dx

A

Def host: Rodents
Int host: Mollusks
Dis: Meningitis, meningoencephilitis, eye infection
Dx: CSF, eye fluid, worm ID, serology

96
Q

Dirofilaria immitis (dog heartworm) - definitive host, intermediate host, disease, Dx

A

Def host: Dog
Int host: Mosquito
Dis: Asymptomatic, pulmonary
Dx: Histopath

97
Q

Capillaria - definitive host, intermediate host, disease, Dx

A

Def host: Fish-eating birds
Int host: Fish
Dis: GI
Dx: Eggs in stool

98
Q

Anisakis - definitive host, intermediate host, disease, Dx

A

Def host: Fish
Int host: N/A
Dis: GI
Dx: endoscopy, radiography, surgery

99
Q

Trichinella - definitive host, intermediate host, disease, Dx

A

Def host: Pig, bear, wild animals
Int host: Pig, bear, wild animals
Dis: GI, fever, edema, marked eosinophilia
Dx: penetrating larvae in tissue, serology

100
Q

Toxocara (dog/cat roundworm) - definitive host, intermediate host, disease, Dx

A

Def host: Dogs, cats
Int host: N/A
Dis: visceral and ocular larva migrans
Dx: larvae in tissue, serology

101
Q

Dracunculus medinensis (guinea worm) - definitive host, intermediate host, disease, Dx

A

Def host: Copopods in water
Int host: N/A
Dis: Tissue damage by worm migration, blister formation
Dx: Worm protruding from blister

102
Q

Baylisascaris (racoon roundworm) - definitive host, intermediate host, disease, Dx

A

Def host: Racoon
Int host:
Dis: Meningitis
Dx: biopsy (poor), serology at CDC

103
Q

Ancylostoma ( dog/cat hookworm) - definitive host, intermediate host, disease, Dx

A

Def host: Gods, cats
Int host:
Dis: cutaneous larva migrans
Dx: eggs in stool

104
Q

Taenia saginata - Intermediate host, life span, worm length, proglottid morphology

A

Int host: Cow
Life span: 25 yrs
Length: 4-12 m
Proglots: 15-20 lateral branches

105
Q

Taenia solium - Intermediate host, life span, worm length, proglottid morphology

A

Int host: Pig
Life span: 25 yrs
Length: 1.5-8 m
Proglots: 7-13 lateral branches

106
Q

Diphyllobothrium latum - Intermediate host, life span, worm length, proglottid morphology

A

Int host: Fish, copopods
Life span: 25 yrs
Length: 4-10 m
Proglots: width greater than length, rosette shaped central uterus

107
Q

Hymenolepsis nana - Intermediate host, life span, worm length, proglottid morphology

A

Int host: Arthropods
Life span: multiple years
Length: 2.5-4 cm
Proglots: rare, Dx eggs in stool

108
Q

Hymenolepsis diminuta - Intermediate host, life span, worm length, proglottid morphology

A

Int host: Arthropods
Life span: <1 yr
Length: 20-60 cm
Proglots: rare, Dx eggs in stool

109
Q

Echinococcus granulosis - Types of disease

A

Cystic disease, hydatid disease

110
Q

Echinococcus multilocularis - Types of disease

A

Alveolar disease, hydatid diease

111
Q

What is the major clinical concern for patients suspected of having Echinococcus?

A

Anaphylactic shock or dissemination

112
Q

Parasites that do NOT cause eosinophilia?

A

Leishmania
Plasmodium
Trypansosoma

113
Q

Amblyomma americanum (Lone Star Tick) vector - pathogens and diseases

A

E. chaffeensis and E. ewingii (Erlichiosis)
F. tularensis (Tularemia)
Unknown (STARI)

114
Q

Ornithodoros (Soft Ticks) vector - pathogens and diseases

A

Borrelia species (Endemic relapsing fever)

115
Q

Ixodes scapularis (Deer Tick) vector - pathogens and diseases

A

B. microti (Babesia)
B. burgdorferi (Lyme)
A. phagocytophilum (Anaplasmosis)
Powassan virus (Powassan disease)

116
Q

Dermacentor variabilis (American Dog Tick) vector - pathogens and diseases

A

F. tularensis (Tularemia)

R. rickettsii (RMSF)

117
Q

Lice vector - pathogens and diseases

A 
R. prowazekii (Epidemic typhus)
R. quintana (Trench fever)
Borellia recurrentis (Epidemic relapsing fever)
118
Q

Flea vector - pathogens and diseases

A

Y. pestis (Plague)

R. typhi (Murine/Endemic typhus)

119
Q

Anopheles vector - pathogens and diseases

A

Plasmodium sp. (Malaria)

120
Q

Aedes vector - pathogens and diseases

A

Flaviviruses (Dengue, Yellow fever)

121
Q

Mosquito vector - pathogens and diseases

A

Brugia, Wucheria (Filariasis)

122
Q

Midge vector - pathogens and diseases

A

Mansonella (Filariasis)

123
Q

Tse tse fly vector - pathogens and diseases

A

Trypansosoma brucei (African Sleeping Sickness)

124
Q

Black fly vector - pathogens and diseases

A

Onchocerca volvulus (Onchocerciasis)

125
Q

Deer fly vector - pathogens and diseases

A

Loa loa (filariasis, eye worm)

126
Q

Fly vector - pathogens and diseases

A

F. tularensis (Tuleremia)

127
Q

Sandfly vector - pathogens and diseases

A

Leishmania sp (Leishmaniasis)

128
Q

Reduvid bug vector - pathogens and diseases

A

Trypanosoma cruzi (Chaga’s disease)

129
Q

Parasites identified in erythrocytes

A

Plasmodium

Babesia

130
Q

Parasites identified in leukocytes

A

Leishmania

Toxoplasma

131
Q

Parasites identified in whole blood

A

Trypanosomes

Microfilariae

132
Q

Parasites identified in bone marrow

A

Leishmania
Plasmodium
Microfilariae

133
Q

Parasites identified in CNS

A 
T. solium
Echinococcus
Naeglaria
Achanthamoeba
Balmuthia
Toxoplasma
Trypanosoma
Microsporidia
134
Q

Parasites identified in cutaneous ulcers

A

Leishmania

Acanthamoeba

135
Q

Parasites identified in the GI tract

A 
Entamoeba
B. hominis
Giardia
D. fragilis
B. coli
Cryptosporidium
Cyclospora
Cystoisospera
Ascaria
E. vermicularis
T. trichuria
Hookworm
S. stercoralis
H. nana/diminuta
Clonorchis
Paragonimus
Schistosoma
136
Q

Parasites identified in liver/spleen

A

Echinococcus
E. histolytica
Leishmania

137
Q

Parasites identified in lungs

A 
Cryptosporidium
Echinococcus
Paragonimus
Toxoplasma
Helminth larvae
S. stercoralis
138
Q

Parasites identified in muscle

A

Trichinella
T. solium
Onchocerca
T. cruzi

139
Q

Parasites identified in urogenital specimens

A

S. haematobium
T. vaginalis
Microfilariae
Microsporidia

140
Q

Parasites identified in skin

A

Onchocerca
Leishmania
Microfilariae

141
Q

Parasites identified in ocular specimens

A

Acanthamoeba
Toxoplasma
Loa loa

142
Q

Parasites treated with Metronidazole

A

E. histolytica

Giradia lamblia

143
Q

Parasites treated with Albendazole

A 
Ancylostoma
Ascaris
E. vermicularis
Gnathostoma
Hookworm
Trichostrongylus
Taenia
Echinococcus
Filariasis
Microsporidium
144
Q

Parasites treated with Mebendazole

A

Angiostrongylus
Capillaria
Trichinella
T. trichuria

145
Q

Parasites treated with Ivermectin

A

S. stercoralis

Onchocerca

146
Q

Parasites treated with Praziquantel

A

Cestodes

Trematodes (not F. hepatica)

147
Q

Parasites treated with Chloroquine

A

Plasmodium

148
Q

Parasites treated with Tetracycline

A

B. coli

D. fragilis

149
Q

Parasites treated with Trim/Sulfa

A

Cyclospora

Cystoisospora

150
Q

Parasites treated with Ampho B

A

Amebic meningoencephalitis

151
Q

Parasites treated with Pentavalent animonial

A

Leishmania

152
Q

Parasites treated with Clindamycin

A

Babesia (plus quinine)

153
Q

Parasites treated with Niturtimox

154
Q

Parasites treated with Suramin

A

African trypanosoma

Parasites (4 decks)

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