Leishmaniasis

Question 1

Visceral leishmaniasis is caused by what strain?

Answer 1

Leishmania donovani

Question 2

What is visceral leishmaniasis known as in Northern India?

Answer 2

Kala azar

Question 3

Leishmania is transmitted from which animal?

Answer 3

Sandfly

Question 4

Visceral leishmaniasis is at which stage of pathogen evolution?

Answer 4

Stage 5 (anthroponotic)

Question 5

What is the life cycle of leishmania donovani?

Answer 5

Promastigote enters the dermis upon biting
Promastigote enters the macrophage and converts to amastigote
Macrophage cells migrate to other parts of the body
Sandfly takes blood meal and amastigotes from human

Question 6

At which stage of infection is cutaneous leishmaniasis found?

Answer 6

Stage 4 (zoonotic)

Question 7

What is the main reservoir for cutaneous leishmaniasis?

Answer 7

Rodents

Question 8

What are the strains that cause cutaneous leishmaniasis?

Answer 8

Leishmania major, leishmania mexicana, leishmania Braziliensis

Question 9

True or false: In cutaneous leishmaniasis, once the promastigotes enter the skin, they spread out and move to other parts of the body

Answer 9

False, they do not move to other parts of the body

Question 10

Mucocutaneous leishmaniasis affects which areas of the body?

Answer 10

Nose, mucus

Question 11

Which strain of leishmania found in Africa, South America and South Europe causes visceral leishmaniasis?

Answer 11

Leishmania infantum

Question 12

In which countries can leishmania donovani be found?

Answer 12

Sudan, Ethiopia, Bangladesh, Nepal, India

Question 13

What is the main reservoir of leishmania infantum?

Answer 13

Dog (zoonotic)

Question 14

Where can cutaneous leishamiansis be found?

Answer 14

Middle East, Africa, South America, Central America

Question 15

Which strain of leishmania causes mucocutaneous leishmaniasis?

Answer 15

Leishmania Braziliensis

Question 16

Where can mucocutaneous leishmaniasis be found?

Answer 16

Brazil, Peru, Colombia

Question 17

What is the main reservoir for mucocutaneous leishmaniasis?

Answer 17

Rodents (zoonotic)

Question 18

True or false: there are more cutaneous cases than visceral cases of leishmaniasis

Answer 18

True

Question 19

True or false: Visceral leishmaniasis in India has been contained in the same region for more than a century

Answer 19

True

Question 20

Place the steps of the development in the sandfly from amastigote to infective promastigote in the correct order
a. Metacyclic promastigote
b. Amastigote in the blood meal
c. Procyclic promastigote

Answer 20

b, c, a

Question 21

How many days does it take for amastigote to become infective promastigote?

Answer 21

6 days

Question 22

What structure helps the migration of the promastigote?

Answer 22

Flagella

Question 23

Which stage of amastigote development is infective once introduced into the human host?

Answer 23

Metacyclic stage

Question 24

Which immune cells do promastigotes infect?

Answer 24

Neutrophils and macrophages

Question 25

Associate the descriptions with either visceral or cutaneous leishmaniasis a. Promastigotes replicated in macrophages b. Amastigotes leave the skin and enter the macrophages of visceral organs

Answer 25

a. Cutaneous b. Visceral

Question 26

What is the domain of Leishmania?

Answer 26

Eukaryota

Question 27

What is the class of Leishmania?

Answer 27

Kinetoplastids

Question 28

What is the genus of Leishmania?

Answer 28

Leishmania or Trypanosome

Question 29

How many chromosomes does Leishmania have?

Answer 29

36

Question 30

True or false: Most Leishmania chromosomes are haploid

Answer 30

False, they are diploid

Question 31

True or false: Chromosomes are well conserved between Leishmania species

Answer 31

True

Question 32

Why does L. donovani cause cutaneous leishmaniasis in Sri lanka?

Answer 32

Host genetic differences: decreased susceptibility to visceral disease Parasitic genetic differences: decreased virulence for visceral infection

Question 33

How are hybrid Leishmania parasites formed?

Answer 33

Co-infected sandflies (bite an animal and a human simultaneously)

Question 34

True or false: Hybrids result in cutaneous Leishmaniasis in Sri Lanka

Answer 34

True

Question 35

What is a common treatment for visceral and cutanepus leishmaniasis?

Answer 35

Pentavalent antimony

Question 36

How is pentavalent antimony administered?

Answer 36

Intramuscular injection

Question 37

Which other drug is a used as treatment for Leishmaniasis?

Answer 37

Ambisome

Question 38

How is Ambisome administered?

Answer 38

Intravenous infusion

Question 39

What is the characteristic of post kala azar dermal leishmaniasis (PKDL)?

Answer 39

Moves to the skin after treatment, leaving patches

Question 40

True or false: Everyone that becomes infected gets the disease

Answer 40

False, there are asymptomatic healthy cases

Question 41

What activates the TH1 cell immune pathway?

Answer 41

TLR activation

Question 42

TH1 pathway corresponds to what response of the macrophage?

Answer 42

Macrophage activation leads to parasite killing

Question 43

TH2 pathway leads to what response from the macrophage?

Answer 43

No macrophage activation, the parasite survives

Question 44

What cytokine activates macrophages in TH1 pathway?

Answer 44

IFN-gamma

Question 45

What cytokine inactivates macrophages in TH2 pathway?

Answer 45

IL-4

Question 46

Imiquimod (IMQ) activates which TLRs in phagolysosomes?

Answer 46

TLR 7/8

Question 47

ssRNA is a natural ligand for which TLRs?

Answer 47

TLR 7/8

Question 48

What happens if IMQ is added to infected macrophages?

Answer 48

TH1 pathway is activated and works on the macrophages without cytokine release

Question 49

IMQ is used for which type of leishmaniasis?

Answer 49

Cutaneous

Question 50

IMQ topical cream works for what percent of affected patients?

Answer 50

30%

Question 51

IMQ increases the rate of cure when combined with which treatment?

Answer 51

Antimony

Question 52

Which TLR is now in clinical trial?

Answer 52

TLR 9

Question 53

What is the ligand for TLR 9?

Answer 53

CpG DNA