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Basic Immunology- Module 1 > Leishmaniasis > Flashcards

Leishmaniasis Flashcards

1
Q

What is the vector for leishmania?

A

sandfly

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2
Q

What is the form of leishmania in sand fly?

A

promastigote

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3
Q

What is the form of leishmania in the cell?

A

amastigote

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4
Q

What is the main feature of promastigotes?

A

have a flagellum- can be cultures

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5
Q

Why amastigotes no longer motile?

A

have resorbed their flagellum

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6
Q

What is the appearance of sand flys?

A

small-3mm; hairy

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7
Q

What is the behaviour of sand flys?

A

hop aroudn before settling down to bite; attack is silent

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8
Q

What sex of sand fly feed on blood?

A

females

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9
Q

What are the resevoir hosts for leishamaniasis?

A

domestic dogs and wild animals e.g rodents; opossum

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10
Q

What are hte 2 main types of leishmaniasis disease?

A

cutaneous and visceral

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11
Q

What are hte forms of cutaneous leishmaniasis?

A

localised cutaneous; diffuse cutaneous; mucocutaneous

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12
Q

What does zoonotic mean?

A

transferred from animals to humans

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13
Q

What are the features of localised cutaneous leishmaniasis?

A

skin lesions of exposed body parts, often self healing, but can leave scars

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14
Q

Are patients after localised cutaneous leishmaniasis immune to reinfection?

A

yes

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15
Q

What are the features of diffuse cutaneous leishmaniasis?

A

disseminated lesions- multiple nodular, nonulcerating; resembles leprosy, difficult to treat, no spontaneous healing, frequent relapses

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16
Q

What are the features of mucocutaneous leishmaniasis?

A

disfiguring, destroys mucous membranes; no spontanous healing, relapses

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17
Q

What is visceral leishmaniasis characterised by?

A

irregular fever; weight loss; hepatosplenomegaly; anaemia

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18
Q

What is the main type of leishmaniasis causing diffuse cutaneous leishmaniasis?

A

L.aethiopica

19
Q

What is the main organism involved in mucocutaneosu leishmaniasis?

A

L.braziliensis

20
Q

Where is mucocutaneous vs mucosal leishmaniasis foudn in the world?

A

mucocutaneous- s.america vs mucosal-africa

21
Q

Why is diagnosis of CL difficult?

A

no serological tests; scraping of lesion to stain and look for amastigotes requires a lot of skill

22
Q

When is treatment withheld in CL?

A

<2 lesions; <5cm awat from the nose/mouth

23
Q

What are hte local treatments for CL?

A

intra-lesional injection of sodium stibogluconate; cryotherapy; thermotherapy

24
Q

When would systemic drugs be given for CL?

A

usually in HIV+ patietns

25
Q

what is the systemic tx for CL?

A

SSG and paramomycin

26
Q

What other name is given to visceral leishmaniasis?

A

black fever

27
Q

What is the prognosis of VL?

A

fatal if untreatmed

28
Q

What are the risk factors for developing clinical VL?

A

malnutrition; immunosuppression; HIV

29
Q

How is VL diagnosed?

A

serological tests- immunochromatographic strip trest with blood or direct agglutination test ( can give titre)

30
Q

What is teh problem with the serological tests available for VL?

A

doesn’t differentiate between past and present infections or symptomatic vs asymptomatic infection

31
Q

What is the parasitological diangostic test of VL?

A

using bone marrow or splenic aspirates

32
Q

What is first line tx of VL?

A

SSG and paramomycin

33
Q

What is the best treatment for VL but is expensive?

A

liposomal amphotericin B

34
Q

What is the principal cause of death in VL patients?

A

diarrhoea

35
Q

What is the commonest comorbidity in VL?

A

pneumonia

36
Q

What can happen after VL?

A

develop post Kala-azar dermal L

37
Q

What is PKDL?

A

nodular lesions on face around mouth which can spread to trunk and limbs

38
Q

What is the problem with HIV and leishmania?

A

accelerates onset of AIDS and can reactivate; treatments are less effective ( become less effective with each relapse until unresponsive)

39
Q

What happens once promastigotes are phagocytosed by macropahges?

A

change to amastigotes; multiply filling the cytoplasm and then the cell bursts

40
Q

What is a feature of the sand fly bite that helps leishmania infection?

A

saliva of sand fly is proinflammatory and chemoattract phagocytes

41
Q

How is complement good/bad for leishmania?

A

complement lysis will eliminate the parasite whereas opsonisation promotes parasite uptake favouring infection

42
Q

How does leishmania avoid complement lysis?

A

lipophosphoglycan coat- which also induces complement activation

43
Q

What protects parasites from ROS and RNS?

A

lipophophoglycan coat; interferes with production of ROS nad RNS

44
Q

What is the significance of leishmania in research defining the Th1/Th2 cell polarisation?

A

L.major murine infection was used to define that model

Basic Immunology- Module 1 (31 decks)

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