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CMBM Exam 4 Gopi > Medical Parasitology > Flashcards

Medical Parasitology Flashcards

0
Q

cyst

A

passed in feces
resistant
infective

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1
Q

schizogony

A

multiple division of the nucleus occur before cell division

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2
Q

trophozoite

A

feeding
motile
replication

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3
Q

Entamoeba Histolytica

A

only pathogenic amoeba
infects about 10% of worlds population
leads to invasive amoebiasis
cysts in contaminated water

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4
Q

Entamoeba trophozoite

A

active stage exists only in the host and in fresh feces

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5
Q

Entamoeba structure

A

contain single nucleus with ingested RBCs

has 4 nuclei (in stool)

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6
Q

Clinical signs of Entamoeba Histolytica

A

asymptomatic carriers
Colitis & ulcer formation - gradual onset of abdominal pain, watery stools with mucus and blood, fever is uncommon, formation of “tear-drop, flask shaped ulcers”

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7
Q

Extra intestinal infection of Entamoeba histolytica

A

Hepatic, pulmonary, CNS
Hepatic amoebiasis is more common
RUQ pain and fever
Rupture is an emergency

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8
Q

Treat Entamoeba with …

A

Metronidazole

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9
Q

Giardia lamblia

A

found world wide
reported in daycare centers, prisons
Single cells protozoa with four pairs of flagella
Cyst in feces

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10
Q

Giardia Lamblia Trophozoite

A 
Pear-shaped 
2 prominent nuclei 
ventral sucking disk -> adhesion 
4 pairs of flagella 
Diagnosis with string test
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11
Q

Clinical signs of Giardia Lamblia

A

coats the distal villi -> malabsorption (no invasion)
Pts with IgA deficiency are predisposed to symptomatic infection
Called Giradiasis
watery, foul smelling diarrhea, nausea, weight loss, cramps and flatulence, low grade fever, abdominal destintion
Disaccharidase deficiency leads to lactose intolerance
Dehydration can be life threatening

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12
Q

Treat Giradiasis with?

A

Metronidazole

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13
Q

Cryptosporidium Parvum

A

associated with gastrointestinal protozoa associated with diarrhea in immunocompromised
10-100 Oocytes may cause infecttion
High resistance to chlorine -> associated with public swimming pools

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14
Q

Cryptosporidosis in Immunocompetent

A

mild self limiting enterocolitis
-watery, bloodless diarrhea, abdominal pain, nausea, vomiting and fever
Spontaneous remission is common

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15
Q

Cryptosoporidosis in the Immunocompromised

A

50 or more stools a day
dehydration - fatigue, abdominal, cramping and nausea
lasts months to years
common in AIDS patients

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16
Q

Apicomplexa

A

isospora belli
cyclospora cayetanensis
toxoplasma gondii

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17
Q

Toxoplasma gondii

A

definitive host: domestic cats
infected from eating rodents
Oocytes in feces - only shed by cats

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18
Q

Tachyzoites

A

Toxoplasma gondii

asexual tissue cycle -> motile, disease producing phase

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19
Q

Bradyzoites toxoplasma

A

non motile “slow” phase in tissue cyst

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20
Q

Clinical signs of Toxoplasma gondii

A

infection is asymptomatic in immunocompetent pt

Immunodeficient pt - focal neurological deficits, retinochoroiditis, or pneumonitis

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21
Q

Congenital Toxoplasmosis

A

30-40% transplacental if mother is infected during pregnancy
60% of infected newborns are asymptomatic but later show chorioretinitis
affected infants may have hydrocephalus, hepatosplenomegaly, jaundice, fever, anemia, pneumonia

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22
Q

MRI of brain in Toxoplasma gondii

A

would see multiple ring enhancing lesions

presented with clumsiness and tested HIV positive

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23
Q

treat Toxoplasma with

A

Pyramethamine
sulfonamides/sulfadiazine for AIDS
no treatment needed for healthy patients

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24
Q

Trypanosoma Cruzi

A

in rural and poor areas of central and south america

Transmitted by Reduvlid (Kissing Bug) bite

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25
Q

Chagoma

A

when trypanosoma cruzi invade macrophages causing inflammation at the site of infection

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26
Q

Romana’s sign

A

painless perorbital swelling

seen with Trypanosoma cruzi

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27
Q

Chaga’s disease

A

caused by trypanosoma
acute phase: asymptomatic - headache, fatigue, mild fever
Chronic symptoms - 2/3 pts with dilated cardiomyopathies
1/3 present with Megacolon and Megaesophagus - loss of innervation, keeps dilating and can lead to toxic megacolon
parasite damages neural cells of autonomic nervous system in intestines and heart

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28
Q

Treat trypanosoma with

A

Nifurtimox, ketoconazole

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29
Q

Trypanosoma bruci

A

sub saharan africa
transmitted by The Glossina Fly - Tse Tse fly
local inflammation at site of infection with swelling of lymph nodes

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30
Q

Winterbottom’s sign

A

enlargement of lymph specially cervical lymph nodes in trypanosoma bruci infection

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31
Q

Clinical signs of Trypanosoma Bruci

A

Also called African Sleeping sickness
can cross the blood brain barrier resulting in CNS involvement
Tremors of tongue and eyelids
Mental dullness and progressive apathy
Neurological symptoms
loss of appetite, extended day time sleeping, paralysis
anemia, irreversible coma

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32
Q

African sleeping sickness

A

Confusion
Somnolence
includes loss of appetite, extended daytime sleeping, paralysis, rapid weight loss, anemia, and eventually irreversible coma

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33
Q

Treat Trypanosoma bruci with?

A

Suramin

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34
Q

Leishmania

A 
donovani - visceral 
Tropica - cutaneous 
major - cutaneous 
aethiopica - cutaneous 
mexicana - cutaneous 
Brazilliensis - mucocutaneous
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35
Q

Sand fly

A

transmits Leishmania
parasite has Ferris wheel appearance
Inside Macrophages

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36
Q

Cutaneous Leishmaniasis

A

most common form
relatively benign self-healing skin lesions
localized or simple CL

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37
Q

Mucocutaneous Leishmaniasis

A

simple skin lesions that metastasize to mucosae - especially around nose and mouth region

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38
Q

Visceral Leishmaniasis

A

pretty bad
Black Death - “Kala Azar” fever -> skin, lymph, bone marrow, spleen and liver involvement
Generalized infection of reticuloendothelial system, hepatosplenomegaly, high mortalitty

39
Q

Treat Visceral Leishmanisis with

A

Sodium Stibogluconate is DOC

Pentamidine - works on many organisms

40
Q

Helmenths - Cestodes

A 
Segmented plane 
No body cavity 
No digestive tube 
Hermaphroditic 
Oral sucker, botridias, and double rostellar hooks
41
Q

Helmenths - Trematodes

A 
Unsegmented plane 
No body cavity 
Digestive tube ends in cecum 
Hermaphroditic except schistosoma which are dioecious 
Oral sucker and ventral sucker
42
Q

Helmenths - Nematodes

A 
cylindrical 
Has body cavity 
Digestive tube ends in anus 
Dioecious 
Lips, teeth, filariform, extremeties and dentary plates
43
Q

Cestodes - Tapeworms

A 
scolex - head 
segmented body - proglottids 
suckers 
Monecieous - each segment female and male 
Eosionphilla from increase in IL5
44
Q

Taenia Saginata - Beef tapeworm

A 
can be up to 25 m 
scolex with 4 suckers 
NO hooks 
in undercooked meat
usually asymptomatic in humans - host only adult worms
45
Q

Treatment of Taenia sagniata

A

Praziquantel

Albendazole

46
Q

Taenia Solium - Pork tapeworm

A

from raw or uncooked pork
scolex with 4 suckers and circle of hooklets (rostullum)
Humans are definitive or intermediate host
possibly get to stomach by reverse peristalsis

47
Q

Clinical signs of Taenia Solium

A

adults rarely cause symptoms
Larvae penetrate intestine, enter blood, and eventually encyst in the brain
Hydrocephalus, motor spasms, paraplegia, loss of vision
Chronic meningitis
seizures

48
Q

Treat Taenia Solium

A

Complex and controversial

Praziquantel and albendazole may kill cysts but death of larvae can increase inflammation, edema and exacerbate symptoms

49
Q

Diphyllobothrium Latum

A 
Fish tapeworm 
yellow with dark markings 
3-15m and lives 5 to 15 years 
Scolex has 2 sucking grooves 
Definitive host: Humans and dogs 
Transmitted through raw, uncooked fish
50
Q

Clinical signs of Diphyllobothrium Latum

A

usually asymptomatic - abdominal discomfort and cramping
Cycles of diarrhea and constipation
Increases B12 excretion/decreases uptake which leads to megaloblastic anemia - pallor, numbness, fatigue

51
Q

Treat Diphyllobothrium Latum?

A

Praziquantel
Avoid undercooked fish
Freezing fish

52
Q

Echinococcus granulosus

A

Dog tapeworm
Scolex with 3 proglottids
Rostulum, 4 suckers
2 raws of hooks

53
Q

Pathology of Echinococcus Granulosus

A 
Hydatid cysts 
Larval cyst develops within organs of intermediate host 
usually cysts in the liver 
Alveolar cysts caused by Fox tapeworm 
symptoms when cyst is 8-10 cm
54
Q

Clinical signs of Echinococcus granulosus

A

Cysts usually in liver - compresses vital structures
erode into billiary tract of bronchus
cysts can become superinfected
leakage or rupture can results in anaphylactic reaction -> Fever, hypotension

55
Q

Hymenolepsis nana

A

Dwarf tapeworm
Only tape worm that completes cycle in host
Most common tapeworm in US
Direct trans: ingestion of eggs that hatch in duodenum
Indirect: ingest infected arthropod

56
Q

Hymenolepsis Nana symptoms

A

immune response
headache
Pruritus

57
Q

Treat Hymenolepsis nana with?

A

Praziqantel

58
Q

Nematodes

A 
round worms 
unsegmented 
bilaterally symmetric 
Body surrounded by cuticle 
Triploblastic - fluid filled cavity, Psuedocoelom, Hydrostatic skeleton 
Complete digestive track 
Can be free living 
Dioecious- male is smaller with bent tail ( bursa)
59
Q

Ascaris Lumbricoides

A

one of largest and most common in world
soil contaminated with human feces
Females can make 200,000 eggs/day
ingest eggs from uncooked meat

60
Q

Pathogenesis of Ascaris Lumbricoides

A

ingest food or water contaminated with eggs
hatch in small intestines and release larvae
penetrate intestinal wall and enter portal circulation
go from liver to heart to lungs
from lung to trachea and coughed and swallowed
back to intestines to mature and mate

61
Q

Clinical signs of Ascaris Lumbricoides

A

During migration -> Hemorrhagic/eosinophilic pneumonia, cough
Intestinal obstruction can lead to rupture
Parasite proteins cause Asthma, urticaria (hives)

62
Q

Loeffler’s Syndrome

A

Hemorrhagic/eosinoophilic pneumonia and cough

seen with Ascaris Lumbricoides

63
Q

Ancylostoma

A

Hook worm
common in warm, humid climate
curved anterior end
mouths have large plates to cut through intestine wall

64
Q

Ancylostoma duodenale pathogenesis

A

Larva can penetrate skin - walking barefoot
attaches to GI mucosa causing blood and fluid loss
Microcyti hypochromic Iron deficiency anemia
Pot-belly and finger clubbing
Pica
Black stool

65
Q

Enterobius Vermicularis

A 
Pinwormq
only infect humans 
inhabit colon 
migrate to perianal region to lay eggs 
Reinfection due to scratching
66
Q

Dx Enterobius Vermicularis

A

Scotch tape test
place scotch on perianal region at night
have Dr. check it out for eggs

67
Q

Microcytic hypochromic Iron deficiency anemia

A

Ancylostoma duodenale

68
Q

Clinical sign of Enterobius Vermicularis

A

Pruritus ani or Perianal itching

69
Q

Treat Enterobius Vermicularis

A

Albendazole kills adults

70
Q

Anisakis

A

Infection due to ingestion of raw saltwater seafood

71
Q

Symptoms of Anisakis

A

Gastroenteritis
Eosinophilia
Presence of occult blood in stool

72
Q

Trichuris Trichiura

A

Whipworm
soil contaminated with human feces
inhabit the cecum and large intestines
Heavy infection causes Tenesmus (urge to defecate), malnutrition, diarrhea, no anemia

73
Q

Severe case of Trichuris Trichiura

A

Prolapse of rectum

74
Q

Strongyloides Strocrailis

A

uncommon in US
tropical areas - caribbean and Africa
Infection through ingestion or larval penetration of skin
Dx. larva in stool, No eggs

75
Q

Clinical signs of Strongyloides strocrailis

A

Itching, blotching, wheezing (eosinophilic pneumonia)
diarrhea
weight loss

76
Q

Trichinella spiralis

A

ingest cysts in undercooked pork (or beat meat)
In US, mainly in pigs
Dx. Encysted larva in striated muscle (adults in intestines)

77
Q

Clinical signs of Trichinosis

A

Gastroenteritis, fever, muscle pain,

Periorbital edema, eosinophilia

78
Q

Treat Trichinella Spiralis

A

Thiabendazole

79
Q

Filarial Nematodes

A

invades the lymphatics

80
Q

Wuchereria Bancrofti

A

tropics with wide spread infection

transmitted by Female Anopheles mosquito bite

81
Q

Filarisasis

A

seen in Wuchereria Bancrofti

obstruction of lymphatics leads to Edema, lymphangitis, cellulites

82
Q

Elephantiasis

A

seen with Wuchereria bancrofti

results from chronic and repeated infection

83
Q

Clinical signs of Wuchereria Bancrofti?

A 
asymptomatic 
Inflammation leads to fever 
chronic - lymphangitis, lymphadenitis, elephantiasis 
Tropical pulmonary eosinophilia 
chylura - microfilariae in urine
84
Q

Treat Wuchereria Bancrofti with

A

Diethycarbamazine and Ivermectin effect against micrfilariae
Albendazole effective against adult
steroids
surgery

85
Q

Oncocerca Volvulus

A

common in africa and central america

transmitted by female “Blackfly”

86
Q

Clinical signs of Oconcerca volvulus

A

causes subcutaneous inflammation and pruritus

microfilariage migrate to eyes leads to Blindness “River blindness”

87
Q

Treat Oncocerca Volvulus with?

A

Ivermecttin

88
Q

Dracunculus Medinensis

A

Guinea Fire Worm disease
Transmitted by drinking water inhabited by small crustaceans
only in Africa
Worm is removed by curling on a stick over a period of days

89
Q

Trematodes

A

Billiary (liver) Flukes
Enteric Flukes
Lung Flukes
Blood Flukes

90
Q

Trematodes

A

Dorso-ventrally flattened
unsegmented, leaf like
Snail are always an intermediate host
hermaphroditic except blood flukes
two radially striated suckers - oral and ventral
incomplete digestive tract
most of body is occupied by reproductive organs

91
Q

Fasciola Hepatica

A

sheep liver fluke
lives in bile duct of sheep
Prominent cephalic cone
small oral and ventral suckers
Eggs hatch and miracidium in water penetrates snails
Free swimming Cercariae are released and collect on plants ingested by humans

92
Q

Clinical signs of Fasciola Hepatica

A

Gallstones
Biliary obstruction
Elevated blood bilirubin
cirrhosis if not treated

93
Q

Clonocrchis Sinensis

A

true hermaphroditic
adult worms in intrahepatic bile ducts
transmitted by ingestion of undercooked fish
Snails first intermediate host
ingest eggs which hatch into free swimming cercariae
these form cysts under scales of fish - second intermediate host

94
Q

Clinical signs of Clonocrchis Sinensis

A

RUQ pain
Jaundice from blockage of biliary tree
Hepatomegaly
complication: adenomatous hyperplasia leading to choangiocarcinoma

95
Q

Paragonimus westermani

A

most encountered in Asia but all over the world
Egg has operculum
Adults are encapsulated in a granuloma, TB signs
When cyst rupture leads to coughing and chest pain

96
Q

Cerebral paragonimiasis

A 
headaches 
fever 
nausea
visual disturbances 
convulsive seizures

CMBM Exam 4 Gopi (10 decks)

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