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CMBM Exam 4 Gopi > Medical Parasitology > Flashcards

Medical Parasitology Flashcards

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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
Trypanosoma Cruzi
in rural and poor areas of central and south america | Transmitted by Reduvlid (Kissing Bug) bite
25
Chagoma
when trypanosoma cruzi invade macrophages causing inflammation at the site of infection
26
Romana's sign
painless perorbital swelling | seen with Trypanosoma cruzi
27
Chaga's disease
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
28
Treat trypanosoma with
Nifurtimox, ketoconazole
29
Trypanosoma bruci
sub saharan africa transmitted by The Glossina Fly - Tse Tse fly local inflammation at site of infection with swelling of lymph nodes
30
Winterbottom's sign
enlargement of lymph specially cervical lymph nodes in trypanosoma bruci infection
31
Clinical signs of Trypanosoma Bruci
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
32
African sleeping sickness
Confusion Somnolence includes loss of appetite, extended daytime sleeping, paralysis, rapid weight loss, anemia, and eventually irreversible coma
33
Treat Trypanosoma bruci with?
Suramin
34
Leishmania
``` donovani - visceral Tropica - cutaneous major - cutaneous aethiopica - cutaneous mexicana - cutaneous Brazilliensis - mucocutaneous ```
35
Sand fly
transmits Leishmania parasite has Ferris wheel appearance Inside Macrophages
36
Cutaneous Leishmaniasis
most common form relatively benign self-healing skin lesions localized or simple CL
37
Mucocutaneous Leishmaniasis
simple skin lesions that metastasize to mucosae - especially around nose and mouth region
38
Visceral Leishmaniasis
pretty bad Black Death - "Kala Azar" fever -> skin, lymph, bone marrow, spleen and liver involvement Generalized infection of reticuloendothelial system, hepatosplenomegaly, high mortalitty
39
Treat Visceral Leishmanisis with
Sodium Stibogluconate is DOC | Pentamidine - works on many organisms
40
Helmenths - Cestodes
``` Segmented plane No body cavity No digestive tube Hermaphroditic Oral sucker, botridias, and double rostellar hooks ```
41
Helmenths - Trematodes
``` Unsegmented plane No body cavity Digestive tube ends in cecum Hermaphroditic except schistosoma which are dioecious Oral sucker and ventral sucker ```
42
Helmenths - Nematodes
``` cylindrical Has body cavity Digestive tube ends in anus Dioecious Lips, teeth, filariform, extremeties and dentary plates ```
43
Cestodes - Tapeworms
``` scolex - head segmented body - proglottids suckers Monecieous - each segment female and male Eosionphilla from increase in IL5 ```
44
Taenia Saginata - Beef tapeworm
``` can be up to 25 m scolex with 4 suckers NO hooks in undercooked meat usually asymptomatic in humans - host only adult worms ```
45
Treatment of Taenia sagniata
Praziquantel | Albendazole
46
Taenia Solium - Pork tapeworm
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
Clinical signs of Taenia Solium
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
Treat Taenia Solium
Complex and controversial | Praziquantel and albendazole may kill cysts but death of larvae can increase inflammation, edema and exacerbate symptoms
49
Diphyllobothrium Latum
``` 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
Clinical signs of Diphyllobothrium Latum
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
Treat Diphyllobothrium Latum?
Praziquantel Avoid undercooked fish Freezing fish
52
Echinococcus granulosus
Dog tapeworm Scolex with 3 proglottids Rostulum, 4 suckers 2 raws of hooks
53
Pathology of Echinococcus Granulosus
``` 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
Clinical signs of Echinococcus granulosus
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
Hymenolepsis nana
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
Hymenolepsis Nana symptoms
immune response headache Pruritus
57
Treat Hymenolepsis nana with?
Praziqantel
58
Nematodes
``` 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
Ascaris Lumbricoides
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
Pathogenesis of Ascaris Lumbricoides
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
Clinical signs of Ascaris Lumbricoides
During migration -> Hemorrhagic/eosinophilic pneumonia, cough Intestinal obstruction can lead to rupture Parasite proteins cause Asthma, urticaria (hives)
62
Loeffler's Syndrome
Hemorrhagic/eosinoophilic pneumonia and cough | seen with Ascaris Lumbricoides
63
Ancylostoma
Hook worm common in warm, humid climate curved anterior end mouths have large plates to cut through intestine wall
64
Ancylostoma duodenale pathogenesis
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
Enterobius Vermicularis
``` Pinwormq only infect humans inhabit colon migrate to perianal region to lay eggs Reinfection due to scratching ```
66
Dx Enterobius Vermicularis
Scotch tape test place scotch on perianal region at night have Dr. check it out for eggs
67
Microcytic hypochromic Iron deficiency anemia
Ancylostoma duodenale
68
Clinical sign of Enterobius Vermicularis
Pruritus ani or Perianal itching
69
Treat Enterobius Vermicularis
Albendazole kills adults
70
Anisakis
Infection due to ingestion of raw saltwater seafood
71
Symptoms of Anisakis
Gastroenteritis Eosinophilia Presence of occult blood in stool
72
Trichuris Trichiura
Whipworm soil contaminated with human feces inhabit the cecum and large intestines Heavy infection causes Tenesmus (urge to defecate), malnutrition, diarrhea, no anemia
73
Severe case of Trichuris Trichiura
Prolapse of rectum
74
Strongyloides Strocrailis
uncommon in US tropical areas - caribbean and Africa Infection through ingestion or larval penetration of skin Dx. larva in stool, No eggs
75
Clinical signs of Strongyloides strocrailis
Itching, blotching, wheezing (eosinophilic pneumonia) diarrhea weight loss
76
Trichinella spiralis
ingest cysts in undercooked pork (or beat meat) In US, mainly in pigs Dx. Encysted larva in striated muscle (adults in intestines)
77
Clinical signs of Trichinosis
Gastroenteritis, fever, muscle pain, | Periorbital edema, eosinophilia
78
Treat Trichinella Spiralis
Thiabendazole
79
Filarial Nematodes
invades the lymphatics
80
Wuchereria Bancrofti
tropics with wide spread infection | transmitted by Female Anopheles mosquito bite
81
Filarisasis
seen in Wuchereria Bancrofti | obstruction of lymphatics leads to Edema, lymphangitis, cellulites
82
Elephantiasis
seen with Wuchereria bancrofti | results from chronic and repeated infection
83
Clinical signs of Wuchereria Bancrofti?
``` asymptomatic Inflammation leads to fever chronic - lymphangitis, lymphadenitis, elephantiasis Tropical pulmonary eosinophilia chylura - microfilariae in urine ```
84
Treat Wuchereria Bancrofti with
Diethycarbamazine and Ivermectin effect against micrfilariae Albendazole effective against adult steroids surgery
85
Oncocerca Volvulus
common in africa and central america | transmitted by female "Blackfly"
86
Clinical signs of Oconcerca volvulus
causes subcutaneous inflammation and pruritus | microfilariage migrate to eyes leads to Blindness "River blindness"
87
Treat Oncocerca Volvulus with?
Ivermecttin
88
Dracunculus Medinensis
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
Trematodes
Billiary (liver) Flukes Enteric Flukes Lung Flukes Blood Flukes
90
Trematodes
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
Fasciola Hepatica
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
Clinical signs of Fasciola Hepatica
Gallstones Biliary obstruction Elevated blood bilirubin cirrhosis if not treated
93
Clonocrchis Sinensis
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
Clinical signs of Clonocrchis Sinensis
RUQ pain Jaundice from blockage of biliary tree Hepatomegaly complication: adenomatous hyperplasia leading to choangiocarcinoma
95
Paragonimus westermani
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
Cerebral paragonimiasis
``` headaches fever nausea visual disturbances convulsive seizures ```

CMBM Exam 4 Gopi (10 decks)

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