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ABBEY MSII U6 > Micro parasitic infections of GI > Flashcards

Micro parasitic infections of GI Flashcards

1
Q

who does giardiasis infect?

A

beavers, raccoons
high risk = infants, young children, international adoptees, travelers, immunocompromised, hypochlorhydria or cystic fibrosis

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2
Q

describe the life cycle of giardia

A

cysts are the infectious form (survive in moist environments for prolonged periods) –> transmitted via water, food, fecal-oral –> ingestion of 10-25 cysts leads to giardiasis –> following ingestion, excystation occurs in proximal small bowel with release of trophozoites

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3
Q

what are the clinical manisfestations of giardia?

A

50-65% asymptomatic.
35-45% symptomatic with prolonged duration of diarrhea, weight loss 10 pounds, malaise, abdominal cramps/bloating, FLATULENCE, nausea, STEATORRHEA

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4
Q

what is the incubation period of giardiasis?

A

1-2 weeks

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5
Q

what is giardia?

A

protozoal parasite (single celled organism)

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6
Q

what are the symptoms of chronic giardiasis?

A

loos stools (not diarrhea), steatorrhea, profound weight loss, malabsorption, malaise, abdominal cramping, borborygmi, flatulence, burping, fatigue, depression (basically same but wax and waning of symptoms)

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7
Q

diagnosis of giardia

A

stool examination for ova and parasites looking for trophozoites or cysts
ALSO detection of giardia specific antigen (GSA-65) through ELISA or immunochromatic assays

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8
Q

treatment of giardiasis

A

tinidazole (like metronidazole)

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9
Q

what is cryptosporidiosis?

A

an intracellular protozoan parasite that is associated with self-limited diarrhea in immunocompetent hosts, persistent diarrhea in children in developing countries, and chronic diarrhea in immunocompromised

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10
Q

what is cryptosporidiosis associated with?

A

unfiltered well water

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11
Q

how does transmission of cryptosporidium occur?

A

fecally passed oocysts (immediately infectious)

although mainly through contact with contaminated water (through run off of manure especially - also swimming pools)

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12
Q

what are cryptosprodium oocytes resistant to?

A

chlorine

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13
Q

clinical manifestations of cryptosporidium

A

incubation 7-10 days - can have asymptomatic, mild diarrhea, or severe enteritis
diarrhea as associated malaise, nausea, anorexia, crampy abdominal pain, low fever

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14
Q

cryptosporidium treatment

A

usually resolves without therapy in 10-14 days - difficult to treat if becomes chronic

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15
Q

cryptosporidiosis diagnosis

A

microscopy or enzyme immunoasays - may be present in stool, duodenal aspirates, bile secretions

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16
Q

what does entamoeba histolytica cause?

A

intestinal amebiasis - usually asymptomatic but can cause amebic dysentery and extraintestinal disease (amebic liver abscess)

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17
Q

what are the forms of entamoeba histolytica

A

single celled protazoa with two forms: cyst stage (infective) and trophozoite (invasive disease)

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18
Q

entamoeba histolytica ID

A

one cysts is sufficient to cause disease

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19
Q

clinical manisfestations of entamoeba histolytica. what are they due to?

A

tissue destruction (abdominal pain) , increased intestinal secretion, bloody diarrhea due to trophozoites invading and penetrating the mucous barrier of the colon

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20
Q

entamoeba histolytica transmission

A

ingestion of amebic cysts via contaminated food or water also associated with venereal transmission via fecal-oral

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21
Q

treatment of entamoeba histolytica

A

ALL should be treated (prevent spread) - 10 day course of metronidazole eliminates intraluminal infection - usually need second agent

22
Q

what are the intestinal cestodes (tapeworms)? which are humans definitive hosts for? intermediate hosts?

A 
taenia solium (pork tapeworm) - exception - usually only definitive of intermediate - this one could be either
taenia saginata (beef tapeworm) - definitive 
diphyllobothrium latum (fish tapeworm) - definitive
23
Q

taenia solium - stage that infects humans and stage most associated with disease

A

infects: larval cysts in nundercooked pork; eggs in food or water contaminated with human feces
disease: adult tapeworm in intestine; cysticerus especially in brain

24
Q

taenia saginata - stage that infects humans and stage most associated with disease

A

infects: larval cysts in undercooked beef (usual intermediate host)
disease: adult tapeworm in intestine

25
Q

diphyllobothrium latum - stage that infects humans and stage most associated with disease

A

infects: larvae in undercooked fish
disease: adult tapeworm in intestine can cause vit B12 deficiency

26
Q

what is cysticercosis? which parasite is it associated with?

A

A tapeworm infection that affects the brain (seizures), muscle, and other tissues (when serving as an intermediate host) - associated with taenia solium

27
Q

what are areas of t. solium infection?

A

mexico, c america, s america, africa, se asia, india, philippines, s europe

28
Q

clinical presentation t solium

A

generally asymptomatic unless cysticercosis caused by autoinfection with parasite eggs supervenes

29
Q

how is t solium infection diagnosed?

A

detecting eggs during stool examination

30
Q

t solium cysticerci transmission

A

fecal oral - eggs shed in stool of a human tapeworm carrier

31
Q

clinical features of taenia saginata

A

LARGE tapeworms that cause mild abdominal cramps or malaise - can sometimes migrate out of anus and be motile in poo or on clothing

32
Q

diphyllobothrium latum clinical manistestations

A

normally asymptomatic - some feel weakness, dizziness, salt craving, diarrhea. since the worm can live 30+ years, some develop macrocytic anemia after 3-4 years

33
Q

what are the GI nematodes (roundworms)

A 
enterobius (pinworm)
trichuris (whipworm)
ascaris (giant roundworm) 
necator and ancylostoma (two hookworms)
strongyloides (small roundworm)
34
Q

what are the MC human parasites?

A

nematodes

35
Q

ascaris lumbircoides: transmission; person to person?; geographic distribution; duration of infection; location of adult worm

A

transmission: ingestion of infective eggs
person to person?: NO
geographic distribution: warm, humid ares and temperate zones in warmer months
duration of infection: 1-2 yrs
location of adult worm: free in lumen of small bowl esp jejunum

36
Q

trichuris trichiura (whipworm): transmission; person to person?; geographic distribution; duration of infection; location of adult worm

A

transmission: ingestion of infective eggs
person to person?: NO
geographic distribution: warm, humid areas and temperate zones in warmer months
duration of infection: 1-3 yrs
location of adult worm: anchored in superficial mucosa of cecum and colon

37
Q

necator americanus, ancylostoma duodenale (hookworms): transmission; person to person?; geographic distribution; duration of infection; location of adult worm

A

transmission: penetration of skin by flariform larvae
person to person?: NO
geographic distribution: warm, humid areas and temperate zones in warmer months
duration of infection: 3-5 yrs (necator) and 1 yr (ancylostoma)
location of adult worm: attached to mucosa of mid to upper portion of small bowel

38
Q

strongyloides stercoralis: transmission; person to person?; geographic distribution; duration of infection; location of adult worm

A

transmission: penetration of skin or bowel mucosa by flariform larvae
person to person?: YES
geographic distribution: primary warm humid areas, can be worldwide
duration of infection: lifetime of host
location of adult worm: embedded in mucosa of duodenum, jejunum

39
Q

enterobius vermicularis (pinworm) transmission; person to person?; geographic distribution; duration of infection; location of adult worm

A

transmission: ingestion of infective eggs
person to person?: YES
geographic distribution: worldwide
duration of infection: 1 month
location of adult worm: free in lumen of cecum, appendix, adjacent colon

40
Q

what is the MC helminthic infection of humans (1/4 world population)? what does it look like?

A

ascariasis - a white or pinish adult worm that lives and mates in the lumen of the small intestine - primarily jejunum

41
Q

ascaris lumbricoides clinical syndrome

A

most asymptomatic - small proportion get pulmonary symptoms during second week after ingestion when larvae invade lung tissue and provoke and immune-mediated hypersensitivity response with nonproductive cough, chest discomfort, fever, eosinophilia (disappear when worm reaches maturity)

42
Q

ascaris lumbricoides complications

A

intestinal obstruction, obstruction of bile and pancreatic ducts, appendicitis, intestinal perforation

43
Q

ascaris lifecycle

A

live in lumen of small bowel - female produces egs which are passed with feces - unfertifilized eggs may be ingested by not infective. infective eggs swallowed, invade intestinal mucosa when hatched then carried via circulation to lungs - penetrate alvelors walls and ascend bronchial tree, swallowed in throat - develop into adult worms in small intestine

44
Q

enterobiasis vermicularis (pinworm) lifecycle

A

small white worm (1cm) inhbaiting cecum, appendix, adjacent gut - female worms migrate at night to the perianal and perineal regions where they deposit eggs and die
MC mode transmission via hands of patients through scratching or handling clothes/bed linen

45
Q

enterobiasis vermicularis clinical

A

symptoms d/t perianal and perineal pruritus and scratching

46
Q

enterobiasis vermicularis diagnosis

A

paddle test and microscopic exam

47
Q

hookworm (ancylostoma duodenale and necator americanus) clinical syndrome

A

iron-deficiency anemia and protein energy malnutrition resulting from bloodloss

48
Q

hookworm infection

A

immature larvae penetrated skin (feet) and then migrate to lung - coughed up and swallowed

49
Q

strongyloidiasis places found

A

SE US, europe, australia, japan

50
Q

strongyloidiasis clinical syndromes

A

fluctuating eosinophilia or asymptomatic

some develop maculopapular or urticarial rashes that involve butt, perineum, thighs

51
Q

hyperinfection

A

happens in immunodeficiency with massive diseemination of larvae to lungs, liver, heart, CNS, endocrine glands

ABBEY MSII U6 (18 decks)

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