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Micro > Micro - Protozoa/Fungal DIT > Flashcards

Micro - Protozoa/Fungal DIT Flashcards

1
Q

acid fast fecal oocyte in AIDS

A

Cryptosporidium
- infects the brush border of the small intestine
Severe Diarrhea

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2
Q

Causes menigoencephalitis in healthy swimmer in fresh water

A

Naegleria fowleri

-enters cribiform plate

Note: Acanthomobia causes in immune compromised

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3
Q

Germ tube test

A

inoculation w/ animal serum

- for Candidia

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4
Q

Encapsulated yeasts characteristic of?

A

Cryptococcus neoformis -> meningitis

-in HIV, hodgkin lymphoma

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5
Q

Hyphae w/ rosettes of microcondria found in?

A

Sporothrix schenckii

-rose garden disease

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6
Q

History of bloody diarrhea, travel and liver tenderness

A

Entamoeba histolytica

cartwheel distribution of chromatin

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7
Q

diaper rash is due to

A

Candidia albicans

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8
Q

Opportunistic Yeast infections(3)

A

Candidia albicans
Crytococcal neoformis
Pneumocystis jirovecii

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9
Q

Opportunistic Mold infections (2)

A

Aspergillus fumigatus

mucor and rhizopus

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10
Q

Dermatophyte causing fungal species (4)

A

Trichophytin
Micosporum
Epidermophyton
malasseezia furfur

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11
Q

Infections caused by dermatophytes (5)

A 
tinea pedis - feet
tinea curis-  groin
tinea ungunium/onchomycosis - nails (usually trichophyton rubrum)
tinea corporis - body
tinea capitis - head

last 2 (ring worm)

agents
Trichophytin
Micosporum
Epidermophyton
malassezia furfur
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12
Q

ringworm means infection of?

A

fungal infection of
body or scalp

tinear corporis/ tinea capitis

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13
Q

trichophytin

A

dermatophyte

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14
Q

micosporum

A

dermatophyte

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15
Q

epidermophyton

A

dermatophyte

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16
Q

malassezia furfur

A

dermatophyte -> tinea versicolor

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17
Q

vulvovaginitis due to candida is more common in?(2)

A

DM or those that use antibiotics

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18
Q

chronic mucocutaneous candidiasis is?

A

persistent candidial infection despite adequate Rx

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19
Q

candidial esphophagitis presents as

A

painful swallow
substernal chest pain
feeling obstructed

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20
Q

intertrigo

A

Candidial infection of the skin and in breast folds

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21
Q

Rx for oral candidiasis(2)

A

FLuconazole

Nystatin

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22
Q

Rx for systemic candidiasis (2

A

amphotercin B
echinocandin
fluconazole

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23
Q

prophylaxis for PCP in HIV

A

TMP-SMX

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24
Q

prophylaxis for crytococcal neoformis in HIV

A

fluconazole

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25
Q

Detect germ tubes in a blood culture, growing what?

A

candidiasis

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26
Q

Pseudophyphae and budding yeast

A

candidiasis

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27
Q

3 ways to detect Cryptococcal neoformis

A

India ink - stains for capsule - not very sensitive
latex agglutination
serum antigin

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28
Q

Heavly encapsulated yeast found in the soil and pigeon droppings

A

cryptococcal neoformans

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29
Q

cultures on sabourauds agar

A 
crytococcal neoformans
histoplasmosis
blastomycosis
cocciodiesmycosis
paracoccidiodomycosis
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30
Q

soap bubble lesions

A

cryptococcoal neoformans

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31
Q

Rx for crytococcal neoformans

prophylactic?

A

amphotercin B
fluconazole

fluconazole prophylaxis

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32
Q

Dsic shaped yeast forms on methionine silver stain

A

pneumocytsis jirovecii

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33
Q

Rx for pneumocystis jirovecii if allergic to sulfa drugs

A

dapsone
aeroslized pentamidine
clindamycin and primaquine

yeast

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34
Q

Aspergillus presents as (3)

A

Allergic bronchopulmonary aspergillosis
-w/ asthma or CF

Aspergillomas (fungus ball)
-esp after TB infection

invasive aspergillosis
-immune compromized

mold

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35
Q

septate hyphae branching at acute angles

A

aspergillus - < 45 degrees

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36
Q

Rx for aspergillus (2)

A

lipid amphotericin B
Voricaonazole

mold infection

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37
Q

Mucor and rhizomes often in attack (3)

key finding

A

DM - DKA
leukemic patients
Trauma patients

black necrotic eschar where grows int the blood vessel wall

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38
Q

Rhinocerebral fungal infection presents as (2)

due to ?

A

facial pain and HA; especially DM and leukemia

due to nucor or rhizomes (molds)

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39
Q

Blindess and opthalmoplegia, black eschar on the palate or inside the nose be concerned w/

A

mucor or rhizopus infection

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40
Q

90 degree angles; broad, nonseptate hyphae infection

rx?(2)

A

mucor or rhizopus infection

mold

surgical debridement and amphotericin B

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41
Q

Tinea versicolor is due to?

Presents as

A

malassezia furfur

presents as hypo or hyper pigmented skin infections affecting the trunk that damages the melanocyes

Spagetti and meatball appearance on KOH prep

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42
Q

spagetti and meatball appearance on KOH prep

A

malassezia furfur causing tinea versicolor

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43
Q

Rx for tinea versicolor

A

hyper/hypopigmented skin fungal infection

topical azole
topical selenium sulfide
oral azole

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44
Q

onchomycosis due to?

Rx?

A

tinea unguinum

trichophyton rubrum often the cause

thickened discolored nails

Rx: oral terbinafine or Itrakonazole

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45
Q

Dermatophyte Rx(2)

A

Simple skin
-topical terbinafine

extensive skin infections or scale/hair
-oral terbinafine or azole

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46
Q

Systemic dimorphic fungal infections (5)

A

Yeast(37 degrees C) and mold (20 degrees C)

Histoplasmosis (histoplasma capsulatum)
Blastomycosis (blastomycoces dermitis)
cocciodiomycosis (coccidiodes immitis)* 
- > spherule instead of true yeast form
paracoccidiodomycosis (paracoccidiodes brasiliensis)

Sporothrix schenckii -> dimorphic but not systemic

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47
Q

forms a spherule (not a yeast) like the other systemic dimorphic fungi

A

coccidiomycosis

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48
Q

Rx for local infection of dimorphic infection(2)

Rx For systemic infection (2)

A

fluconazole or itraconazole

amphotericin B for systemic infection

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49
Q

Systemic infection and pulmonary symptoms w/ granuloma formation but NOT caseating

A

think of a dimorphic systemic mycosis

  • histoplasmosis
  • blastomycosis
  • coccidiomycosis
  • paracoccidiomycosis
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50
Q

Patient can either have a disseminated lung infection or local self limited pneumonia with this if they live in the ohio or mississippi river valley

A

Histoplasmosis

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51
Q

hides w/in macrophages w/ infection

yeast size

A

histoplasmosis

smaller than RBC

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52
Q

Size of yeast clue

-systemic dimophic disease

A

Smaller than RBC - histoplasmosis
same size as RBC - blastomycosis
larger than RBC - coccidiomycosis

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53
Q

Diseases associated w/ birds (5)

A 
Histoplasmosis
Cryptococcal neoformans
Chlamidophila psittaci
H5N1
West nile virus
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54
Q

Splenukers who acquire pneumonia

A

histoplasmosis

resides in bird and bat droppings

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55
Q

fungal infection associated w/ east of the mississippi river as well as central america

A

blastomycosis

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56
Q

blastomycosis presentation (2)

A

inflammatory lung disease

disseminate to skin and bone

forms granulomatous nodules -> calcifying lesions

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57
Q

broad based budding yeast that is the same size as an RBC

A

Blastomycoses

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58
Q

fungal disease prevalent in SW US, Cali,

Causes?(3)

A

coccidiomycosis - San joaquin valley fever

penumonia*
meningitis
can disseminate to skin and bone

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59
Q

Spherule filled with endospores that are much larger than RBC seen on smear

pulmonary symptoms

A

coccidiodomycosis

mold forms -> big barrels in the environment called athroconidia filled

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60
Q

Paracoccidiomycosis is endemic where?

Presentation

A

Latin america

causes non caseating granulomatous disease
budding yeast looks like a captains wheel

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61
Q

captains wheel appearance dimorphic fungi that leads to pneumonia and granulomatous changes in the mucous membranes and skin

A

Paracoccidiomycosis

  • Latin america
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62
Q

mold form contains barrel shaped athroconidia

A

coccidiomycosis

63
Q

cigar shaped dimorphic fungi that lives on vegetation

A

sporothrix schenckii

64
Q

Presentation of sporothrix scheckii infection

A

local pustule or ulcer that drains along the nodules of the lymphatics; painless nodules

typically due to a thorn

65
Q

Rx for sporothrix schenckii(2)

A

itraconazole

potassium iodide

66
Q

binds to ergosterol to form membrane pores(2)

A

nystatin

amphoteracin B

67
Q

Inhibits ergosterol synthesis

A

terbinafine -1st
(squaline -> lansoterol)

‘azoles - 2nd
(lanosterol -> ergosterol)

68
Q

fungal drug w/ arrhythmia and nephrotoxicity as concerns

A

amphoteracin B

69
Q

deposits in keratin containing tissue - fungal drug

A

griseofulvin

70
Q

Fungal drug SFx w. liver dysfunction(2)

A

terbinafine

‘azoles

71
Q

used for crytptococcal meningitis in AIDS (2)

A

Flucytosine

IV amphoteracin B

72
Q

Toxicity w/ Amphoteracin B (7)

A 
Fever/chills
hypotension
nephrotoxicity**
-reduced w/ hydration
arrythmias
anemia
IV phlebitis
hypokalemia
73
Q

How can you reduce toxicity amphoteracin?

A

liposomal given, difficulty crossing BBB though

74
Q

Use of amphoteracin

A

serious systemic mycoses

  • crytococcocus w/ flucytosine
  • blastomycoses
  • cocciodies
  • histoplasma
  • mucor
  • histoplasma
75
Q

Used for invasive aspergillus infections

A

cASPofungin

76
Q

Uses for nystatin(3)

A

Diaper rash
vaginal candidiasis
oral candidiasis

77
Q

fungal drug for chronic suppression of cryptoccoal memningitis

A

fluconazole

78
Q

azole of choice for fungi refractive to other Rx

A

posaconazole

79
Q

azole used in aspergillus

A

voriconazole

80
Q

Rx for topical fungal infections (2 azoles)

A

clotimazole

mocnazole

81
Q

Flucytosine concerns(2)

A

Fungal drug

bone marrow suppression and GI symptoms

82
Q

patient has a higher INR than expected after being placed on this drug for ringworm,

A

Griseofulvin

p450 inducer -> anti seizure drugs and OCPs

teratogenic
HA also

83
Q

Severe diarrhea in an HIV patient

Diagnosis?

A

Cryptosporidium

oocysts on acid fast stain

84
Q

How is cryptosporidium Rx?

A

it is hard

usually prevented through filtration of the city water

85
Q

small oocysts on acid fast stain causing mild diarrhea in a nonimmunecopromised

A

Cryptosporidium

86
Q

Symptoms of giardia

A

bloating,
flatullence
foul smelling
fatty diarrhea

87
Q

pear shaped trophozoite w/ four flagella and double nuclei?

Rx?

A

giardia lamblia

metronidazole

88
Q

diagnosis of giardia?

A

pear shaped trophocyts or cysts in the stool

89
Q

Patient goes campine and has a prior history of diarrhea but now presents w/ RUQ abdominal pain

See what on histology

A

entamoeba histolytica

flask shaped ulcer if submucosal abcess of colon ruptures (usually bloody diarrhea)

90
Q

Presentation of entamoeba histolytic

Rx?(2 steps)

A

bloodly diarrhea
liverabcess
RUQ pain
flask shaped ulcer

metronidazole/tinidazole
-kill off trophozoites

iodoquinol/paromomycin
- kill off cysts

91
Q

trophozoite found w/ RBC in the cytoplasm

what does the cyst ook like?

A

entamoeba histolytica

cysts contain multiple nuclei

92
Q

Rx for entamoeba histolytica(2 steps

A

metronidazole/tinidazole
-kill off trophozoites

iodoquinol/paromomycin
- kill off cysts

93
Q

amoebic dystentery

A

entameoba histolytica

94
Q

ring enhancing lesion on MRI of an HIV patient (2)

A

toxoplasmosis gondii
primary CNS lymphoma

need a biopsy

95
Q

Congenital triad of why we don’t let pregnant women change kitty litter

A

Chorioretinitis
hydrocephalis
intracranial calcifications

96
Q

2 ways to spread toxoplasma gondii

Rx?

A

infected cat feces

contaminated raw meat - pork

97
Q

rx for toxoplasma gondii

A

sulfadiazime and primethamine and folinic acid

98
Q

sulfadiazime and primethamine and folinic acid is for?

A

Rx for toxoplasmosis gondii

99
Q

Naegleri fowleri is caught by?

Rx?

A

swimming in freshwater lakes

Rx - amphotericin B

100
Q

meningioencephalitis due to passage of this organism through the cribiform plate,

A

naegleria fowleri

101
Q

Early presentation of Tyrpansoma bruci infection(3)

Late(2)?

A

either T. gambiense or T rhodesiense - African Sleeping Sickness

Early - enlarged lymph nodes, recurring fever, somnolence

Late - Encephalitis and coma/death

102
Q

Transmission of African sleeping sickness is due to

A

Tsete fly- Painful bite

long wispy looking on blood smear

103
Q

Rx for T. gambiense and T rhodesiense?(2)

A

African sleeping sickness

Surman - if blood bourne
melarosprol if CNS

104
Q

Surman - if blood bourne
melarsoprol - if CNS

used in?

A

Rx for African Sleeping sickness

105
Q

fever pattern in malaria?
due to?

vivax
ovale
malariae
falciparum

A

fever pattern is due to the hemolytic rupture of RBC by merozoites -> chills and fever

Vivax/ovale - 48 hrs
malariae - 72 hrs
falciparum - 24 hrs?

106
Q

Which form of malaria needs additional Rx w/ primaquine

A

Plasmodium vivax and ovale due to presence of hypnosoite

107
Q

Rx for hypnozoites in Ovale and vivax?

A

primaquine

108
Q

Sever symptoms due to P. falciparum are due to?

A

parasitized RBCs occlude capillaries

  • Brain- cerebral
  • kidneys- renal failure
  • lungs - edema
109
Q

Blood smear shows trophozoite ring be concerned of (2)

A

Babesia

Plasmodium

110
Q

Mosquito species carrying plasmodium?

infectious form ?

A

anopheles

sporozoite

111
Q

Plasmodium falciperum’s gamete shape?

A

like a banana

112
Q

babesiosis presentation? (2)

A

fever

hemolytic anemia

113
Q

Prevalence of babesia located to?

due to?

A

NE United states

Due to being carried by ixodes tick (same as borreila burgdorferi)

114
Q

2 blood smear clues of babesia infection?

A

trophozoite - ring form

merozoites -Maltese cross

115
Q

Cyclic Fever, HA, anemia, splenomegaly

Concern w?

Rx?

A

Malaria

Chloroquine - 1st line
Methloquine if resistant (quinine/doxycycline; atorvaquine/proguanil; artemethera/ lumefantide)

116
Q

Sandfly transmits?

A

Leishmania donovani

117
Q

Presentation of leishmania donavani? (3)

Rx?

A

visceral:
spiking fevers
hepatosplenomegaly
pancytopenia

can also be cutaneous form - erythematous macuoles and skin ulcers

Rx Amphoteracin B or sodium stibogluaonate if cutaneous

118
Q

macrophages containing amastigotes the disease was caught by?

A

sandfly bite - leishmania donovani

119
Q

Chagas disease is due to what organism?

transmitted by?

A

Trypanosoma cruzi

Reduviid bug is the cause

120
Q

Presents w/ dilated cardiomegaly, megacolon and megaesphophagus?

Rx?(2)

A

Chagas disease

Nifurtimox and benznidazole

121
Q

nifurtimox and benznidazole used in the Rx of

A

Trypanosoma cruzi - chagas disease (South america’s Reduviid bug)

dilated cardiomyopathy, megacolon and megaesophagus

122
Q

Foul smelling, greenish discharge w/ itching and burning of the vagina

A

Trichimonas vaginalis

most common in the US
- raises vaginal pH; Rx w/ metronidazole

123
Q

Most common helminth infection in the US

A

enterobius vermicularis

2nd - ascaris lumbricoides

124
Q

Diagnosed w/ Scotch tape and presents w/ intense anal itching

A

Enterobius vermicularis

-roundworm

125
Q

Rx for most round worms (2)

A

Bendazoles - (albendazole/mebendazole) blocks glucos uptake; do not tak w/ fatty meal

pyrantel pamoate

126
Q

Intestinal infection that can lead to obstruction, early signs may be pulmonary

A

ascaris lumbricoides

round worm

127
Q

Path ascaris lumbricoides follows for infection?

A

fecal oral, eggs hatch in small intestine-> burrow through to blood, get to the lung, coughed up and swallowed again

Strongyloides is similar except it enters via the skin

128
Q

Roundworms that enter the body via fecal oral(3)

A

EAT

Enterobius vermicularis
Ascaris lumbricoides
Trichenella spiralis

129
Q

Round worms that enter the body through the skin

A

SANd

stronglyoides stercoralis
Ancyostroma duodenale
necator americanus

130
Q

ingestion of undercooked meat leads to myositis and periorbital edema, Offending agent?

Diagnosis through?

A

Trichenella spiralis

diagnose through muscle biopsy

also causes fever and esosinophilia

131
Q

Trichenella spiralis presentation?(4)

due to?

A 
Infection of the muscle ->
myosisitis
periordital edema
eosinophilia
fever

ingestion of undercooked meat

132
Q

Strongyoides stercoralis presentation (3)

due to?

Rx?

A

intesinal infection causing:

  • vomiting
  • diarrhea
  • anemia

Infection via skin penetration

ivermectin or albendazole

133
Q

2 roundworms that can cause anemia due to sucking of blood from the intestinal wall

A

Ancylostoma duodenal

necator americanus

134
Q

Ancylostoma duodenale presentation?

A

larvae penetrates the skin -> intestinal infection and anemia

round worm

135
Q

Necator americanus presentation

A

larvae penetrates the skin -> intestinal infection and anemia

round worm

136
Q

infectious agent that causes elephantiasis

A

Wuchereria bancrofti

infects the lymphatic -> elephantitis of the limbs or hydrocele

137
Q

Wuchereria bancrofti presentation ?(2)

A

round worm causing elephantiasis or hydrocele

138
Q

Loffler eosinophilic pneumonitis

A

complication of ascaris lumbricoides -> pneumonia

due to migration of ascaris as it makes its way to the small intestine

139
Q

Rx for Lice?

A

permethrin and pyrethrin

topically

140
Q

Taenia solium presentation (2)

A

depends on

  • ingestion of worm -> intestinal infection
  • ingestion of eggs -> cystocercosis/neurocysticercosis (seizure and calcifying lesions on MRI)

often in mexico, south america and SE asia

141
Q

Rx for cestodes and trematodes (tapeworms and flukes)

A

praziquantel

142
Q

neurocysticercosis

A

infection of Taenia solium eggs (vs the worm itself) leading to seizures and calcifying lesions on MRI

143
Q

Patient from mexico comes in w/ new onset of seizures and calcifying lesions on MRI

Where did the infection come from?

A

eating the eggs of taenia solium off of undercooked pork

144
Q

Tapeworm infection associated w/ B12 deficiency

acquired where?

A

Diphyllobothrium latum

due to ingestion of freshwater fish

145
Q

diphyllobithrium latum infection presentation

A

megaloblastic anemia due to a B12 deficeincy

acquired from freshwater fish

Praziquantel Rx

146
Q

Echinococcus granulosus infection presentation

due to?

Rx?

A

ingestion of eggs from dog feces

have cysts in the liver causing anaphylaxis if antigens released

bendazole (differs from other tapeworms) and surgical removal (after killing cysts w/ ethanol)

147
Q

Cysts in the liver that can cause anaphylaxis if released due to what?

A

Echinococcus granulosus

ingestion of eggs from dog

148
Q

The definitive host of schistosoma is?

get into humans how?

A

snails allow maturation -> cercariae which penetrate human skin

Blood flukes

149
Q

Chronic infection w/ this can lead to concerns of squamous cell carcinoma of the bladder

A

schisotosoma haematobium

150
Q

Helminth infection where the patient has portal HTN

causal agent?

-another presentation w/ similar pathology?

A

Schistosomal eggs embolize and get stuck in portal system

can also cause splenomegaly

151
Q

Clonorchis sinensis infection is due to?

Presents as(2)

A

undercooked fish consumption

biliary tract inflammation -> pigmented stones

Cholangiocarcinoma

152
Q

Japanese man comes to you complaining of RUQ pain. Pigmented stones are found. What infection could the patent have?

Risk of?

Rx?

A

clonorchis sinensis -> undercooked fish consumption

Risk of cholangiocarcinoma

Praziquantel for all trematodes/flukes

153
Q

Risk of infection of this w/ undercooked crab meat?

Presentation?

A

Paragonimus westermani - lung fluke (praziquantel)

lung inflammation -> hemoptysis and chronic bronchitis

154
Q

Paragonimus westermani presentation ?

Due to

A

lung inflammation -> hemoptysis and chronic bronchitis

Due to ingestion of undercooked crab meat

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