Opportunistic protozoan infections of the GIT Flashcards by Iseoluwa Ojo

Opportunistic protozoan infections of the GIT

Affects mainly the immuno_________

Parasitic infections of the GIT is one of the highest causes of morbidity and mortality among _____ infected individuals

OIPs which usually occurs when CD4+ T cell count is __________ cells/mm

Most common symptom is _______

compromised

HIV

below 200

diarrhoea

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Cryptosporidium species

Minute _______ in the subphyllum ______

(Obligate or facultative?) tissue parasite with sexual and asexual life cycle

Associated with ________ in a variety of domestic animals like calves,pigs and chicken

In humans iit is usually associated with __________

coccidian; sporozoa

sporozoa; enterocolitis

HIV infection

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Cryptosporidium species: Epidemiology

The organisms are widespread and probably infect (asymptomatically or symptomatically?) a significant proportion of the human population.

The incubation period for cryptosporidiosis is from ____ to ——— and the disease is acquired from infected animal or human feces or from faecally contaminated food or water

asymptomatically

1 to 12 days

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Cryptosporidium species: Epidemiology

Risk factors include
– Extremes of ____
– Immuno_______
– Close contact with _________

age

compromised

infected animals

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Oocysts of Cryptosporidium species are eliminated by chlorination

T/F

Oocysts of Cryptosporidium species are not eliminated by chlorination and may persist after water treatment

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Life cycle of Cryptosporidium species

When ______ in contaminated foods and water are ingested (as few as ___ organisms can initiate an infection)

________ ———- and invade intestinal cells and the parasites multiply ______ within the ______ portion of the intestinal cells

are released, and _________ to begin a new cycle.

They also reproduce sexually, forming __________ and ____________ that fuse and develop into the _______.

oocysts; 30

Sporozoites excyst

asexually; apical

infect other intestinal cells

male microgamonts and female macrogamonts

oocysts

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Life cycle of Cryptosporidium species

Parasite has the ability to complete its life cycle, including the sexual phase, within the same individual

T/F

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Cryptosporidium species : Pathogenesis

Cryptosporidium inhabits the _________ of ____________ of the gastrointestinal tract, especially the surface of _____ of the _______________

______ attach to the brush border of the epithelial cells with loss or degeneration of the ______ at the attachment zone

Loss of ________ = impaired ______,_______ that make up the clinical syndrome

Cryptosporidium Infections have also been found in other organs, including other digestive tract organs and the _____.

brush border of mucosal epithelial cells

villi; lower small intestine

Oocyst; microvilli

microvilli; digestion, malabsorption

lungs

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Cryptosporidium species: clinical feature

The prominent clinical feature of cryptosporidiosis is ________-like _____ or ______ diarrhea

Persistent ______ with varying degrees of ______,________, and __________

cholera

watery or mocous

gastroenteritis

vomiting, malabsorption and low grade fever

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Cryptosporidium species: clinical feature

(mild or severe?) and ________ ( __________ ) in normal persons

but may be severe and prolonged ( _______) in immunocompromised or very young or old individuals

Mild ; self-limited

1–2 weeks

months

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Oocysts of Cryptosporidium species

____ μm

_____ to _________ shape

stain ______ in stool samples stained with ___________ stain

4–6

ovoid to spherical

pink; an acid-fast

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Oocysts of Cryptosporidium species

Highly _______ on wet mount

__________ may be observed internally or with phase contrast microscope

May contain up to ___ slender ___ shaped sporozoite

refractile

Small granules

4; bow

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Diagnosis of Cryptosporidium species

Detection of _____ in __________

_____ concentration techniques + a modified ____________ .

__________ microscopy with _______ staining.

detection of fecal ______ using immunological techniques like ______

Molecular - PCR

Oocysts; fresh stool samples.

Stool; acidfast stain

fluorescent; auramine

antigen; ELISA

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Treatment of Cryptosporidium species

List 3

paramomycin

Azithromycin

Nitazoxanide

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CYCLOSPORA AND CYSTOISOSPORA (ISOSPORA) species

Both are only opportunistic pathogens in immunocompromised hosts

T/F

Both are opportunistic pathogens in immunocompromised hosts but also infect noncompromised patients.

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CYCLOSPORA AND CYSTOISOSPORA (ISOSPORA) species

Cyclospora: distribution is _____ and is endemic in _______ areas, with outbreaks in ________ areas.

Cystoisospora: occurrence is primarily in _______________ climes, especially South America, Africa, and Southeast Asia.

________ and _________ are primary sources.

worldwide; developing

developed

tropical and subtropical

Contaminated food and water

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Oocysts of CYCLOSPORA AND CYSTOISOSPORA (ISOSPORA) species can survive in environment for _______ but must _______ to become infective.

months

sporulate

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Life Cycle of Cystoisospora( Isospora belli)
(Mature or Immature?) Cystoisospora oocysts, each containing a ______________, are excreted in the stool of infected hosts.

Oocysts can remain viable in the environment for _______.

_______ in the environment is required before oocysts become infectious

The _________ divides in two, and each newly formed _______ subsequently matures into a _______.

Immature

single sporoblast

months

Sporulation

single sporoblast

sporoblast

sporocyst

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Life Cycle of Cystoisospora( Isospora belli)

The resulting infective ______ ————- contains ________, each with ________.

Ingestion of ____________ results in the release of ______ in the ____________ which may develop into _____, with subsequent ________ reproduction occurring within enterocytes;

over time, _____ reproduction follows, resulting in the development and passage of (mature or immature?) ________ ———- in feces.

Rarely, some sporozoites can _________________where they may remain _________ and later give rise to _______ disease.

elliptical oocyst

two sporocysts; four sporozoites

sporulated oocysts; sporozoites

proximal small intestine; merozoites; asexual

sexual; immature, unsporulated oocysts

migrate out of the intestine to various
tissues

dormant as cysts; extraintestinal

Diagnosis of CYCLOSPORA AND CYSTOISOSPORA (ISOSPORA) species

Acute or chronic ______ occurs with other constitutional and gastrointestinal symptoms.

______ in stool may be visualized using ______________ stain.

_______ stool examinations may be required

diarrhea

Oocysts

modified acid-fast

Multiple

Treatment of CYCLOSPORA AND CYSTOISOSPORA (ISOSPORA) species

____________
or

___________

Trimethoprim-sulfamethoxazole

ciprofloxacin

Microsporidia

are (obligate or facultative?) ___karyotic _____cellular pathogens related to _____

contains at least ______ species

distributed into more than _____ genera.

obligate eukaryotic intracellular

fungi; 1200

190

Microsporidia

Several different genera and species of microsporidia cause disease in humans

Microsporidiosis occurs in both immunocompromised and immune-competent hosts.

T/F

Microsporidia

can be transmitted by __________ and are likely ———-

__________ or ____________ are the most common presenting manifestations of infection, but infection can occur in any organ system.

food or water ; zoonotic

Diarrhea or keratoconjunctivitis

Microsporidia Diagnosis can be made by finding characteristic _____ in body fluids _______________________ of the microsporidia causing an infection can be done using ____ examination or molecular techniques. Patients with diarrhea or keratoconjunctivitis should have _____ examined to look for disseminated infection. Species-specific diagnosis is useful for guiding treatment.

spores Definitive identification ultrastructural urine

Treatment of Microsporidia Systemic ________ and fumagillin ____ in HIV patients

albendazole ART

Phylum Ciliophora are group of ______ characterized by _____ like structure called ______ which is important in movement and nutrition •Possess _____

protozoa; head; cilium cilia

Phylum Ciliophora • Possess cilia- _______ or ________ organelles during some part of their life cycle • Most species have 2 kinds of nuclei: _______ and _________

simple cilia or compound ciliary macronuclei and micronuclei

Phylum Ciliophora • Some members of the phylum engage in sexual reproduction, involving _______,________, and ________ • Most ciliates are _______; however, a few groups are ________ or ________

conjugation, autogamy, and ctyogamy free-living commensals or parasitic

Family Balantidiidae, which includes only one genus and species (__________) are found in the _______ of _____ and some vertebrates, including mammals

Balantidium coli intestinal tract; arthropods

Family Balantidiidae • Pathogens of ______,_______,______ •______ are non-pathogenic carrier •Mostly infect at ———-,———— •Balantidium coli cause ________,_________

humans, dogs and monkeys Swine Cecum, large intestine Balantidiosis Ciliary dysentery

Family Balantidiidae B.coli :- is the ______ intestinal protozoa that effect human and can be seen _____scopically Balantidiosis regarded as a ______ disease

largest macro zoonotic

B.coli : Epidemiology _________ distribution but is most often found in _____ regions Although B. coli is found in many mammals, ________ and ________ are considered to be the main reservoir for human infection with prevalence rates of ___% to ___%.

worldwide; tropicale domestic and wild pigs 40; 100

B.coli: Epidemiology It is not a common human disease the prevalence is usually _____% higher rates have been reported among individuals in hyperendemic areas and residential institutions. ____ is transmitted (fecal oral)

less than 1 Cyst

B.coli: epidemiology Human infection most often results from the ingestion of produce or water contaminated with ________ or from _________. ______ transmission can also occur. However, humans are generally (sensitive or resistant?) to infection, and _________ seem to be risk factors for disease

pig excrement; handling of the animal Person-to-person resistant poor nutrition and underlying debility

Morphology :- the parasite is observed in two stages only which are :- A) trophozoite :- (Smal or Large?) size , the _____ trophozoite usually measures 30 to 150 μm in length and 25 to 120 μm in width but may reach 200 μm in length. •the invasive stage . covered by _____ & the (anterior or posterior?) end are longer than the (anterior or posterior?) end . in the anterior end there is mouth called _______ .

Large ; oval cilia; anterior ; posterior cytosome

Morphology :- the parasite is observed in two stages only which are :- trophozoite :- the internal structures :- have ______ nuclei , the _______ (the large one) & ________ (the small one ) . the macronucleus is _______ or _——— in shape . the micronucleus is _____ ——- shape located in the ______ of macronucleus . have two secretory contractile vacuoles . numerous food vacuoles .

two; macronucleus; micronucleus kidney or bean small spherical ; concavity

Balantudium coli Morphology :- the parasite is observed in two stages only which are :- B- Cyst :- ___ to _____ μm in diameter typically ______ in shape . surrounded by (thin or thick?) wall (one or two layers ) by ______ in small intestine to protect the parasite from the host . contain the _______ and ________ which are visible in the cyst . the cilia are _______ , only the ______ may present .

40 to 60; spherical Thick ; encystation macronucleus and contractile vacuoles undetectable; roots

B.Coli 1- Asexual type by _______ . 2- Sexual type by ________ .

binary fission conjugation

B.coli Life cycle :- direct life cycle or simple life cycle that mean __________________ (Mature or immature?) cysts are passed with feces.

the parasite not need for intermediate host . Mature

B.coli Infective stage Transmission :- by ingestion of ___________ (NOT in __________) with feces contain the ________. Excystation occurs in the _________, and the __________ colonize in the large intestine. Trophozoites undergo ________ to produce infective cysts.

contaminated food or water undercooked meat mature cyst ; small intestine trophozoites; encystation

Pathogenesis of B.coli Balantidium coli produces proteolytic enzymes that __________________ . Colon ________ develops which allows for ______________ _________ and secondary bacterial infections develop . ___________ of the large intestine and appendix will occur.

break down and digest the intestinal epithelium ulceration; infiltration by lymphocytes and leukocytes. Hemorrhage; Perforation

Clinical manifestation of B.coli A chronic course characterized by intermittent _____, Alternating periods of _________; abdominal pain, and weight loss. Rarely, a more ___________ with _____ and _______ in stools may occur this may lead to ________ of the gut wall and intestinal _______ with subsequent peritonitis, mesenteric adenitis or extraintestinal disease to the lungs, liver and other organs pulmonary hemorrhage,and symptomatic (hematuria) and asymptomatic urinary infection.

diarrhea; constipation fulminant colitis ; blood and mucus Ulceration; perforation

Treatment of B.coli

Tetracycline Iodoquinol Metronidazole

Control of of B.coli Eradication of ___ contamination of food and water. Cysts killed by ________ Resistant to ____ doses chlorine (halide tablets) Avoid practices that allow ______ contact Improved sanitation in institutions.

fecal boiling of water low fecal-oral