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Opportunistic protozoan infections of the GIT Flashcards

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1
Q

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 _______

A

compromised

HIV

below 200

diarrhoea

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2
Q

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 __________

A

coccidian; sporozoa

sporozoa; enterocolitis

HIV infection

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3
Q

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

A

asymptomatically

1 to 12 days

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4
Q

Cryptosporidium species: Epidemiology

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

A

age

compromised

infected animals

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5
Q

Oocysts of Cryptosporidium species are eliminated by chlorination

T/F

A

F

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

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6
Q

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 _______.

A

oocysts; 30

Sporozoites excyst

asexually; apical

infect other intestinal cells

male microgamonts and female macrogamonts

oocysts

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7
Q

Life cycle of Cryptosporidium species

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

T/F

A

T

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8
Q

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 _____.

A

brush border of mucosal epithelial cells

villi; lower small intestine

Oocyst; microvilli

microvilli; digestion, malabsorption

lungs

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9
Q

Cryptosporidium species: clinical feature

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

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

A

cholera

watery or mocous

gastroenteritis

vomiting, malabsorption and low grade fever

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10
Q

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

A

Mild ; self-limited

1–2 weeks

months

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11
Q

Oocysts of Cryptosporidium species

____ μm

_____ to _________ shape

stain ______ in stool samples stained with ___________ stain

A

4–6

ovoid to spherical

pink; an acid-fast

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12
Q

Oocysts of Cryptosporidium species

Highly _______ on wet mount

__________ may be observed internally or with phase contrast microscope

May contain up to ___ slender ___ shaped sporozoite

A

refractile

Small granules

4; bow

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13
Q

Diagnosis of Cryptosporidium species

Detection of _____ in __________

_____ concentration techniques + a modified ____________ .

__________ microscopy with _______ staining.

detection of fecal ______ using immunological techniques like ______

Molecular - PCR

A

Oocysts; fresh stool samples.

Stool; acidfast stain

fluorescent; auramine

antigen; ELISA

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14
Q

Treatment of Cryptosporidium species

List 3

A

paramomycin

Azithromycin

Nitazoxanide

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15
Q

CYCLOSPORA AND CYSTOISOSPORA (ISOSPORA) species

Both are only opportunistic pathogens in immunocompromised hosts

T/F

A

F

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

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16
Q

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.

A

worldwide; developing

developed

tropical and subtropical

Contaminated food and water

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17
Q

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

A

months

sporulate

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18
Q

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 _______.

A

Immature

single sporoblast

months

Sporulation

single sporoblast

sporoblast

sporocyst

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19
Q

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.

A

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

20
Q

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

A

diarrhea

Oocysts

modified acid-fast

Multiple

21
Q

Treatment of CYCLOSPORA AND CYSTOISOSPORA (ISOSPORA) species

____________
or

___________

A

Trimethoprim-sulfamethoxazole

ciprofloxacin

22
Q

Microsporidia

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

contains at least ______ species

distributed into more than _____ genera.

A

obligate eukaryotic intracellular

fungi; 1200

190

23
Q

Microsporidia

Several different genera and species of microsporidia cause disease in humans

Microsporidiosis occurs in both immunocompromised and immune-competent hosts.

T/F

A

T

T

24
Q

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.

A

food or water ; zoonotic

Diarrhea or keratoconjunctivitis

25
Q

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.

A

spores

Definitive identification

ultrastructural

urine

26
Q

Treatment of Microsporidia

Systemic ________ and fumagillin

____ in HIV patients

A

albendazole

ART

27
Q

Phylum Ciliophora

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

•Possess _____

A

protozoa; head; cilium

cilia

28
Q

Phylum Ciliophora

• Possess cilia- _______ or ________ organelles during some part of their life cycle

• Most species have 2 kinds of nuclei: _______ and _________

A

simple cilia or compound ciliary

macronuclei and micronuclei

29
Q

Phylum Ciliophora

• Some members of the phylum engage in sexual reproduction, involving _______,________, and ________

• Most ciliates are _______; however, a few groups are ________ or ________

A

conjugation, autogamy, and ctyogamy

free-living

commensals or parasitic

30
Q

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

A

Balantidium coli

intestinal tract; arthropods

31
Q

Family Balantidiidae

• Pathogens of ______,_______,______

•______ are non-pathogenic carrier

•Mostly infect at ———-,————

•Balantidium coli cause ________,_________

A

humans, dogs and monkeys

Swine

Cecum, large intestine

Balantidiosis Ciliary dysentery

32
Q

Family Balantidiidae

B.coli :- is the ______ intestinal protozoa that effect human and can be seen _____scopically

Balantidiosis regarded as a ______ disease

A

largest

macro

zoonotic

33
Q

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 ___%.

A

worldwide; tropicale

domestic and wild pigs

40; 100

34
Q

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)

A

less than 1

Cyst

35
Q

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

A

pig excrement; handling of the animal

Person-to-person

resistant

poor nutrition and underlying debility

36
Q

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 _______ .

A

Large ; oval

cilia; anterior ; posterior

cytosome

37
Q

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 .

A

two; macronucleus; micronucleus

kidney or bean

small spherical ; concavity

38
Q

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 .

A

40 to 60; spherical

Thick ; encystation

macronucleus and contractile vacuoles

undetectable; roots

39
Q

B.Coli

1- Asexual type by _______ .

2- Sexual type by ________ .

A

binary fission

conjugation

40
Q

B.coli

Life cycle :- direct life cycle or simple life cycle that mean __________________

(Mature or immature?) cysts are passed with feces.

A

the parasite not need for intermediate host .

Mature

41
Q

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.

A

contaminated food or water

undercooked meat

mature cyst ; small intestine

trophozoites; encystation

42
Q

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.

A

break down and digest the intestinal epithelium

ulceration; infiltration by lymphocytes and leukocytes.

Hemorrhage; Perforation

43
Q

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.

A

diarrhea; constipation

fulminant colitis ; blood and mucus

Ulceration; perforation

44
Q

Treatment of B.coli

A

Tetracycline
Iodoquinol
Metronidazole

45
Q

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.

A

fecal

boiling of water

low

fecal-oral

House Microbiology (93 decks)

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