(P) Hemoflagellates and Ciliates Flashcards by ASHLEY JARED DEFENSOR

Q

These are aka blood and tissue flagellates

A

Hemoflagellates

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Q

What class do hemoflagellates belong to?

A

Zoomastigophorea

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Q

TOF: Hemoflagellates have chromatophores

A

False (do not)

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Q

Member species of kinetoplastida are disease-producing parasites which need what vectors for transmission?

A

Blood-sucking insects

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Q

Hemoflagellates inhabit what 2 body parts?

A

Tissues and blood

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Q

What biologic vectors do hemoflagellates need?

A

Blood-sucking insects

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Q

What are the 4 developmental stages of hemoflagellates?

A

Amastigote
Promastigote
Epimastigote
Trypomastigote

Mnemonics: APET (kasi apat sila)

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Q

TOF: All hemoflagellate species have all 4 developmental stages

A

False (some only have the amastigote and promastigote stage)

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Q

Hemoflagellate: Stages of Development

This is round, ovoid, or shaped like a torpedo (torpedo form), is singly nucleated, non-flagellate, with a prominent kinetoplast and axoneme

A

Amastigote

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Q

Hemoflagellate: Stages of Development

TOF: The amastigote is the first form to have a flagella

A

False (promastigote)

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Q

Hemoflagellate: Stages of Development

This is elongated (elliptical) with pointed ends, singly nucleated, with a prominent kinetoplast and axoneme with an anterior flagellum

A

Promastigote

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Q

Hemoflagellate: Stages of Development

This is elongated (elliptical), curved, with a prominent kinetoplast at the anterior near the single nucleus, has an undulating membrane that extends from the kinetoplast to the most anterior end with a free flagellum

A

Epimastigote

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Q

Hemoflagellate: Stages of Development

This is curved, S or C-shaped, has a single nucleus and plenty of volutin granules on the sides, has prominent kinetoplast near the tip of the posterior end while the undulating membrane extends to the entire length of the body with a free flagellum

A

Trypomastigote

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Q

Hemoflagellate: Stages of Development

What stages have a free flagellum?

A

Epimastigote and Trypomastigote

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Q

Hemoflagellate: Stages of Development

What stages have a single nucleus?

A

All four of them

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Q

TOF: Some hemoflagellate species exhibit different characteristics/stages when in the human and insect vector, some can exist in one or the other, or both

A

True

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Q

The “bulging kinetoplast” is the characteristic feature of what hemoflagellate stage?

A

Trypomastigote

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Q

This is an intracellular parasite that causes visceral leishmaniasis, Kala-azar, death fever, and Dum-dum fever (most severe form of leishmaniasis)

A

Leishmania donovani

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Q

Leishmania donovani

What is the most severe form of leishmaniasis?

A

Dum-dum fever

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Q

Leishmania donovani

What is the definitive and intermediate host of Leishmania donovani?

A

Definitive: Humans
Intermediate: Sandflies

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Q

Leishmania donovani

This is the stage (A-P-E-T) that can be found in the mononuclear phagocyte and circulatory system of man

A

Amastigote

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Q

Leishmania donovani

The amastigote is intracellular and non-motile because it lacks what?

A

An external flagellum

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Q

Leishmania donovani

TOF: The amastigote form is motile

A

False (it lacks an external flagellum)

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Q

Leishmania donovani

This is the extracellular and motile stage (A-P-E-T) occurring in the alimentary tract of the insect vector and are the ones that grow in artificial culture media

A

Promastigote

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# Leishmania donovani Promastigotes are injected by what during their blood meals?

Sandflies

# Leishmania donovani Some Leishmania donovani promastigotes enter the circulation and are destroyed by macrophagic cytolysis while some are taken up through what process by mononuclear phagocytes?

Phagocytosis

# Leishmania donovani Phagocytosis of the promastigotes happens in what kind of cells of the spleen, liver, bone marrow, intestinal mucosa, and mesenteric lymph nodes?

Reticuloendothelial cells

# Leishmania donovani TOF: The Leishmania donovani promastigotes can also be present in the endothelial cells of the kidneys, suprarenal capsules, lungs, meninges, and CSF

True

# Leishmania donovani What is the scientific name for sandflies?

Phlebotomus papataci

# Leishmania donovani TOF: Promastigotes within the intestines of the sandflies transform into amastigotes after their blood meals

False (reverse)

# Leishmania donovani How do the promastigotes multiply?

Via longitudinal binary fission

# Leishmania donovani After the transformation of the amastigote to the promastigote in the sandfly's intestines, it migrates to where?

Pharynx of the insect where it will be injected into man once it starts its blood meal again

# Leishmania donovani If promastigotes multiply by longitudinal binary fission, how do amastigotes multiply?

Simple binary fission

# Leishmania donovani What is the infective stage to humans and insects?

Promastigotes to humans; Amastigotes to insects (reversal as to what they acquire vs. what is already within them)

# Leishmania donovani Once the promastigotes are engulfed by reticuloendothelial cells, it transforms into what stage until the host cell is fillied up with it?

Amastigotes | Amastigote (insect) > Promastigote (insect) > Amastigote (human)

# Leishmania donovani Once the host cell is destroyed by the colony of amastigotes, they are released and are taken up by?

Phagocytes

# Leishmania donovani Once an infected person gets their blood sucked on by another sandfly, what stage is it on?

Amastigote | Basically, the promastigote only exists within the pharynx of the vector

# Leishmania donovani These cells with amastigote stages within them are set free in the circulation, from skin to viscera, what is the cell?

Macrophages

# Leishmania donovani Amastigotes that are released in the circulation because they are colonized with amastigotes are taken by what cells?

Fixed macrophages (in the spleen, liver, bone marrow, and other centers of reticuloendothelial activity)

# Leishmania donovani If Leishmania donovani stimulates the proliferation of macrophages in the bone marrow which comprises of various blood cells, what are the conditions that will be manifested? (2 answers)

Granulocytopenia (decreased WBCs) and anemia (decreased RBCs)

# Leishmania donovani Infection can cause enlargement of the spleen, liver, and lymph nodes; specifically when the spleen is enlarged, it is referred to as hypersplenism which has what effect on the RBCs?

Causes more destruction of the RBCs

# Leishmania donovani As the host's humoral immunity is also stimulated, there is an increased production of what protein leading to the reversal of the albumin-globulin ratio?

Globulin

# Leishmania donovani As the infection reverses the albumin-globulin ratio, it is referred to as a form of what illness?

Reticuloendotheliosis

# Leishmania donovani The incubation period lasts for how long?

From less than 10 days or more than one year (girl pick a struggle tf)

# Leishmania donovani Patients will have an undulant fever which could have how many peaks in a day?

2 peaks

# Leishmania donovani The manifestation of decreased RBCs is accompanied with a decreased WBC count as well, this condition is referred to as?

Anemia with Leukopenia

# Leishmania donovani Both the spleen and liver are enlarged during infection (splenomegaly and hepatomegaly), but which is more enlarged than the other?

Hepatomegaly

# Leishmania donovani This complication arises when the organism transforms from viscerotropic to dermatropic (internal organs to the skin) resulting in skin lesions

Post Kala-Azar Dermal Leishmaniasis

# Leishmania donovani Skin lesions of the Post Kala-Azar Dermal Leishmaniasis manifest what symptom everywhere on the body with less on the face, hands, and feet?

Hypopigmented macules (discolored skin)

# Leishmania donovani Nodule formation on the nose, chin, cheek, lips, forehead, and ears can mimic what other disease?

Leprosy

# Leishmania donovani TOF: Physical examination findings can be used to diagnose Leishmania donovani

False

# Leishmania donovani TOF: Findings in the spleen, liver, and lymph nodes are specific for Leishmania donovani

False (not specific)

# Leishmania donovani The biopsy of what organs can be used to demonstrate amastigotes?

Spleen, liver, or lymph nodes

# Leishmania donovani What sample is preferred more than the tissue biopsy because of it being safer and less tedious?

Bone marrow aspiration

# Leishmania donovani This serologic test may be used to test for immunity against Leishmania donovani

Montenegro (Leishmanin) Test

# Leishmania donovani What medication is used for visceral Leishmaniasis?

IV Liposomal Amphotericin B (L-AmB)

# Leishmania donovani What medication is used for cutaneous, visceral, and mucosal Leishmaniasis?

Oral Miltefosine

The "Sleeping Sickness" is caused by 2 subspecies of what?

Trypanosoma brucei (gambiense or rhodesiense)

The "Sleeping Sickness" is aka what?

Human African Trypanosomiasis

Human African Trypanosomiasis is transmitted to man by what organism under the name Glossina palpalis/Glossina morsitans?

Tsetse Fly

What is the causative agent of Gambian trypanosomiasis which is prevalent in Mid and West Africa?

Trypanosoma gambiense

What is the causative agent of Rhodesian trypanosomiasis which is prevalent in the East and Southern Africa?

Trypanosoma rhodesiense

# Trypanosomes What stages can be found in trypanosomiasis?

Amastigote, Epimastigote and Trypomastigote

# Trypanosomes Where can the Epimastigote and Trypomastigote stages be found? (2 answers)

Epimastigote: Salivary glands of the insect vector Trypomastigote: Proboscis of the tsetse fly

# Trypanosomes Which among Epimastigotes and Trypomastogotes can be found in the bodies of humans?

Trypomastigote (infective stage to man)

# Trypanosomes Trypomastigotes in the salivary glands of the vector are injected into the organism when the tsetse fly is doing what?

Feeding on blood

# Trypanosomes What kind of transmission happens when tsetse flies inject the trypomastigotes into the organism during feeding time?

Anterior Transmission - coming directly from the salivary glands of the vector

# Trypanosomes Once the trypomastigote enters the circulation, it transforms into what stage as it reproduces through longitudinal binary fission?

Epimastigote

# Trypanosomes After an epimastigote reproduces via longitudinal binary fission, it becomes what?

A trypomastigote (again)

# Trypanosomes In what form of the parasite do the insect vectors obtain when they ingest blood from already infected individuals?

Trypomastigote (it becomes an epimastigote again once it enters the vector's body)

# Trypanosomes What kind of trypanosome is produced when an epimastigote multiplies in the vector's body?

Metacyclic Trypanosome

# Trypanosomes Where does the metacyclic trypanosome lodge into in the vector's body?

Salivary Glands

# Trypanosomes What is the incubation period for Trypanosoma gambiense?

6-14 days (less for T. rhodesiense)

# Trypanosomes Once the parasite induces a local inflammatory reaction, it multiplies via longitudinal binary fission which results in what?

Parasitemia

# Trypanosomes TOF: These organisms invade tissue as they circulate through the blood vessels

False (they do not invade tissues, only circulate the blood)

# Trypanosomes TOF: The parasites lodged in various tissues are considered patent and asymptomatic

True (no significant sign/symptom yet)

# Trypanosomes In the lymph nodes, there is a proliferation of what kind of cells that line the sinuses and leukocytic infiltration around blood vessels?

Endothelial Cells

# Trypanosomes The enlargement of post-cervical, submaxillary, inguinal, and femoral nodes is due to the invasion of the parasite in what organ?

Lymph Node

# Trypanosomes During the incidence of irregular fever, it usually occurs during this time period, what is that time period?

Evening

# Trypanosomes Prominent signs during the febrile period include: 1. Enlarged nodes at the posterior neck triangle 2. Delayed sensation to pain What are the other names for the two? (2 answers)

1. Winterbottom's sign 2. Kerandel sign

# Trypanosomes TOF: During the febrile period, it attacks with a period of intense symptoms majority of the time

False (period of no symptoms at all)

# Trypanosomes Where do the parasites invade into to cause the chronic sleeping sickness stage?

CNS

# Trypanosomes TOF: The "sleeping death's" death cases are caused via induced coma from the host's final feelings of sleepiness

False (may be due to pneumonia, meningitis, dysentery, heart failure, or severe fall when falling asleep)

# Trypanosomes In this trypanosome subspecies, CNS problems are usually lacking because of the rapidity of its course which doesn't allow the condition to progress into its chronic stages, what is this subspecies?

T. rhodesiense

# Trypanosomes The parasites of the "sleeping sickness" are quite numerous where during the period of the fever?

Blood

# Trypanosomes Animal inoculation is done when the normal sites for recovery of the parasite are positive or negative for it?

Negative | If you can't detect it in humans, inoculate it in the animals

# Trypanosomes This procedure is mandatory for those confirmed with trypanosomiasis or in those with neurological symptoms

Lumbar puncture

# Trypanosomes Pentamidine and Eflornithine are more effective against what disease?

Gambian trypanosomiasis | Pentamide is the drug of choice for early-stage infections

# Trypanosomes This alternative treatment to Gambian trypanosomiasis is the drug of choice for early-stage Rhodesian trypanosomiasis

Suramin

# Trypanosomes What is the drug of choice for late-stage Gambian sleeping sickness?

Eflornithine

# Trypanosomes This drug is the ONLY choice for late-stage T. rhodesiense

Melarsoprol

# Trypanosomes This is a protozoan parasite that is the etiologic agent of Chaga's disease or South American trypanosomiasis

Trypanosoma cruzi

# Trypanosomes T. cruzi parasites are mainly transmitted by contact with the feces or urine of what kind of bugs?

Blood-sucking triatomine bugs Panstrongylus megistus, Triatoma infestans, and Rhodnius prolixus

# Trypanosomes In what stages does T. cruzi occur when in man?

All four stages

# Trypanosomes In what stages does T. cruzi occur when in the vector?

Amastigote, Epimastigote, and Trypomastigote

# Trypanosomes T. cruzi vectors are aka?

Kissing Bugs (they bite on the mucus membranes of the lips and eyes)

# Trypanosomes TOF: Kissing bug bites often occur at night accompanied by a burning sensation

False (painless)

# Trypanosomes Which population (children or adults) is more susceptible to being infected with the metacyclic trypanosome of T. cruzi ?

Children

# Trypanosomes What is the infective stage of T. cruzi?

Metacyclic trypanosome

# Trypanosomes After the kissing bug has had its blood meal, the infection doesn't start with the bite, what instead infects the human?

Feces deposited near the puncture site along with rubbing into the wound

# Trypanosomes This refers to when the kissing bug punctures the skin and defecates near it, causing the parasite lodged into the feces to infect the open wound via rubbing

Posterior Transmission

# Trypanosomes Metacyclic trypanosomes that enter the skin are engulfed by phagocytes and is deposited where?

Adipose cells of subcutaneous tissue

# Trypanosomes After the trypomastigote of T. cruzi is engulfed by phagocytes, what stage will it assume next wherein it will reproduce by simple binary fission?

Amastigote

# Trypanosomes The fibrous encapsulation of the T. cruzi amastigote results in the formation of this blockade of lymph flow that leads to edema of the affected area

"Chagoma"

# Trypanosomes After the amastigotes have formed the "chagoma", what organ system will they invade next wherein they will transform back into trypomastigotes before they can circulate anywhere in the body?

Lymphatic System (adjacent lymph nodes)

# Trypanosomes When the kissing bugs feed on an infected individual, what stage of the T. cruzi parasite do they ingest?

Trypomastigote

# Trypanosomes Where does the metacyclic trypomastigote reside in the vector's body?

In their gut (because the mode of transmission is through urine/feces)

# Trypanosomes Chaga's disease manifests as a destruction of reticuloendothelial cells due to the increasing number of what?

Amastigotes

# Trypanosomes The T. cruzi parasites prefer to invade cells of what origin? (e.g. adipose, myocardial, reticuloendothelial, and neuroglial)

Mesenchymal

# Trypanosomes In acute Chaga's disease, the patient develops these 2 conditions before it turns into leukopenia (decreased WBCs)

Leukocytosis and Lymphocytosis (high WBC count) (anemia is also present)

# Trypanosomes During the peak of a Chaga's disease fever, what form is predominantly found in the patient?

Trypomastigote

# Trypanosomes Neurotropic strains of T. cruzi invade what kind of cells?

Neuroglial cells (amastigotes cause death to nerve cells)

# Trypanosomes What other 3 neurological conditions can occur in Chaga's disease apart from decreased neuroglial cells?

Encephalitis, Encephalomyelitis, and Meningoencephalitis

# Trypanosomes What part of hollow and viscous organs is destroyed due to T. cruzi?

Autonomic ganglia

# Trypanosomes In T. cruzi infections, an organ segment that is originally denerved will later on become what?

Progressively dilated (causes enlarged large intestine, esophagus, and ureters) *other names for the enlargement are as follows: megacolon, megaesophagus, and megaureter

# Trypanosomes What important organ is ALWAYS involved in Chaga's disease?

Heart (can lead to acute myocarditis)

# Trypanosomes Involvement of the heart in Chaga's disease leads to what condition characterized by conduction defects in the right bundle branch block?

Acute myocarditis

# Trypanosomes In chronic Chaga's disease, this condition is associated with dilated and thickened ventricular muscle accompanied by thinning and fibrosis at the apex

Cardiomegaly

# Trypanosomes In Chaga's disease, the initial cardiomegaly manifestation may progress into what?

Ventricular Aneurysm (one of the most important causes of death, the aneurysm)

# Trypanosomes In T. cruzi, what stages can be found in blood films and tissues during diagnosis? (2 separate answers)

Blood films: Trypomastigote Tissues: Amastigote

# Trypanosomes What organism is used for the xenodiagnosis of Chaga's disease?

Laboratory-bred Triatomid bug

# Trypanosomes Refers to a set of symptoms manifesting as the swelling of the face with marked edema of the eyelids of one or both signs

Romana's/Romaña's sign

# Trypanosomes What 2 medications can treat Chaga's disease?

Beznidazole (approved for 2-12 year olds) and Nifurtimox

These include one of the largest free-living amoeba where they are abundant in bodies of water, marine sediments, and even soil

Ciliatea/Ciliates

What ciliate species is known to be the only one to cause disease which is also the largest protozoa that can infect man?

Balantidium coli

# Balantidium coli This parasite produces what specific disease?

Balantidiasis

# Balantidium coli TOF: Balantidium coli exists in both cyst and trophozoite forms

True

# Balantidium coli Cyst or Trophozoite? Exclusively has a cytopyge and a cystosome

Trophozoite

# Balantidium coli Cyst or Trophozoite? Has retracted cilia

Cyst

# Balantidium coli Cyst or Trophozoite? Contains cilia

Both

# Balantidium coli Cyst or Trophozoite? Has a very thick wall which is hardly penetrated by stains (can still be stained though)

Cyst

# Balantidium coli Cyst or Trophozoite? Its endoplasm is coarsely granular

Cyst

# Balantidium coli TOF: The cyst stage has a cytostome and cytopyge

False

# Balantidium coli Cyst or Trophozoite? Has a large kidney-shaped macronucleus and a small spherical micronucleas situated near the concavity of the macronucleus

Both cyst and trophozoite

# Balantidium coli How does Balantidium coli multiply?

Transverse binary fission

# Balantidium coli What is its natural habitat in humans?

Large intestine (particularly the cecum)

# Balantidium coli What 2 animals can also be sources of cysts that are infective to man?

Monkeys and Pigs

# Balantidium coli How does one get infected with Balantidium coli?

Ingestion of mature viable cysts from contaminated food

# Balantidium coli In what organ does it undergo excystation?

Large intestine

# Balantidium coli TOF: Transforming from cyst to trophozoite (and vice versa) increases and decreases the organism's number of micro and macronuclei

False (no change in number of nuclei occur, still 1 of each macro and micronucleus)

# Balantidium coli In what event does it undergo encystation?

When being passed out into the feces

# Balantidium coli TOF: This cannot invade tissue, instead it solely travels through the bloodstream

False (it an invade tissue with the help of its cilia and lytic enzymes)

# Balantidium coli The trophozoite produces an ulcer similar to the one produced by E. histolytica but with a slightly larger opening, what does that ulcer look like (shape)?

Flask-shaped (+round, ovoid, or irregular with an undetermined edge)

# Balantidium coli The ulcer floor is covered with what?

Pus and necrotic material

# Balantidium coli Where does the ulcer lesion usually occur in?

Cecum

# Balantidium coli TOF: The patient manifests with diarrhea accompanied by watery blood-filled stool with right lower quadrant pain and tenderness

False (stool may come with or without blood)

# Balantidium coli Very rarely, the ulcer may perforate the walls of the intestine leading to what condition?

Peritonitis

# Balantidium coli What is the diagnostic form of balantidiasis when performing fresh fecal smears?

Cyst or Trophozoite are both accepted

# Balantidium coli Which forms can be found on watery stool and semi-formed or formed stool? (2 answers)

Watery: Trophozoite Semi-formed or formed: Cyst

# Balantidium coli What is the diagnostic feature of both the cyst and trophozoite form?

Macronucleus

# Balantidium coli What 3 anti-protozoal drugs are used?

1. Tetracycline 2. Metronidazole 3. Iodiquinol