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2A PRELIM > PARA ENTA > Flashcards

PARA ENTA Flashcards

1
Q

What are the seven species of amebae

A

Entamoeba histolytica
Entamoeba coli
Entamoeba dispar
Entamoeba moshkovskii
Entamoeba hartmanni
Endolimax nana
Iodamoeba butchlii

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2
Q

Intestinal ameba of pigs and monkeys, ocassionally found in humans (zoonotic)

A

Entamoeba polecki

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3
Q

Ameba Trophozoites divide by:

A

Binary Fission

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4
Q

Cyst-forming ameba divide by:

A

Nuclear division

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5
Q

Where does the final nuclear divison of cyst-forming ameba happen?

A

Excystion in a new host

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6
Q

Complete the taxonomy of the Entamoeba histolytica:Subphylum:Superclass:Class:Order:Family:Genus:

A

Sarcodina Rhizopoda Lobosea Amoebida Entamoebidae Entamoeba

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7
Q

Describe the characterization of the genus Entamoeba:

A

Vesicular nucleus
Centrally (or near central) located karyosome
Varying numbers of Chromatin Granules adhering to the Nuclear membrane

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8
Q

What are the Laredo Strain

A

Entamoeba histolytica
E. dispar
E. moshkovskii

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9
Q

The tests that distinguish Entamoeba histolytica from the complex:

A

Isoenzyme analysis
Polymerase chain reaction
Restriction fragment length polymorphism
Monoclonal antibodies typing

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10
Q

This species is known to be morphologically similar to E. histolytica, but differentiated through size”Small race” of E. histolytica

A

Entamoeba hartmanni

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11
Q

Entamoeba hartmanni

A

This species is known to be morphologically similar to E. histolytica, but differentiated through size”Small race” of E. histolytica

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12
Q

Pseodopod-forming non-flagellated protozoan parasite

A

Entamoeba histolytica (parasite biology)

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13
Q

Entamoeba histolytica (parasite biology)

A

Pseodopod-forming non-flagellated protozoan parasite

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14
Q

Invasive species of the Entamoebidae:

A

Entamoeba dispar
E. moshkovskii
E. gingivalis
Entamoeba histolytica
E. hartmanni
E. polecki
E. coli

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15
Q

The only species of the family to cause liver abscess

A

Entamoeba histolytica (common pathology and clinical manifestation)

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16
Q

Entamoeba histolytica (common pathology and clinical manifestation)

A

The only species of the family to cause liver abscess

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17
Q

What are the two stages of the life cycle of E. histolytica?

A

Infective cyst stage
Invasive (vegetative) trophozoite stage

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18
Q

The main host of E. histolytica

A

Human (and occasional infection of primates)

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19
Q

Resitant to gastric acidity and dessication, and can survive in a moist environment for several weeks.

A

Quadrinucleate cyst (E. histolytica)

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20
Q

Infection with E. histolytica occurs due to:

A

Ingestion of mature cyst from fecally-contaminated material

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21
Q

Aside from ingestion of fecally-contaminated material, what are the other modes of transmission of E. histolytica:

A

Venereal transmission through fecal-oral contactDirect colonic inoculation through contaminated enema equipment

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22
Q

Where does excystation of E. histolytica cyst occurs?

A

Small or large bowel

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23
Q

1 cyst: ___ trophozoite (number of excysted troph)

A

Eight

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24
Q

The E. histolytica trophozoites are […] motile and possess […]

A

The E. histolytica trophozoites are highly motile and possess pseudopodia

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25
Q

Size of E. histolytica troph:

A

12-60 micrometer (ave. 20 micrometer)

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26
Q

Motility of E. histolytica:

A

Progressive and (uni)directional

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27
Q

Locomotory organelle of E. histolytica

A

Pseodopodia

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28
Q

Characteristics of Psedopodia of E. histolytica:

A

contains Hyaline Clear, glasslike EctoplasmGranular Endoplasm flows into the extrusion

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29
Q

Observed as pale, greenish, refractile bodies in the cytoplasm

A

Ingested red blood cells

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30
Q

Size of the E. histolytica cyst

A

10-20 micrometer

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31
Q

Characteristics of E. histolytica cyst:

A

Hyaline wall
1-4 nuclei
Rod-shaped (cigar-shaped) Chromatoidal bars

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32
Q

How mant successive nuclear division occur in the E. histolytica cyst

A

two

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33
Q

What are the genes that suggest E. histolytica may have had a mitochondria?

A

Pyridine nucleotide transhydrogenase
hsp60

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34
Q

Where can the functionality of the ER and Golgi body be found in the E. histolytica?

A

Cell surface (with secreted proteins)

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35
Q

What structure inhibits protein glycosylation in E. histolytica?

A

Tunicamycin

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36
Q

What are some differences in biochemical pathways from higher eukaryotes in E. histolytica?

A

Lack of glutathione metabolismPyrophosphate is used instead of ATP in glycolysisInability to synthesize de novo of purine nucleotides

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37
Q

End product of glucose metabolism of E. histolytica:

A

EthanolCO2Aerobic condition:Acetate

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38
Q

Proposed mechansim for virulence of E. histolytica:

A

Production of enzyme or other cytotoxic substances (which forms Amebapores)Contact-dependent cell killing (via Gal Lectin)Cytophagocytosis

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39
Q

The parasitic ameba kills mucosal cell via activation of what enzyme/protein that leads to the apoptotic death of the cells

A

Caspase-3

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40
Q

Susceptibility of humans to E. histolytica may be associated with what specific allele?

A

HLA complex

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41
Q

The differentiation of E. dispar to E. histolytica has confirmed what about the prevalence of the two?

A

E. dispar is higher compared to E. histolytica via PCR testing

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42
Q

A clinical manifestation of E. histolytica with the gradual onset of abdominal pain and diarrhea, with or without blood and mucus in the stools.

A

Amebic colitis

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43
Q

Fever is not common in E. histolytica infection, and occurs only:

A

1/3 of the patients

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44
Q

These demographic is susceptible to developing fulminant colitis with severe bloody diarrhea, fever, and abdominal pain.

A

Children

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45
Q

This clinical manifestation in E. histolytica infection is a mass-like lession with abdominal pain and history of dysentery. And it occurs ___ of intestinal infections

A

Ameboma

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46
Q

Ameboma can be mistaken with what other condition?

A

Carcinoma

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47
Q

The most common extra-intestinal form of amebiasis.

A

Amebic liver abscess (ALA)

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48
Q

What are the cardinal signs of ALA?

A

Fever
Right upper quadrant (RUQ) pain

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49
Q

ALA pain is localized or referred to in what location of the body?

A

Right shoulder?

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50
Q

The […] is tender, especially in acute cases, and […] is present in 50% of cases. (ALA clinical manifestations)

A

The liver is tender, especially in acute cases, and hepatomegaly is present in 50% of cases. (ALA clinical manifestations)

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51
Q

The onset of amebic colitis is sudden after an incubation period of?

A

8-10 days

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52
Q

ALA may have all the acute presentation in ____ (time), and chronic of ____ (time)

A

2 weeks
2 weeks

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53
Q

The most serious complication of amebic colitis is:

A

Perforation
Bacterial peritonitis

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54
Q

[…] occurs in 60% of fulminant colitis cases.

A

Colonic perforation occurs in 60% of fulminant colitis cases.

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55
Q

The most serious complication in ALA are:

A

Rupture into the pericardium (70% mortality)Rupture into the Spleura (15-30%)Superinfection

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56
Q

Second most common complication in ALA:

A

Intraperitoneal rupture (2-7.5% of cases)

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57
Q

It should be considered in cases of amebiasis with abnormal mental status.

A

Secondary amebic meningocephalitis (clinical manifestation and consideration)

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58
Q

Genital involvement is caused by what? (ALA and colitis)

A

fistulae

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59
Q

Natural or innate immunity to E. histolytica in the involves what to the amebic attachment to the underlying mucosal cells?

A

Mucin inhibition

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60
Q

In systemic circulation, what is the mode of immunity for trophozoites?

A

Complement-mediated killing

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61
Q

What are the three processes in which activated T-cells kill E. histolytica?

A

Directly lysing trophozoites in a contact-dependent processproducing cytokines which activate macrophage and other effector cells (neutrophils and eosinophils)Providing helper effect for B-cell antibody production

62
Q

What are the two cytokines that enable macrophage to activate for ameboidal activity?

A

interferons (IFN)interleukin (IL-2)

63
Q

What compound does macrophage release that is lethal to trophozoites?

A

Nitric oxide

64
Q

What factor stimulates the release of nitric oxide in macrophage?

A

Tumor necrosis factor

65
Q

What stage in E. histoylityca infection does the human subjects (and animals) show immunosuppresion?

A

Acute stage of amebiasis

66
Q

The acute stage of amebiasis present these characteristics that is favorablef for amebic survival:

A

T-cell hyporesponsiveness
Suppressed proliferation and cytokine production
Depressed delayed-type hypersensitivity Macrophage suppression

67
Q

What are some etiologic agent that should different shate bacilliary dysentery from amebic colitis?

A

Shigella Salmonella Campylobacter YersiniaEscherichia coli

68
Q

Fever and high leukocyte-count is less common in? (comparison between bacillary and amebic)

A

Amebic colitis

69
Q

Amebic colitis should be ruled out before this therapy for this condition due to the risk of developing toxic megacolon

A

Steroid therapy for inflammatory bowel disease

70
Q

What are the differential diagnosis for ALA:

A

Pyogenic liver diseaseTuberculosis of the liverHepatic carcinoma

71
Q

Genital amebiasis should be differentiated from:

A

CarcinomaTuberculosisChancroid Lymphogranuloma venereum

72
Q

The standard method for parasitologic diagnosis, especially for E. histolytica, is what?

A

Microscopic detection of trophozoites and cyst in stool specimens

73
Q

How many stool specimen and days for examination of E. histolytica?

A

Three stool sample for every 2-3 days in 10 days

74
Q

For detection of trophozoites of E. histolytica, what stool sample should be examined?

A

Fresh stool sample defacated within 30 minutes

75
Q

What technique is used to see the motility of E. histolytica trophozoite?

A

Direct fecal smear (DFS) with saline solution

76
Q

What technique or stain is used to differentiate Entamoeba spp. from white blood cells?

A

Saline and methylene blue

77
Q

What technique or stain is used to differentiate E. histolytica from nonpathogenic species?

A

Saline and iodine

78
Q

What feature seen in the stool is diagnostic of amebiasis?

A

E. histolytica trophozoites with ingested red blood cells. Charcot-leyden crystals can also be observed.

79
Q

These concentration technique is more sensitive than DFS in detection of E. histolytica cysts

A

Formalin Ether/Ethyl acetate concentration test (FECT)Methiolate-Iodine-Formalin concentration test (MIFC)

80
Q

These morphological structure are noted of E. histolytica cyst:

A

Size of the cystNumber of nucleiLocation and appearance of karyosomeCharacteristic appearance of chromatoid bodiesPresence of cytoplasmic features such as glycogen vacuole

81
Q

What stool culture is more sensitive than stool microscopy?

A

Robinson’s and Inoki medium

82
Q

Differentiation of E. histolytica to what other Entamoeba sp. is not possible by microscopy

A

E. dispar (and E. moshkovskii)

83
Q

This is the key diagnosis of ALA

A

Detection of antibodies in the serum

84
Q

Why is microscopy not suitable for the diagnosis of ALA?

A

Aspiration is an invasive procedureTrophozoites are missed because they are located in the periphery of the abscess

85
Q

What are the serological tests for amebic disease?

A

Indirect hemagglutination (IHAT)
Counter immunoeletrophoresis (CIE)
Agar gel diffusion (AGD)
Indirect fluorescent antibody test (IFAT)
Enzyme Immunosorbent Assay (ELISA)

86
Q

This serological test can detect amebic infection for as long as 10 years ago?

A

Indirect hemagglutination (IHAT)

87
Q

Noninvasive methods that are sensitive in detecting early ALA

A

Ultrasound Computerized Tomography (CT) scan
Magnetic Resonance imaging (MRI)

88
Q

What are the two objectives for treatment of amebiasis?

A

To cure invasive disease at both intestinal and extraintestinal sitesTo eliminate passage of cysts from the intestinal lumen

89
Q

Drug of choice for treatment of invasive amebiasis

A

Metronidazole

90
Q

Drug of choice for asymptomatic cyst passers in amebiasis:

A

Diloxanide

91
Q

Indicated for patient who do not respond to metronidazole and who need prompt symptomatic relief of severe pain.Also done for left lobe abscess that may rupture to the pericardium, large abscesses in danger of rupture, and multiple abscesses with a probable associated pyogenic etiology.

A

Percutateous drainage of liver abscess

92
Q

What are the three species in E. histolytica complex?

A

E. histolytica E. disparE. moshkovskii

93
Q

What are the two significance of the presence of commensal amebae in the stool of an individual:

A

They can be mistaken for the pathogenic E. histolytica It is an indication of fecal contamination of food or water

94
Q

What are the three genera of the intestinal amebae:

A

EntamoebaEndolimaxIodamoeba

95
Q

This genus has a spherical with a distinct nuclear membrane lined with chromatin granules and a small karyosome found near the center of the nucleus.

A

Entamoeba

96
Q

How many nucleus is typical of the Entamoeba trophozoites?

A

One

97
Q

This genus has a vesicular nucleus with a relatively large, irregularly shaped karyosome anchored to the nucleus by achromatic fibrils.

A

Endolimax

98
Q

This genus is characterized by a large, chromatin-rich karyosome surrounded by a layer of achromatic globules and anchored to the nuclear membrane by achromatic fibrils.

A

Iodamoeba

99
Q

All species of the commensal amebae have the following stages:Except:

A

TrophozoitePrecystCyst Metacystic Trophozoite;Entamoeba gingivalis

100
Q

Commensal amebae excyst in what environment and location in the body?

A

Alkaline environment of the lower small intestines

101
Q

These colonize the large intestines and live on the mucus coat covering the intestinal mucosa.

A

Metacystic trophozoites of commensal amebae

102
Q

What is the division of Commensal amebae trophozoite?

A

Binary fission

103
Q

Encystation of commensal amebae happens at what location of the body?

A

Lower colon (where colonic contents are more dehydrated)

104
Q

This commensal amebae is morphologically similar to E. histolytica, but their DNA and ribosomal RNA is different.

A

E. dispar

105
Q

First detected in sewage, and is morphologically indistinguishable from E. histolytica.

A

E. moshkovskii

106
Q

This is uniquely osmotolerant and able to grow at room temperature (25-30 degrees celsius)

A

E. moshkovskii

107
Q

All human isolates of E. moshkovskii belong to one group called?

A

Ribodeme 2

108
Q

The appearance of this commensal amebae is relatively similar to that of E. histolytica but smaller

A

E. hartmanni

109
Q

Size of trophozoite of E. hartmanni:What about cyst?

A

3-12 micrometer;4-10 micrometer

110
Q

Characteristics of the mature cyst of E. hartmanni:

A

Quadrinucleate cystRod-shaped chromatoidal bars with rounded or squared ends

111
Q

A commensal amebae that is cosmopolitan in distribution and is considerably more common than other human amebae:

A

Entamoeba coli

112
Q

Size of Entamoeba coli trophozoite: What about cyst?

A

15-50 micrometer;10-35 micrometer

113
Q

What are the characteristics of Entamoeba coli trophozoites in comparison with E. histolytica?

A

More vacuolated or granular endoplasm with bacteria and debris, but no red blood cells Narrower, less-differentiated ectroplasmBroader and blunter pseudopodia, for feeding than locomotionSluggish, undirected movementsthicker, irregular peripheral chromatin with a large, eccentric karyosome in the nucleus

114
Q

Characteristics of Entamoeba coli cyst, in comparison with E. histolytica:

A

Larger size (10-35 micrometer)More nuclei (8-16)More granular cytoplasm Splinter-like chromatoidal bars

115
Q

Iodine staining reveals what feature or structure in Entamoeba histolytica cyst:

A

Dark-staining, perinuclear masses of glycogen

116
Q

Where is the glycogen mass of the Entamoeba coli located?

A

Surrounds the nucleus

117
Q

A commensal amebae found in the intestines of pigs and monkeys, and is rarely found in humans.

A

Entamoeba polecki

118
Q

Motility of E. polecki:

A

Sluggish (and undirectional)

119
Q

Characteristics of E. polecki cyst:

A

consistently uninucleateAngular or pointed chromatoidal bars

120
Q

In stained fecal smear of E. polecki, these strutures are prominent:

A

nuclear membranekaryosome

121
Q

This commensal amebae is found in apes and monkeys and is morphologically simillar to E. polecki

A

Entamoeba chattoni

122
Q

Recently, how many human infections are detected of E. chattoni?

A

Eight

123
Q

This commensal amebae is found in the mouth

A

Entamoeba gingivalis

124
Q

Motility of Entamoeba gingivalis:

A

Quick

125
Q

Characteristics of E. gingivalis:

A

Numerous blunt pseudopodiaFood vacuoles contain cellular debris (mostly leukocytes) and bacteria

126
Q

A commensal amebae occurs the same frequency of Entamoeba coli:

A

Endolimax nana

127
Q

Size of E. nana trophozoites:Cyst?

A

5-12 micrometer;same sa trophozoite

128
Q

Motility of E. nana:

A

Sluggish

129
Q

What are the characteristics of E. nana trophozoites?

A

Blunt, hyaline pseudopodiaLarge, irregular karyosomeFood vacuoles has bacteria

130
Q

How many nucleus of cyst of E. nana?

A

Quadrinucleate (4)

131
Q

Identified by large, vesicular nucleus with a large, central karyosome, surrounded by acrhomatic granules

A

Iodamoeba butschlii

132
Q

Size of I. butschlii trophozoite:Cyst?

A

9-14 micrometer (ave. 4-20 micrometer);9-10 micrometer (ave. 6-16 micrometer)

133
Q

A commensal amebae that has no peripheral chromatin granules on the nuclear membrane:

A

Iodamoeba butschlii

134
Q

Characteristics of I. butschlii cyst:

A

UninucleateLarge glycogen body that stains dark brown with iodine

135
Q

‘Diagnosis’ of commensal amebae:

A

Stool examination

136
Q

These technique and stain are useful to differentiate the species of commensal amebae:

A

FECT and iodine stain

137
Q

This is the sample collection of E. gingivalis:

A

Swab between gums and teeth

138
Q

Cyst are recovered in what stool?How about trophozoite?

A

Formed stools; Watery or semi-formed stools

139
Q

What are the concentration techniques for commensal amebae?

A

FECT or Zinc Sulfate floatation

140
Q

Who discovered E. histolytica and what time range?

A

Losch between 1873-1875

141
Q

Who differentiated E. coli and what year?

A

Schaudinn in 1903

142
Q

Who established the pathogenicity of E. histolytica and what year?

A

Walker and Sellards in 1913

143
Q

Cyst stage of E. histolytica can survive in what condition:What about trophozoite?

A

2 days in 37 degrees celsius up to 60 days at 0 degrees celsius;5 hours in 37 degrees celsius up to 96 hours at 5 degrees celsius

144
Q

Virulence factors of E. histolytica:

A

Gal/GalNAc lectinAmebaporesCysteine proteinase/protease

145
Q

Bull’s eye karyosome

A

E. histolytica

146
Q

Blot-like karyosome

A

E. nana

147
Q

Mahogany brown iodine cyst

A

Iodamoeba butschlii

148
Q

Commensal ameba with “basket nuclei”

A

Iodamoeba butschlii

149
Q

ADDITIONAL!!!Identified initially as an amoeba, but later became a flagellate

A

Dientamoeba fragilis

150
Q

Isoenzyme marker of E. dispar that differentiate it from E. histolytica:And the antigen?

A

Hexokinase;Gafractose specific lectin

2A PRELIM (29 decks)

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