PARA INTESTINAL FLAGELLATES Flashcards by Reign A. E.

an intestinal parasitic flagellate known to cause epidemic and endemic diarrhea

Giardia intestinalis

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symptoms include diarrhea, stomach cramps, and bloating

Giardiasis

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Giardia intestinalis was discovered by ______________________________ in his own stool (1681)

Antoine van Leeuwenhoek

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first described by _________ a french scientist

Dr. F. Lambl (1859)

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Dr. F. Lambl called it

Cercomonas intestinalis

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replication of Giardia intestinalis

Longitudinal Binary Fission

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young cyst of G. intestinalis have __ nuclei while mature cysts have ___

2, 4

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shape of Giardia intestinalis cyst

Ovoid in shape

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shape of Giardia intestinalis trophozoite

pyriform or teardrop-shaped

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Giardia intestinalis trophozoite nuclei

pair of ovoidal nuclei, each side of the midline

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Giardia intestinalis dorsal side is _________ while ventral side is _______________

Convex, Concave

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Medial line of Giardia intestinalis is called

axostyle

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the Giardia intestinalis trophozoite has 4 pairs of flagella,____________________, ______________________, ________________________

1 pair extending anteriorly, 1 pair extending posteriorly, 2 pairs extending centrally

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infective stage of Giardia intestinalis

MATURE CYST

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excystation of Giardia intestinalis happens in

duodenum

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Giardia intestinalis trophozoites attaches to the ______________________

intestinal villi

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Giardia intestinalis cysts are passed out in the stool and are viable up to ___________ in water

3 months

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encystation of Giardia intestinalis occurs in

colon or large intestine

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Giardia intestinalis is able to alter _____________________ once it has attached to the apical portion of the enterocyte

mucosal intestinal cells

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Giardia intestinalis attachment is maximal at _________________ and stable at pH ____________

Body temperature, 7.8- 8.2

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Giardia intestinalis avoid peristalsis by __________________

trapping in between the villi

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alterations caused by Giardia intestinalis include

villous flattening, crypt hypertrophy

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Clinical manifestation of Giardia intestinalis in chronic cases

Steatorrhea

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Clinical manifestation of Giardia intestinalis in acute cases

Abdominal pain and cramping
Abdominal Bloating
Diarrhea
Excessive flatus
Odor of rotten eggs
Nausea
Anorexia

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Clinical manifestation of Giardiasis

Mild Diarrhea Abdominal Cramps Anorexia Flatulence

motility of Giardia intestinalis

Falling leaf or Floating leaf-like

recommended number of stool specimens for Giardia intestinalis

3 stool examinations on alternate days

Treatment for Giardia intestinalis

- Metronidazole - Tinidazole - Furazolidone - Albendazole - Nitazoxanide (Drug resistant Cases)

common flagellates of the tropical areas

Trichomonas spp.

Trichomonas spp. only exist in ____________

trophozoite stage

Trichomonas spp. has an ________ which runs down the middle of the body and ends in the pointed end of the trophozoite

axostyle

Trichomonas spp. consists of _____ flagella

3-5

inhabits the mouth and the smallest among the Trichomonas spp.

Trichomonas tenax

inhabits the intestine and is slightly larger than T. tenax

Trichomonas hominis

inhabits the genital tract and is the largest among the Trichomonas spp.

Trichomonas vaginalis

most robust Trichomonas spp.

Trichomonas vaginalis

most slender Trichomonas spp.

Trichomonas tenax

Trichomonas vaginalis and tenax have _______________ undulating membrane accompanied by a very narrow costa with ________________

less than body length, no posterior trailing flagellum

nucleus of Trichomonas vaginalis

Nucleus Elongated with chromatin usually appearing like small or fine granules, uniformly distributed Rounded, oval, or angular in shape with chromatin varying in appearance: homogenous or large masses

nucleus of Trichomonas tenax

Rounded, oval, or angular in shape with chromatin varying in appearance: homogenous or large masses

axostyle of Trichomonas vaginalis

May split up into 2-8 splinters

axostyle of Trichomonas tenax

slender

appearance in iron hemotoxylin prep of Trichomonas vaginalis

granules are prominent

appearance in iron hemotoxylin prep of Trichomonas tenax

granules along the costa, but are few

lives in the tartar around the teeth and gums

T. tenax

Non pathogenic Trichomonas spp.

T. tenax T. hominis

inhabits the cecal area of large intestine

T. hominis

mode of transmission of Trichomonas hominis

Fecal-oral Route

motility of Trichomonas spp.

jerky, quirvy

most prevalent non-viral STI

Trichomoniasis

Trichomonas vaginalis is found in the ____________________ of women

vagina, renal pelvis

Trichomonas vaginalis is found in the ____________________ of men

urethra, prostate, epididymis

Mode of transmission of Trichomonas vaginalis

Sexual Intercourse

include symptoms of scanty secretion mixed with mucus and purulent and copious

Vaginal Infection (STRAWBERRY CERVIX)

Trichomonas vaginalis secretes foul-smelling liquid vaginal secretions, __________ or ________ in color

greenish or yellow

quickest and most inexpensive way to diagnose trichomoniasis

saline preparation of vaginal fluid

golden standard of Trichomonas vaginalis Culture

2 to 5 days - Diamond's modified medium - Feinberg and Whittington medium

standard treatment of Trichomonas vaginalis

Metronidazole

Motility of T. vaginalis

Rapid, jerky

Motility of T. hominis

Nervous, jerky

only intestinal ciliate infecting humans

Balantidium coli

reservoir host of Balantidium coli

PIGS

disease caused by Balantidium coli

Balantidiasis

bean shaped, easily identified

Macronucleus

extrusive organelles beneath the cell membrane

Mucocysts

color of Balantidium coli if unstained

greenish-yellow

incubation period of Balantidium coli

4-5 days

excystation of Balantidium coli occurs in _________________

small intestine

trophozoite inhabit the lumen, mucosa, and submucosa of the ____________________

large intestine

Balantidium coli reproduction

asymmetric binary fission

infective stage of Balantidium coli

Cysts via hog's feces

Do not present with diarrhea or dysentery, may serve as parasite reservoir

Asymptomatic Carriers

diarrhea with bloody and mucoid stool

Balantidial Dysentery/ Fulminant Balantidiasis

6 to 15 episodes of diarrhea accompanied with abdominal pain, nausea, and vomiting

Acute Balantidiasis

Diarrhea may alternate with constipation, and may be accompanied by non specific symptoms such as: - Abdominal pain - Anemia

Chronic Balantidiasis

infection of mesenteric nodes, appendix, liver, genitourinary sites, pleura, and lungs

Extraintestinal Balantidiasis

Extraintestinal Balantidiasis complications

Intestinal Perforation & Acute Appendicitis

treatment for Balantidium coli

metronidazole 750g per 3 times daily tetracycline 500mg or 40mg/kg/dose divided in 4 doses for 10 days (adult and children)

diagnosis for Pulmonary Balantidiasis

Bronchoalveolar washing