PARA INTESTINAL FLAGELLATES Flashcards
an intestinal parasitic flagellate known to cause epidemic and endemic diarrhea
Giardia intestinalis
symptoms include diarrhea, stomach cramps, and bloating
Giardiasis
Giardia intestinalis was discovered by ______________________________ in his own stool (1681)
Antoine van Leeuwenhoek
first described by _________ a french scientist
Dr. F. Lambl (1859)
Dr. F. Lambl called it
Cercomonas intestinalis
replication of Giardia intestinalis
Longitudinal Binary Fission
young cyst of G. intestinalis have __ nuclei while mature cysts have ___
2, 4
shape of Giardia intestinalis cyst
Ovoid in shape
shape of Giardia intestinalis trophozoite
pyriform or teardrop-shaped
Giardia intestinalis trophozoite nuclei
pair of ovoidal nuclei, each side of the midline
Giardia intestinalis dorsal side is _________ while ventral side is _______________
Convex, Concave
Medial line of Giardia intestinalis is called
axostyle
the Giardia intestinalis trophozoite has 4 pairs of flagella,____________________, ______________________, ________________________
1 pair extending anteriorly, 1 pair extending posteriorly, 2 pairs extending centrally
infective stage of Giardia intestinalis
MATURE CYST
excystation of Giardia intestinalis happens in
duodenum
Giardia intestinalis trophozoites attaches to the ______________________
intestinal villi
Giardia intestinalis cysts are passed out in the stool and are viable up to ___________ in water
3 months
encystation of Giardia intestinalis occurs in
colon or large intestine
Giardia intestinalis is able to alter _____________________ once it has attached to the apical portion of the enterocyte
mucosal intestinal cells
Giardia intestinalis attachment is maximal at _________________ and stable at pH ____________
Body temperature, 7.8- 8.2
Giardia intestinalis avoid peristalsis by __________________
trapping in between the villi
alterations caused by Giardia intestinalis include
villous flattening, crypt hypertrophy
Clinical manifestation of Giardia intestinalis in chronic cases
Steatorrhea
Clinical manifestation of Giardia intestinalis in acute cases
Abdominal pain and cramping
Abdominal Bloating
Diarrhea
Excessive flatus
Odor of rotten eggs
Nausea
Anorexia
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