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Parasitology > parasite treatment of choice > Flashcards

parasite treatment of choice Flashcards

1
Q

What is the treatment of choice for S haematobium
S mansoni ?

A

Praziquantel 40 mg/kg Stat

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2
Q

What is the treatment of choice of S japonicum

A

Praziquantel 60mg/kg stat

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3
Q

What is the treatment of choice for :
- Ascaris
- Hookworms
- Trichuris

A
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4
Q

What is the treatment of choice for Ascaris?

A
  • Mebendazole 500 mg stat
    Or:
  • Mebendazole 100 mg BD for 3 days
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5
Q

What is the treatment of choice for Hookworm?

A
  • Albendazole 400 stat
    or
  • Mebendazole 100 mg BD for 3 days
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6
Q

What is the treatment of choice for Trichuris?

A
  • Albendazole 400 mg stat (Plus: Ivermectin for 3 says )

Or:

  • Mebendazole 100 mg BD for 3 days
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7
Q

What is the treatment of choice for Strongyloides?

A

Ivermectin 200 mg/kg/day for 2 days

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8
Q

Treatment of:
Early stage gHAT?

A

1st line:
Fexinidazole orally 1800 mg po OD X 4 days then 1200 mg OD x6 days
2nd line:
IM Pentamidine Isetionade 4mg/kg/ day for 4 days

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9
Q

Late stage gHAT?
(West African sleeping sickness)

A

Eflornithine IV 200 mg/kg BD X 7 days PLUS Nifurtimox PO TDS 5mg/kg for 10 days

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10
Q

Early stage rHAT?
(East African sleeping sickness)

A

IV Suramin 5mg/kg as test dose then 20mh/kg on day 3,10 , 17 , 24 ,31

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11
Q

Late stage rHAT?
(East African sleeping sickness)

A

Melarsoprol IV 3 cycles of 3 days of 3.6mg/kg with rest for 7-10 days

Or: 2.2mg/kg OD for 10 days

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12
Q

Chagas disease treatment?

A

1- Nifurtimox :
* 8-10mg/kg PO in 3 daily divided doses for 90 days .
* used (alongside with Eflornithine) in late gHAT and Acute and chronic Chagas disease.

2- Benznidazole:
*5-7 mg/kg (children 10mg/kg) PO in 2 divided doses for 60 days
*If weight >60 kg can extend course beyond 60 days
* Maximum daily dose 300 mg
* used in acute and chronic Chagas

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13
Q

Uncomplicated P falciparum and non-falciparum in pregnant 1st trimester?

A

Artemether + lumefantrine

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14
Q

treatment of sever malaria ( including pregnant women af all trimesters and infants)

A

IV/IM artesunate for at least 24h or until can tolerate orally then 3 days course of ACT

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15
Q

Documented 3 plasmodium with Antimalaria resistant

A

P falciparum
P vivax
P malariae

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16
Q

brucella growth in chocolate agar is indistinguishable from which organism?

A

Haemophilus influenzas

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17
Q

Brucellosis treatment?

A

6 weeks of treatment :

1- Doxy +rifampicin (first line)
2- Doxy + CN or Streptomycin
3-Doxy+ Cipro or ofloxacin
4- Rif + cipro or ofloxacin
5- cotrim +rif in pregnancy

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18
Q
A
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19
Q
A
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20
Q
A
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21
Q

Isospora belli ?

A

Cotrimoxazole
Ciprofloxacin
Pyrimethamine

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22
Q

Toxoplasmosis

A

1- Pyrimethamine (with Leucovorin) plus Sulfadiazine
2- Clindamycin
3- Cotrimoxazole
4- Atovaquone and pyrimethamine
5- Azithromycin

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23
Q

Taenia saginatum

A

1- Niclosamide
2- Praziquantel

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24
Q

How to detect Artemisinin resistance gene Mutation

A

K13 gene deletion

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25
Q

Treatment of choice :
Fasciola hepatica?

A

triclabendazole

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25
Q

Treatment of intestinal stage of all tapeworms (cestode)?

Tissue forms( hydatid and cysticercosis??

A

1- Praziquantel

2- Albendazole and surgical

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25
Q

Giardia treatment of choice ?

A

1- Metronidazole
2- Tinidazole
3- Nitazoxanide (mainly for children - available in liquid form)
4- Paromomycin if pregnant

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26
Q

Cyclospora caytanensis

A

Cotrimoxazole
hydration

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27
Q

Amoebiasis treatment?

A

1- Asymptomatic(cysts only): Diloxanide-furoate

2-Symptomatic (Cyst and trophozoites) Metronidazole

3- extra-intestinal:
HD Metronidazole

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28
Q

What is the cause and treatment of choice of Buruli ulcer?

A

Mycobacterium ulcerans

Treatment:
rifampicin (10 mg/kg once daily) Plus clarithromycin (7.5 mg/kg twice daily)

for 8 weeks then skin graft

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29
Q

Management of tetanus ?

A

1- Wound management
2- IV Metronidazole for 10 days
3-Active immunisation: (3 doses , 1 month apart)
4- Immunoglobulins
5-Benzodiazepine
6- Neuromuscular blockage (Pancuronium)
7- Mg sulphate (adrenergic blockade)
8- Early tracheostomy

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30
Q

Treatment of choice of Melioidosis ?

A

1- Induction:
first 2 weeks ( can be extended to 6 -8 weeks if deep seated infection/ bone /joint/ abscesses:
- IV Ceftazidime 2 grams QDS or IV Meropenem 1 gram TDS
- Consider IV G-CSF 300 MG OD for 10 days

2- Eradication phase:
- for 3-6 months
Cotrimoxazole PO 80mg/kg/day in divided doses +/- Doxycycline 100 mg po bd
- alternative : oral co-amoxiclav but can be less effective

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31
Q

T/F:
When diagnosing histoplasmosis , antigen detection in better from Urine sample than serum ?

A

T
sensitivity 96.7% v/s 78.7%

32
Q

Pathognomic microscopy feature of Histoplasma capsulatum

A

Thick walled , spherical Macroconidia with distinctive projections

33
Q

What is the mainstay diagnostic test for Histoplasmosis?

A

Serology is the best modality
others include:
1- culture and microscopy
2- EIA antigen detection urine>serum
3- PCR - disappointing

34
Q

Treatment of Histoplasmosis?

A

1- Itraconazole if mild disease

2- Amphotericin if disseminated histoplasmosis

35
Q

What are the clinically important dimorphic fungi ?

A

1- Histoplasmosis : -
- Histoplasm capsulatum var capsulatum (worldwide)
- Histoplasma capsulatum var duboisii (Africa).

2- Blastomyces dermatitidis

3- Coccidioides immitis
(inland California)
Coccidioides posadasii (widespread in SW USA)

4- Paracoccidiomycosis

5- Sporothrix schenckii
(rose handlers disease)

6- Talaromyces marneffei (penicellosis/
talaromycosis) with fever and anaemia similar to disseminated cryptococcosis

36
Q

Treatment of Coccidioidomycosis and Paracoccidiomycosis ?

A

1- Ampizome and azole

2- Sulphadiazine or cotrimoxazole
alternative : amphotericine or itraconazole

37
Q

What is the recommended treatment of phthiriasis (Pediculosis pubis )?

A

1- Malathion 0.5% (wash off after 2h to12 h)

2- Permethrin 1% rinse cream (wash off after 10 min)

3- Phenothrin 0,2% (wash off after 10 min)

4- Carbaryl 0.5-1%
(unlicenced)

38
Q

What are the cause and the vectors of :
1- Murine endemic typhus.
2- Epidemic typhus

A

1- Murine endemic typhus:
- Caused by rickettsia typhi
- Transmit by Oriental rat flease (Xynopsella cheopis)

2- Epidemic typhus
- Cused by Rickettsis prowazikii
transmit by body lice (Pediculus

39
Q

Treatment of scabies?

A

1- Malathion 0.5%
2- Permethrin 5% rinse cream
3- Benzyl benzoate 25% emulsion
4- Oral ivermectin

40
Q

Treatment of Leprosy?

A

1- Paucibacillary: 6 months :
Rifampicin 600 mg po once monthly
Plus: daily Dapsone

2- Multibacillary: 1 year
Monthly :Rifampicin 600 mg and Clofazimine 300 mg
Plus: daily Dapsone 100mg and Clofazimine 50mg

41
Q

What is the recommended Tx for American HAT?

A

Benznidazole and Nifurtimox

42
Q

What is Tx Of choice for Strongyloidiasis hyper infection?

A

Ivermectin 200 Microgram/kg per day PO until the stool/sputum is clear for 2 weeks

43
Q

treatment of choice for
Mansonella filiria?

A

Ivermectin

44
Q

Treatment of Lymphatic filariasis ?

A

DEC 6mg /kg + Albendazole 400 mg (If Onchocerciasis has been excluded)

Or Albendazole 400 mg + Ivermectin 150-200 micrograms /kg (if Onchocerciasis is suspected)

45
Q

Which antimalarials are effective against Gametocytes and can reduce transmission in low transmission countries?

A

Artemisinins and Primaquine

46
Q

Which antimalarials are effective against
Liver Schizonts??

A

Primaquine
Atovaquone-proguanil

47
Q

Which antimalarials are effective against
Liver Hypnozoites ?

A

Primaquine

48
Q

Malaria treatment in pregnancy?

A
  • 1st Trimester – Quinine + Clindamycin for 7 days
  • 2nd + 3rd Trimester – ACT
  • Severe disease –IV Artesunate
49
Q

What is the Loa loa encephalopathy?

A

Occurs in pt with Loa loa who recently treated with:
1- Ivermectin (commonest)
or
2- DEC (less common)

50
Q

What is Mazotti teaction?

A

fever , urticarial reaction , lymphadenopathy and hypotension due to treatment with DEC in patient with Onchocerciasis

51
Q

Tx of acute and chronic Chagas disease?

A

1- Benznidazole PO
7mg/kg in adult
10 mg/kg in kids in 2 daily divided doses for 60 days

2-Nifortimox 10 mg /kg TDS divided doses PO for 60 days

52
Q

Tx Late gHAT?

A

1- Nifortimox 5 mg/kg in TDS Divided doses for 10 days PLUS:

2- Eflornithine 200 mg/kg IV BD for 7 days

53
Q

Tx Late rHAT?

A

IV Melarsorpol
3 cycles of 3 days with 7-10 days off between the doses
3.6 mg/kg od

54
Q

early gHAT?

A

1- Fexinidazole po for 10 days
or:

2- IM Pentamidine 4 mg /kg OD for 7 days

55
Q

What is the Tx of choice for early rHAT ?

A

IV Suramin
5mg/kg OD as test dose
then:
20 mg/kg on D 3 ,10, 17, 24 and 31

56
Q

Visceral leishmaniasis treatment of choice?

A

1- Amphotericin B IV 20 Mg/kg (Current first line)
2- Antimonial ( Na-stibogluconate)
newer agents:
3-Miltefosine: Oral
4- Paromomycin :IV and cream
5- Pentamidine

57
Q

PKDL ?

A

Africa:
only treat grade 2 and 3
1- Antimonial +paromomycin
2- LAmB
3-Miltefosine in HIV pt

India and Bangladesh:
Treat all cases
1- Miltefosine for 12 weeks
2-LAmB

58
Q

Treatment of choice for Melioidosis ?

A

Ceftazidime

59
Q

Intestinal tapeworms?

A

Praziquantel

60
Q

Asymptomatic Intestinal amoebiasis ?

A

Diloxanide furoate

61
Q

Symptomatic intestinal amoebiasis and extraintestinal amoebiasis ?

A

Metronidazole

62
Q

Giardiasis ?

A

Metronidazole 750 mg TDS X 5 Days
or
Tinidazole
or:
paromomycin
(pregnancy)

63
Q

Fascioloa hepatica ?

A

Praziquantel

64
Q

Strongyloidiasis ?

A

1- Ivermectin 200 microgram /kg 1+2 days

2- Albendazole 400 mg /kg BD x 3 days (7 days if immunocompromised )

65
Q

Trichuris trichura ??

A

1- Mebendazole

2- Albendazole +/- Ivermectin, 3 days

3- Nitazoxanide

66
Q

Hookworms?

A

Albendazole/
Mebendazole
1-3 days

67
Q

Visceral larva migrans (Toxocara spp)

A

1- Albendazole 400 mg BD, 5 days (both adult and paediatric dosage)

2- Mebendazole
100-200 mg BD, 5 days (both adult and paediatric dosage)

68
Q

Entrobius vermicularis ?

what are the diagnostic methods?

A

1- Mebendazole
2- Albendazole

1- Sellotape Test (early morning)
2- stool sample
3- colonoscopy

69
Q

PJP

A

1st line : IV or Oral cotrim 120 mg /kg divided in 2-4 doses +/- Prednisolone 40 mg BD

2nd line :
* IV Clinda + oral primaquine , or
* IV Pentamidine

3rd line if non-sever:
oral trimethoprim +Dapsone
or:
oral Atovaquone

70
Q

Talaromycosis ?

A

Induction phase:
IV liposomal Amophotericin B 5 mg/Kg per day for 2 weeks

Manitainance :
PO Itraconazole 200 mg BD for 10 weeks

Itraconazole 200 mg po OD or:
Fluconazole 400 mg po once weekly

71
Q

Histoplasmosis

A

Induction phase:
IV liposomal Amophotericin B 4 mg/Kg per day for 2 weeks

Manitainance :
PO Itraconazole 200 mg BD for 1 year

72
Q

Toxoplasmosis?

A

Induction phase (6 weeks):
# Oral sulphadiazine (1-2 grams qds)
(alternative: clindamycin 600 mg qds) plus: #pyrimethamine (loading dose 200 mg then 50 mg po od) plus #Folinic acid 10 mg po od

Maintenance :
#Sulphadiazine 500 mg po qds (alt: Clinda 300 qds) , plus:
#Pyrimethamine 25mg po od, plus:
#Folinic acid 10 mg po od

73
Q

T/F:
Steroids is not indicated in cryptococcal meningitis ?

A

T

74
Q

What is the WHO recommended HIV treatment ?

A

1- Dolutegravir (DTG) in combination with a (NRTI) backbone

2- second line :
Efavirenz at low dose (EFV 400 mg) in combination with an NRTI backbone

3- raltegravir (RAL)-based regimen may be recommended as the alternative first-line regimen for infants and neonate

75
Q

T/F:
Nevirapine can cause hepatitis?

A

T

76
Q

T/F:
Efavirenz can cause neuropsychiatric manifestations ?

A

T

77
Q

T/F:
Abacavir can increase CVS disease risk ?

A

T

78
Q

Entamoeba histolytica ?

A

Metronidazole TDS for 5 days followed by 10 days of diloxanide furoate

79
Q

T/F:
Triclabendazole is the only drug available to treat Fasciola infection.

A

T

80
Q
A

Parasitology (5 decks)

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