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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
Treatment of choice : Fasciola hepatica?
triclabendazole
25
Treatment of intestinal stage of all tapeworms (cestode)? Tissue forms( hydatid and cysticercosis??
1- Praziquantel 2- Albendazole and surgical
25
Giardia treatment of choice ?
1- Metronidazole 2- Tinidazole 3- Nitazoxanide (mainly for children - available in liquid form) 4- Paromomycin if pregnant
26
Cyclospora caytanensis
Cotrimoxazole hydration
27
Amoebiasis treatment?
1- Asymptomatic(cysts only): Diloxanide-furoate 2-Symptomatic (Cyst and trophozoites) Metronidazole 3- extra-intestinal: HD Metronidazole
28
What is the cause and treatment of choice of Buruli ulcer?
Mycobacterium ulcerans Treatment: rifampicin (10 mg/kg once daily) Plus clarithromycin (7.5 mg/kg twice daily) for 8 weeks then skin graft
29
Management of tetanus ?
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
30
Treatment of choice of Melioidosis ?
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
31
T/F: When diagnosing histoplasmosis , antigen detection in better from Urine sample than serum ?
T sensitivity 96.7% v/s 78.7%
32
Pathognomic microscopy feature of Histoplasma capsulatum
Thick walled , spherical Macroconidia with distinctive projections
33
What is the mainstay diagnostic test for Histoplasmosis?
Serology is the best modality others include: 1- culture and microscopy 2- EIA antigen detection urine>serum 3- PCR - disappointing
34
Treatment of Histoplasmosis?
1- Itraconazole if mild disease 2- Amphotericin if disseminated histoplasmosis
35
What are the clinically important dimorphic fungi ?
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
Treatment of Coccidioidomycosis and Paracoccidiomycosis ?
1- Ampizome and azole 2- Sulphadiazine or cotrimoxazole alternative : amphotericine or itraconazole
37
What is the recommended treatment of phthiriasis (Pediculosis pubis )?
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
What are the cause and the vectors of : 1- Murine endemic typhus. 2- Epidemic typhus
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
Treatment of scabies?
1- Malathion 0.5% 2- Permethrin 5% rinse cream 3- Benzyl benzoate 25% emulsion 4- Oral ivermectin
40
Treatment of Leprosy?
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
What is the recommended Tx for American HAT?
Benznidazole and Nifurtimox
42
What is Tx Of choice for Strongyloidiasis hyper infection?
Ivermectin 200 Microgram/kg per day PO until the stool/sputum is clear for 2 weeks
43
treatment of choice for Mansonella filiria?
Ivermectin
44
Treatment of Lymphatic filariasis ?
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
Which antimalarials are effective against Gametocytes and can reduce transmission in low transmission countries?
Artemisinins and Primaquine
46
Which antimalarials are effective against Liver Schizonts??
Primaquine Atovaquone-proguanil
47
Which antimalarials are effective against Liver Hypnozoites ?
Primaquine
48
Malaria treatment in pregnancy?
* 1st Trimester – Quinine + Clindamycin for 7 days * 2nd + 3rd Trimester – ACT * Severe disease –IV Artesunate
49
What is the Loa loa encephalopathy?
Occurs in pt with Loa loa who recently treated with: 1- Ivermectin (commonest) or 2- DEC (less common)
50
What is Mazotti teaction?
fever , urticarial reaction , lymphadenopathy and hypotension due to treatment with DEC in patient with Onchocerciasis
51
Tx of acute and chronic Chagas disease?
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
Tx Late gHAT?
1- Nifortimox 5 mg/kg in TDS Divided doses for 10 days PLUS: 2- Eflornithine 200 mg/kg IV BD for 7 days
53
Tx Late rHAT?
IV Melarsorpol 3 cycles of 3 days with 7-10 days off between the doses 3.6 mg/kg od
54
early gHAT?
1- Fexinidazole po for 10 days or: 2- IM Pentamidine 4 mg /kg OD for 7 days
55
What is the Tx of choice for early rHAT ?
IV Suramin 5mg/kg OD as test dose then: 20 mg/kg on D 3 ,10, 17, 24 and 31
56
Visceral leishmaniasis treatment of choice?
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
PKDL ?
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
Treatment of choice for Melioidosis ?
Ceftazidime
59
Intestinal tapeworms?
Praziquantel
60
Asymptomatic Intestinal amoebiasis ?
Diloxanide furoate
61
Symptomatic intestinal amoebiasis and extraintestinal amoebiasis ?
Metronidazole
62
Giardiasis ?
Metronidazole 750 mg TDS X 5 Days or Tinidazole or: paromomycin (pregnancy)
63
Fascioloa hepatica ?
Praziquantel
64
Strongyloidiasis ?
1- Ivermectin 200 microgram /kg 1+2 days 2- Albendazole 400 mg /kg BD x 3 days (7 days if immunocompromised )
65
Trichuris trichura ??
1- Mebendazole 2- Albendazole +/- Ivermectin, 3 days 3- Nitazoxanide
66
Hookworms?
Albendazole/ Mebendazole 1-3 days
67
Visceral larva migrans (Toxocara spp)
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
Entrobius vermicularis ? what are the diagnostic methods?
1- Mebendazole 2- Albendazole 1- Sellotape Test (early morning) 2- stool sample 3- colonoscopy
69
PJP
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
Talaromycosis ?
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
Histoplasmosis
Induction phase: IV liposomal Amophotericin B 4 mg/Kg per day for 2 weeks Manitainance : PO Itraconazole 200 mg BD for 1 year
72
Toxoplasmosis?
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
T/F: Steroids is not indicated in cryptococcal meningitis ?
T
74
What is the WHO recommended HIV treatment ?
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
T/F: Nevirapine can cause hepatitis?
T
76
T/F: Efavirenz can cause neuropsychiatric manifestations ?
T
77
T/F: Abacavir can increase CVS disease risk ?
T
78
Entamoeba histolytica ?
Metronidazole TDS for 5 days followed by 10 days of diloxanide furoate
79
T/F: Triclabendazole is the only drug available to treat Fasciola infection.
T
80

Parasitology (5 decks)

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