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Pulmonary > Parasites > Flashcards

Parasites Flashcards

1
Q

Normal IgE and eosinophil values?

A
  • 0-180 IU/mL

- 1-7%

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2
Q

Malignancy associated with eosinophilia?

A

15% of Hodgkins lymphoma

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3
Q

Autoimmune vasculitis associated with eosinophilia?

A
  • Churg-Strauss syndrome - allergic granulomatous angiitis (medium and small arteries and veins)
  • c-ANCA along with Wegener’s and microscopic polyangiitis
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4
Q

What is unique about the presentation of Churg-Strauss?

A
  • SEQUENTIAL
  • allergic rhinitis –> asthma –> vasculitis
  • multisystem involving paranasal sinuses, lungs, nerves, skin, joints (Wegener’s hits upper respiratory tract, lungs, kidneys)
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5
Q

Which fungal infection is associated with eosinophilia?

A

Coccidiomycosis (desert southwest)

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6
Q

Remember, cholesterol emboli can produce eosinophilia

A

RARE

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7
Q

What fungal infection can mimic TB in almost every way?

A

Histoplasmosis

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8
Q

What three organisms can produce CXR miliary pattern?

A
  • histo, blasto, TB
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9
Q

What two parasites can participate in person-person transmission?

A
  • strongyloides

- amoeba

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10
Q

What is the commonest helminth infection?

A

ascaris lumbricoides

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11
Q

Transmission and life cycle of ascaris?

A
  • fecal-oral ingestion of eggs

- lungs - coughed and swallowed - maturation in GIT

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12
Q

What is Loeffler’s syndrome? Associated organism?

A
  • initial migration of ascaris larvae through luna may produce TRANSIENT pulmonary symptoms (cough), radiographic opacities, and eosinophilia
  • adult eventually croaks and infection ends
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13
Q

How is hookworm route of transmission different from ascaris?

A
  • dermal penetration

- fecal-oral ingestion

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14
Q

Which helminth survives chronically due to auto-infection? Transmission?

A

Strongyloides stercoralis - eggs hatch and re-infect GI tract
DERMAL penetration

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15
Q

What is a complication of strongyloides in immunocompromised?

A
  • hyperinfection - larvae migrate throughout boy with disastrous results
  • larvae take bowel bacteria out with them = polymicrobial sepsis
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16
Q

What parasite is prevalent in areas with livestock and canines? Transmission?

A

Echinococcus - egg ingestion

17
Q

Which parasite produces mass lesions (cysts)?

A

Echinococcus

18
Q

Which parasite commonly causes hemoptysis and sets up shop via cysts in the lungs (instead of the bowel)? Transmission?

A
  • Paragonimus westermani

- requires right kind of snail and crustacean = ingestion or raw/undercooked shellfish

19
Q

Presentation of paragonimiasis?

A
  • adult organisms encyst in lungs producing pneumonic infiltrates, cavities, and pleural effusions
  • hemoptysis – can mimic TB
20
Q

How does lymphatic filariasis occur?

A
  • mosquito carries parasite and bites human
  • adults live in inguinal LN’s/vessels
  • microfilaria (larvae) migrate through lymph at night and mosquito bites you, passing on the infection
21
Q

What is a common symptom of lymphatic filariasis?

A
  • large adult parasite burdens may obstruct lymphatic vessels causing elephantiasis of genitals and LE’s
22
Q

70% of infections by what organism occur in Nigeria, Bangladesh, and Indonesia?

A

Wucheria –> lymphatic filariasis

23
Q

What is the hypersensitivity response to migrating microfilariae called?

A

Tropical pulmonary eosinophilia - 0.5% of infected patients (South Asians)

24
Q

Pathogenesis of TPE?

A
  • microflariae are opsonized by AB’s and cleared by pulmonary microvasculature
25
Q

Similarities and differences of TPE to asthma?

A
  • wheezing, cough, dyspnea, worse at night (migration)
  • variable age of onset, fever, malaise, weight loss and persistent profound blood eosinophilia (80,000)
  • additionally, requires months in endemic area
26
Q

What is seen in CXR of TPE patients?

A
  • reticulonodular or military opacities in mid/lower lung zones
  • 20% may have normal CXR
27
Q

What are complications of untreated TPE? Treatment?

A
  • pulmonary HTN with granulomatous vasculitis becoming fibrosis with time
  • diethylcarbamazine for 21 days
28
Q

What is a paradoxical result seen in TPE?

A
  • LACK of microfilariae in blood due to rapid immune clearance

Pulmonary (7 decks)

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