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Parasites Flashcards

1
Q

List the 5 intestinal nematodes (roundworms)

A
  1. Pinworm (Enterobius vermicularis)
  2. Ascariasis
  3. Whipworm (Trichuris trichura)
  4. Hookworm (Necator americanus, Anclyostoma duodenale)
  5. Strongyloides
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2
Q

List the 3 tissue nematodes (roundworms)

A
  1. Trichinella spiralis (trichinosis)
  2. Wuchereria bancrofti (filariasis)
  3. Toxocara canis, Toxocara cati (visceral/cutaneous larva migrans)
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3
Q

List the trematode (flukes) vs. cestodes (tapeworm) flatworms

A

Trematode = Schistosoma (blood fluke)

Cestode = Taenia saginata (intestinal), Taenia solium (intestinal or tissue), Echinococcus granulosus (hyatid cyst disease)

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4
Q

Treatment = mebendazole/albendazole

A

Whipworm

Hookworm

Ascariasis

Strongyloides

Trichinella (adult only)

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5
Q

Tx with metronidazole

A

Trichomonas

Entamoeba histolyticum

Giardia

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6
Q

Dx via eggs in feces

A

Hookworm

Ascarisis

Tapeworm (or proglottid)

Schistosoma japonicum/mansoni

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7
Q

Dx via larva in feces

A

Strongyloides

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8
Q

Dx via ID in urine

A

Schistosoma haematobium

Legionella

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9
Q

Dx via cyst in stool

A

Entamoeba histolyticum

Giardia (or trophozoite)

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10
Q

Dx via card agglutination test

A

T. brucei

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11
Q

Dx via Giemsa stain (thin/thick)

A

Malaria

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12
Q

Chronic infection

A

Strongyloides

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13
Q

Must be fertilized in soil

A

Whipworm

Ascariasis

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14
Q

Larval stage is migratory

A

Hookworm

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15
Q

Larva penetrates skin –> migrates in subQ tissue –> inflammation

A

Toxocara canis/cati

(Cutaneous larva migrans)

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16
Q

Dx?

A

Leishmaniasis

(Amastigote form in macrophages)

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17
Q

Eggs in feces –> rhabdiform larva hatches –> filariform larva penetrates skin –> adults in SI

A

Hookworm (Necatur americanus, Ancylostoma duodenale)

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18
Q

Fever + diarrhea + muscle pain + periorbital edema + eosinophilia

A

Trichinosis

(Trichinella spiralis)

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19
Q

Snail is essential intermediate host

A

Schistosoma

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20
Q

Taken up by and multiplies in macrophages

A

Leishmaniasis

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21
Q

Cyst form can survive outside the body

A

Entamoeba histolyticum

Giardia

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22
Q

What are the protozoan endoparasites?

A

Single celled eukaryotes

(Flagellates [Leishmania, Giardia, trypanosomes] + amoebas [Entamoeba, Naegleria] + sporozoea [Cryptosporidium, malaria] + ciliates)

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23
Q

Daycare

A

Pinworm (Enterobius vermicularis)

Giardia

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24
Q

Damage due to eosinophil basic protein

A

Loeffler’s syndrome

(think Stryongyloides in heart and lung)

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25
Q

Perianal itching at night

A

Pinworm (Enterobius vermicularis)

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26
Q

Blood meal –> releases trophozoite into human –> infects liver cell –> schiont –> ruptured schizont –> infects RBC –> immature trophozoite/ring form –> forms mature trophozoite, ruptures, and reinfects more RBCs OR forms gametocytes –> gametocytes taken up with blood meal –> inside vector, microgamete enters macrogamete –> ookinete –> oocyst –> oocyst ruptures –> trophozoites released –> blood meal –> releases trophozoite into human ….

A

Malaria

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27
Q

Wormballs

A

Ascariasis

(Intestinal obstruction)

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28
Q

Ingested oocyst –> sporozoites released –> infect gastric epithelial cells –> differentiate into merozoites –> some become male and female gametes –> fuse to form a zygote –> reduction division inside zygote –> oocyst containing 4 sporozoites

A
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29
Q

Vector for African trypanosomiasis

A

Tsetse fly

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30
Q

How do you diagnose early lymphatic filariasis/Wuchereria bancrofti?

A

Microfilaria in blood

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31
Q

Obstructive jaundice +/- seizures and increased ICP

A

Echinococcus granulosus

(Hydatid cyst; presentation depends upon location of the cyst)

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32
Q

Host in which sexual reproduction takes place

A

Definitive host

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33
Q

Anchovy paste aspirate

A

Entamoeba histolytics

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34
Q

Transmitted via cysts in meat or oocysts in cat poop

A

Toxoplasmosis (Toxoplasma gondii)

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35
Q

Egg from cat/dog feces swallowed –> larva penetrate mucosa –> enter circulation –> larva migrate to liver, lungs, eye –> inflammatory necrosis

A

Toxocara canis/cati

(Visceral larva migrans)

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36
Q

Miracidia

A

Infective form of Schistosoma in freshwater snails

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37
Q

What are the 3 soil-transmitted helminths?

A
  1. Hookworm (Necator americanus, Ancylostoma duodenale)
  2. Whipworm (Trichuriasis)
  3. Ascaris lumbricoides
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38
Q

Worldwide distribution

A

Giardia

Toxoplasmosis (Toxoplasma gondii)

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39
Q

Tapeworms

A

Taenia solium, Taenia saginata

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40
Q

What 3 types of sx can one get with a Whipworm infection?

A
  1. Asymptomatic
  2. Diarrhea +/- blood
  3. Chronic blood loss/IBD-like sx
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41
Q

How does T. brucei move?

A

Undulating membrane

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42
Q

Quartan fevers

A

P. malariae

(every 72 hours)

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43
Q

MC helminth infection in US

A

Pinworm (Enterobius vermicularis)

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44
Q

Intermittent fevers

A

Malaria

African trypanosomiasis (T. brucei)

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45
Q

Penetrates cribiform plate/olfactory neuroepithelium

A

N. fowleri

(Primary amebic meningoencephalitis)

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46
Q

Outcomes of congential toxoplasmosis

A

70% - normal

5-10% - miscarriage

10% - brain damage

10% - visual problems (chorioretinitis)

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47
Q

Fever, chills, rigors; respiratory distress, pulmonary edema; decreased consciousness, seizures; anemia; HA, N/V, diarrhea; hypoglycemia; lactic acidosis

A

Malaria

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48
Q

What cannot occur in an intermediate host?

A

Sexual reproduction

(Only growth &/or sexual reproduction occurs)

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49
Q

Fork-like tail

A

Cercariae form of Schistosoma, allows it to be free-living in freshwater and penetrate skin

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50
Q

Possible parasitic cause?

A

Chronic T. cruzi infection

(Chagas disease; damage to autonomic ganglia causes achalasia)

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51
Q

Liver cyst

A

Echinococcus granulosus

(Hydatid cyst)

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52
Q

Dx?

A

Trichomonas

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53
Q

How is Ascariasis prevented?

A

Proper disposal of sewage

(Eggs become fertilized in soil)

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54
Q

Purpuric papule + Loeffler’s syndrome + N/V + diarrhea + epigastric pain

A

Strongyloides

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55
Q

Vector of American trypanosomiasis

A

Reduviid/triatomine bug

(Chagas disease)

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56
Q

Blood meal –> vector picks up metacyclic trypomastigotes –> transform into procyclic trypomastigotes and multiply in vector’s midgut –> leave the midgut and transform into epimastigotes –> transform into metacyclic trypomastigotes and multiply in salivary gland –> blood meal –> metacylic trypomastigotes transform into bloodstream trypomastigotes in human –> trypomastigotes multiply in blood/CSF/lymph fluid –> blood meal ….

A

T. brucei

(African trypanosomiasis)

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57
Q

3 teeth on either side

A

Hookworm (Necatur americanus, Ancylostoma duodenale)

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58
Q

Dermatitis

A

Schistosoma

(Due to penetration of cercariae)

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59
Q

Acid fast oocysts

A

Cryptosporidium

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60
Q

Prefers pH > 4.5

A

Trichomonas

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61
Q

Hemaphrodites

A

Tapeworm

(T. solium, T. saginata; THINK: only one tapeworm in a host at a time…. has to reproduce somehow)

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62
Q

Diving into fresh water

A

N. fowleri

(Primary amebic meningoencephalitis)

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63
Q

Elevated immunoglobulins

A

Leishmaniasis

(But they’re ineffective againt the bug because it’s inside macrophages + other cells)

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64
Q

Dx via microfilaria (with multiple nuclei) in blood at night

A

Wuchereria bancrofti

(lymphatic filariasis/elephantiasis)

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65
Q

Sticky tape test

A

Pinworm (Enterobius vermicularis)

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66
Q

Vector takes blood meal –> ingests infected cell –> amastigotes transform into promastigotes in vector’s midgut –> divide –> migrate to proboscis –> blood meal –> promastigotes taken up by macrophages –> transform into amastigotes in macrophages –> multiply and macrophages and cells of various tissues –> blood meal ….

A

Leishmaniasis

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67
Q

Major cause of iron deficiency anemia in developing countries

A

Hookworm

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68
Q

Reinfection occurs but with reduced viremia

A

Malaria

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69
Q

Autoinfection

A

Strongyloides

(Eggs in GI mucosa hatch –> rhabidiform larva can travel to lung –> filariform larva travel to trachea –> swallowed –> goes to intestine –> lays eggs –> repeat)

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70
Q

Hypnozite

A

Chronic liver state of malaria with P. vivax/ovale

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71
Q

Dx via trophozoites or flagellated form in CSF

A

N. fowleri

(Primary amebic meningoencephalitis)

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72
Q

Camping

A

Giardia (drink from stream)

(or trichinosis if eat raw meat)

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73
Q

Hepatosplenomegaly + ascites

A

Schistosoma japonicum/mansoni

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74
Q

Latches onto intestinal wall and eats tissue

A

Hookworm (Necatus americanus, Ancylostoma duodenale)

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75
Q

What respiratory disease can be caused by larval migration through the lungs?

A

Pneumonitis via Ascariasis

76
Q

Host in which parasite cannot complete life cycle

A

Intermediate host (dead-end host)

77
Q

Produces anticoagulant

A

Hookworm (Necatur americanus, Ancylostoma duodenale)

78
Q

Scolex (head) + proglottid (branched uteri)

A

Tapeworm (T. solium,saginata)

Echinococcus granulosus (1 immatue + 1 mature scolex)

79
Q

Tertian fevers

A

P. falciparum/ovale/vivax

(every 48 hours, occurs on first and third days)

80
Q

Portal HTN

A

Schistosoma japonicum/mansoni

81
Q

3 manifestations: asymptomatic carriage in intestine; dysentery; extra-intestinal abscesses

A

Entamoeba histolyticum

82
Q

Dx?

A

Cryptosporidium

83
Q

Egg fertilized in soil –> egg swallowed –> hatches in body –> eggs passed out in feces

A

Whipworm

Ascaris

(Remember: hookworm filariform larva directly penetrates skin)

84
Q

Eggs or progrottid ingested by animal –> oncospheres hatch –> circulation –> oncospheres form cysticerci in muscle –> human eats animal –> scolex attaches to intestine –> eggs or gravid proglottid passed in feces

A

Tapeworm

(Taenia solium, Taenium saginata)

85
Q

Oocyst must be in enviornment for a while to become infectious

A

Toxoplasmosis (Toxoplasma gondii)

86
Q

Tx for hypnozoites (P. ovale/P. vivax)

A

Primaquine

(Check for G6PD deficiency!!)

87
Q

How do you diagnose intestinal Taenia solium/saginata?

A

Eggs/progottids in feces

88
Q

Leukopenia, anemia, thrombocytopenia

A

Lieshmaniasis

89
Q

Most common protozoal intestinal infection

90
Q

Severe deformity

A

Mucocutaenous leishmaniasis

(L. braziliensis - Latin America)

91
Q

Reactivation

A

Toxoplasmosis (Toxoplasma gondii)

92
Q

Blood meal –> trypomastigotes become epimastigotes in vector’s midgut –> multiply in midgut –> become metacyclic trypomastigotes in vector’s hindgut –> vector takes blood meal + passes trypomastigotes in feces –> metacyclic trypomastigotes penetrates human cells and becomes amastigote –> multiply intracellularly –> transform into trypomastigotes and burst out of cells –> taken up by another blood meal or reinfects other cells

93
Q

Which form of T. brucei is most rapidly fatal?

A

T. brucei rhodesiense

(East African sleeping sickness)

94
Q

What causes cerebral disease related to malaria?

A

Sticky RBCs

(Decreased consciousness, seizures)

95
Q

Filariform larva penetrates skin –> circulatory system –> travels to lung –> trachea –> swallowed –> small intestine –> become adults –> eggs deposited in intestinal mucosa –> rhabidiform larva either passed in feces or become filariform –> filariform larva penetrate mucosa –> circulatory system –> lungs …..

A

Strongyloides

(Remember autoinfection! Also the larva are diagnosed in stool, not eggs!)

96
Q

Eggs in soil/feces –> swallowed –> hatch –> larva attach to gut wall –> eggs excreted in feces –> embryonate in soil

A

Whipworm (Trichuriasis)

97
Q

Vector of Leishmaniasis

98
Q

Tissue cysts in sheep/pig –> eaten by humans –> pseudocysts in cells

-OR-

Tissue cysts in mice/birds –> eaten by cat –> fecal oocysts –> ingested by human/sheep/pig –> pseudocysts in human cells

A

Toxoplasmosis (Toxoplasma gondii)

99
Q

Is Trichinosis transmissible between humans?

A

No (unless they’re cannibals)

100
Q

Ingestion of larva = GI infection

Ingestion of eggs = cysts in various tissues

A

Tapeworm/cysticercosis

(T. solium)

101
Q

Undercooked meat, especially pork

A

Trichionosis (Trichinella spiralis)

Tapeworm (Taenia solium/saginata)

102
Q

Flask-shaped ulcers

A

Entamoeba histolyticum

(Superficial ulcer looks small but spread out underneath)

103
Q

Kinetoplast

A

T. brucei

(Kinetoplast = circular DNA inside a mitochondrion)

104
Q

Hypersensitivity to egg causes periportal fibrosis

A

S. japonicum/mansoni

105
Q

Agent of elephantiasis

A

Wushceria bancrofti

106
Q

Agents of visceral/cutaneous larva migrans

A

Toxocara canis, Toxocare cati

(vs. Toxoplasma gondi = toxoplasmosis)

107
Q

Larva form can produce cysts in various tissues

A

Tapeworm

(T. solium, T. saginata)

108
Q

How does T. cruzi cause cardiomyopathy? Megacolon and achalasia?

A

Cardiomyopathy via direct damage to myocytes

Achalasia/megacolon via damage to autonomic ganglia

109
Q

What symptoms would you expect in the patient from whom this egg was isolated?

A

Terminal hematuria, suprapubic pain (bladder CA)

(Terminal spine = Schistosoma haematobium)

110
Q

Cyst in definitive host, pseudocyst in intermediate host

A

Toxoplasmosis (Toxoplasma gondii)

(Definitive host = cat; intermediate host = human, pig, sheep, bird, mouse)

111
Q

Mature cyst contains thousands of protscolexes

A

Echinococcus granulosus

(Hydatid cyst disease)

112
Q

Female lives inside male’s gynaecophoric canal

A

Schistosoma (paired adults)

113
Q

Treatment = 2 doses of pyrental two weeks apart for whole family

A

Pinworm (Enterobius vermicularis)

114
Q

Seropositive for life

A

Toxoplasmosis

(Think: reactivation in AIDS)

115
Q

No protective immunity

A

Entamoeba histolyticum

Malaria

116
Q

Flagellated protozoa

A

Giardia + trichomonas

117
Q

Eggs hatch –> release miracidia –> penetrate snail tissue –> form sporocysts –> snail releases cercariae into water –> cercariae lose tails and penetrate human skin becoming schistosomulae –> get into circulation –> migrate into portal blood –> mature in the liver –> paired adults migrate to mesenteric venules –> lay eggs –> circulate to liver/venous plexus of bladder or passed in stool

A

Schistosoma

118
Q

What disease is caused by Schistosoma japincum/mansoni?

A

Portal HTN

119
Q

Adults live in blood vessels draining the bladder or intestine

A

Schistosoma

(Intestine = japonicum/mansoni; bladder = haematobium)

120
Q

Severe diarrhea in AIDS patient

Mild watery diarrhea in immunocompetent patient

A

Cryptosporidium

121
Q

Dx?

122
Q

Malabsorption diarrhea

123
Q

Undulating membrane

A

T. brucei

(African trypanosomiasis)

124
Q

Liver, lung, brain abscesses

A

Entamoeba histolyticum

125
Q

Dog eats sheep –> infected –> passes eggs via feces –> ingest eggs –> larva released in intestine –> spread hematogenously –> secrete membrane –> inner part matures into germinal layer –> produces protscolexes in various tissues

A

Echinococcus granulosus

(Protscolexes = hydatid cyst)

126
Q

Cysts ingested –> trophozoites undergo binary fission in SI –> encystation as trophozoites move toward LI –> cysts passed in feces

127
Q

Painless bite

A

Chagas disease/reduviid bug

128
Q

Neti pots

A

N. fowleri

129
Q

Most common presentation is asymptomatic eosinophilia

A

Strongyloides

130
Q

Mature cysts ingested –> excystation in SI –> released trophozoites travel to LI –> produce cysts –> cysts excreted in feces

A

Entamoeba histolyticum

131
Q

Egg has clear outer shell

A

Hookworm (Necatur americanus, Ancylostoma duodenale)

132
Q

Encysted larva ingested from muscle of animal –> larva released in SI –> adults deposit larva in mucosa –> circulation –> encysted larva in muscle

A

Trichinosis

(Trichinella spiralis)

133
Q

Anaphylaxis

A

Rupture of hydatid cyst

(Echinococcus granulosus)

134
Q

What are the Metazoan endoparasites?

A

Multicellular organisms = helminths

(Roundworms [nematodes = Ascaris, Strongyloides] + flatworms [tapeworm = Taenia, fluke = Schistosoma])

135
Q

Eggs flattened on one side

A

Pinworm (Enterobius vermicularis)

136
Q

Baby born with hydrocephalus + generalized lymphadenopathy + hepatosplenomegaly + diffuse cerebral calcifications

A

Toxoplasmosis (Toxoplasma gondii)

137
Q

Adults die after 5 years

A

Wuchereria bancrofti

(Filariasis/elephantiasis; this causes calcification and inflammation that blocks lymphatics )

138
Q

(T/F): The Whipworm eggs shed in feces are infectious

A

False - must embryonate in soil to become infectious

139
Q

Not killed by chlorine

A

Cryptosporidium

140
Q

Where does the adult form of this organism reside? Where would this egg be found inside the body?

A

Blood vessels draining the intestine

Liver or intestines

(Middle spine = Schistosoma mansoni)

141
Q

Agent of cysticercosis

A

Taenia solium (tapeworm)

142
Q

The metezoan life cycle consists of what 3 stages?

A

Egg

Larva

Adult

143
Q

Local swelling at site of infection + fever + myalgia + rash; chronically - achalasia + cardiomyopathy + megacolon

A

T. cruzi

(Chagas disease/American trypanosomiasis)

144
Q

Cat is definitive host

A

Toxoplasmosis (Toxoplasma gondii)

(Human, bird, mouse, sheep, and pig can be intermediate host)

145
Q

Hyperinfection syndrome

A

Disseminated Strongyloides in immunocompromised host

146
Q

Multiplies via binary fission = no cyst stage!

A

Trichomonas

147
Q

Adult in lymphatics, microfilaria in blood stream

A

Wuchereria bancrofti

(Elephantiasis)

148
Q

Recurring fever + chancre + somnolence + coma

A

African trypanosomiasis (T. brucei)

149
Q

Smallest of all tapeworms

A

Echinococcus granulosus

(hydatid cysts)

150
Q

What should you check for to ensure clearance of a tapeworm infection?

A

Scolex

(If head still attached, worm can grow back)

151
Q

Sx caused by immune response to egg deposition

A

Schistosoma

152
Q

Active form = trophozoite

Excreted, durable form = cyst

A

Entamoeba histolyticum

153
Q

Matures in liver

A

Schistosoma

154
Q

Swimming pools, water parks

A

Cryptosporidium

155
Q

What causes fever, malaise, rigors with malaria?

A

RBC rupture (cyclic if untreated)

156
Q

Host which maintains parasite in nature as a source for continued transmission

157
Q

Resolves ~2 years if untreated

158
Q

Cannot exist outside of the body because it cannot form cysts

A

Trichomonas

159
Q

Romana’s sign

A

Periorbital swelling due to T. cruzi/rdeuviid bug bite

160
Q

What causes anemia with malaria infection?

A

RBC rupture

161
Q

Adult in intestines, larva in muscle

A

Trichinosis

(Trichinella spiralis)

162
Q

Hepatosplenomegaly + spiking fevers + pancytopenia + hyperpigmented skin + superinfections

A

Visceral leishmaniasis

163
Q

What causes the symptoms of cysticercosis?

A

Dying worms

164
Q

Intermediate hosts of toxoplasmosis (Toxoplasma gondii)

A

Human, bird, mouse, pig, sheep

165
Q

Agent of American typanosomiasis/Chagas disease?

A

T. cruzi

(vector = reduviid bug)

166
Q

Embryonated eggs ingested by human –> larva hatch in SI –> adults in lumen of cecum –> Gravid female migrates to perianal region at night to lay eggs

A

Pinworm (Enterobius vermicularis)

167
Q

Dx of this egg in feces?

A

Hookworm (Necatus americanus, Ancylostoma duodenale)

(Clear shell around egg!!)

168
Q

No digestive tract

A

Tapeworms

(T. solium, T. saginata)

169
Q

Tx with metronidazole for symptomatic infection or paromycin to eliminate luminal carriage

A

Entamoeba histolyticum

170
Q

Cutaneous leishmaniasis symptoms

A

Ulcer at sandfly blood meal site

171
Q

Host in which development and possibly asexual reproduction occurs but not sexual reproduction

A

Intermediate host

172
Q

Reinfection is very common

173
Q

Common sx are pneumonitis and intestinal obstruction

A

Ascariasis

174
Q

Respiratory failure + gram negative rod sepsis + acute abdomen

A

Hyperinfection syndrome (Strongyloides in immunocompromised host)

175
Q

Brain cysts + seizures

A

Neurocysticercosis

(Taenia solium)

176
Q

VSG

A

T. brucei

(Variable surface glycoprotein - accounts for intermittent fever + ability to evade immune system; only one glycoprotein expressed at a time)

177
Q

Transmitted by mosquitos

A

Malaria

Wuchereria bancrofti (filariasis/elephantiasis)

178
Q

Agent of hydatid cyst disease

A

Echinococcus granulosus

179
Q

Hematuria, bladder cancer

A

Schistosoma haematobium

180
Q

Sheep dogs

A

Echincoccus granulosus

(Hydatid cyst)

181
Q

Cercariae

A

Infective form of Schistosoma in humans

182
Q

Dysentery + RUQ pain

A

Entamoeba histolyticum

183
Q

Survival < 1%

A

N. fowleri

(Primary amebic meningoencephalitis)

184
Q

HIV/AIDS patients with low CD4+ and visual complaints

A

Toxoplasmosis (Toxoplasma gondii)

185
Q

Prevention by filtering water supplies

A

Cryptosporidium

186
Q

Anopholes mosquito

187
Q

Dx?

A

Malaria ring form

Wrap up path/micro (2 decks)

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