Parasites

Question 1

Giardia diagnosis

Answer 1

diagnosed with trophozoites / cysts in stool

Question 2

giardia transmission + treatment

Answer 2

cysts in water

metronidazole

Question 3

giardia presentation

Answer 3

bloating, flatulence, fatty diarrhea (seen in campers + hikers)

Question 4

entamoeba histolytica diagnosis

Answer 4

serology + trophozoites (RBCs in the cytoplasm) + cysts w/ +4 nuclei in stool

Question 5

entamoeba histolytica treatment

Answer 5

metronidazole, iodoquinol for asymptomatic cyst passers

Question 6

entamoeba histolytica

Answer 6

amebiasis: bloody diarrhea, liver abscess w/ an anchovy paste exudate, RUQ pain w/ flask-shaped ulcer if there is rupture of colon abscess

Question 7

cryptosporidium treatment

Answer 7

prevention by filtering water + nitazoxanide in mmunocompetent hosts

Question 8

cryptosporidium presentation

Answer 8

severe diarrhea in AIDS, mild watery diarrhea in non-immunocompromised

Question 9

cryptosporidium transmission + diagnosis

Answer 9

oocytes in water + oocytes on acid-fast stain

Question 10

toxoplasma gondii presentation

Answer 10

brain abscess in HIV (ring-enhancing brain lesions)

Question 11

toxo in utero

Answer 11

classic triad of chorioretinitis, hydrocephalus, and intracranial calcifications

Question 12

toxo transmission

Answer 12

cysts in meat / oocyts in cat feces –> crosses placenta

Question 13

toxo diagnosis

Answer 13

serology, biopsy (tachyzoite)

Question 14

toxo treatment

Answer 14

sulfadiazine pyrimethamine

Question 15

n. fowleri presentation

Answer 15

rapidly fatal meningoencephalitis

Question 16

n. fowleri transmission

Answer 16

swimming in freshwater lakes –> enters cribriform plate

Question 17

n. fowleri diagnosis + treatment

Answer 17

amoebas in spinal fluid + amphotericin B

Question 18

trypanosoma brucei presentation

Answer 18

african sleeping sickness: enlarged lymph nodes, recurring fever (antigenic variation), somnolence, coma

Question 19

t. brucei transmission, diagnosis, treatent

Answer 19

tsetse fly
blood smear
suramin for blood-borne disease
melarsoprol for CNS penetration

Question 20

plasmodium general features + transmission

Answer 20

anopheles leading to fever, headache, anemia, splenomegaly

diagnosis: blood smear, trophozoite ring w/in RBC. schizont wih merozoites

Question 21

plasmodium treatment

Answer 21

1) chloroquine –> blocks plasmodium heme polymerase.
2) may add mefloquine / atovaquone / progunail.
3) life threatening –> IV quinidine (test for G6PD deficiency)

Question 22

plasmodium treatment for vivax / ovale

Answer 22

add primaquine for hypnozoite –> test for G6PD deficiency

Question 23

p. vivax/ovale presentation

Answer 23

48 hr cycle (tertian: fever on 1st day + 3rd day –> fevers 48 hrs apart). dormant hypnozoite in liver

Question 24

p. falciparium presentation

Answer 24

severe, irregular fevers, parasitezed RZBCs occlude capillaries in brain (cerebral malaria), kidneys, lungs

Question 25

p. malariae

Answer 25

72 hr cycle (quartan

Question 26

babesia presentation

Answer 26

fever, hemolytic anemia, NE US.

aslpenia incr. risk of disease

Question 27

babesia transmission, diagnosis, treatment

Answer 27

1) ioxdes tick
2) maltese cross + PCR
3) atovaquone + azithromycin

Question 28

trypanosoma cruzi diagnosis + treatment

Answer 28

1) blood smear with curved RBC

2) benznidazole / nifurtimox

Question 29

t. cruzi transmission + presentation

Answer 29

1) reduviid bug –> painless bite

2) chagas disease w/ dilated cardiomyopathy, megacolon, megesophagus

Question 30

leishmania donovani presentation, transmission, diagnosis, treatment

Answer 30

1) visceral leishmaniasis (spiking fevers, hepatosplenomegaly, pancytopenia)
2) sandfly transmission
3) macrophages with amastigotes
4) amphotericin B w/ sodium stibogluconate

Question 31

trichomonas vaginalis presentation

Answer 31

vaginitis: foul-smelling, greenish discharge, itching / burning

Question 32

trichomonas vaginalis transmission, diagnosis, treatment

Answer 32

1) sexual (no cyst formation)
2) trophozoites on wet mount + strawberry cervix
3) metronidazole for patient / partner

Question 33

ingested nematodes

Answer 33

enterobius, ascaris, toxocara

E/A –> treat w/ bendazole / pyrantel
T –> albendazole / mebendazole

Question 34

cutaneous nematodes

Answer 34

strongyloides, ancylostoma, necator (feet in sand)

S = ivermectin / albendazole
A/N = bendazole / pyrantel pamoate

Question 35

Bites for nematode infection

Answer 35

Loa loa
Onchocerca volvulus
Wuchereria bancrofti

L/W = diethylcarbamazine

Onchocerca = ivermectin

Question 36

general treatment for cestodes + trematodes

Answer 36

praziquantel

Question 37

taenia solium transmission

Answer 37

1) larvae cysts in undercooked pork –> intestinal infection.
2) ingestion of eggs –> cysticercosis / neurocysticercosis

Question 38

diphyllobothrium latum transmission

Answer 38

1) ingestion of larvae from raw freshwater fish
2) presents with vit. b12 deficiency
3) treatment = pranziquantel

Question 39

echinococcus granulosos transmission

Answer 39

1) ingestion of eggs from dog feces
2) hydatid cysts in liver –> anaphylaxis if antigens released (inject EtOH before removal)
3) albendazole treatment

Question 40

schistosoma transmission, disease, treatment

Answer 40

1) snails –> skin
2) liver / spleen granulomas, chronic infection –> squamous cell carcinoma of the bladder –> painless hematuria
3) praziquantel

Question 41

clonorchis sinesis transmission, disease, and treatment

Answer 41

1) undercooked fish
2) biliary tract inflammation / pigmented gallstones –> associatd w/ cholangiocarcinoma
3) praziquantel