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Clin Med - ID > Parasites > Flashcards

Parasites Flashcards

1
Q

Common name for helminth

A

hookworm

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2
Q

What are complications of helminth?

A

Anemia (10%)
Impairs physical and intellectual growth in children
May persist for many years in the host

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3
Q

How are helminths acquired

A

Through skin exposure to larvae in soil contaminated by human feces
Third stage larvae are 500-700 micro meters long and rapidly penetrate into skin (feet) within >5min contact

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4
Q

Pathway of a helminth (in the body)

A

penetration site - ground itch
puncture and feed on mucosal capillaries in the jejunum
embolize to lungs and break into alveoli
coughing brings the larvae to mouth
pt swallows and that transports the helminth to the stomach where the female begins to produce eggs.

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5
Q

what is seen on the skin with a hookworm infection?

A

“creeping eruption”

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6
Q

W/u for hookworm

A

O+P direct stool exam

CBC-anemia, eosinophilia

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7
Q

Tx for hookworm

A

Albendazole (single dose)
mebendazole (3 day corse)
Retreat quarterly (improved anemia and malnutrition)
Iron supplement not that helpful

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8
Q

What is the common name for Ascaris lumbricoides?

A

Round worm

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9
Q

Symptoms of roundworm?

A

many are asymptomatic

may present with pulm or severe GI complaints (signs of obstruction)

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10
Q

Pathogenesis (pathway) of roundworm?

A

ingestion of infected eggs in feces-contaminated soil or food.
Once ingested eggs hatch in small intestine and release larvae that penetrate though intestinal wall.
Larvae migrate to pulm/vasc beds
go to alveoli via portal veins (1-2 weeks) and causes pulmonary symptoms
During pulm symptoms eggs are not shed so still ova and parasite is not possible
After migrating to res tract they mature copulate and lay eggs in intestine .
Live in the gut for 6-12 mos. and can cause bowel obstruction

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11
Q

What other places can roundworm migrate to (other than the bowel)

A

appendix
hepatobiliary system
pancreatic ducts
(rarely kidneys or brain)

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12
Q

R/f for roundworm?

A 
international travelers
recent immigrants
refugees
international adoptees
indigenous to rural southeast where cross-infection from pigs can occur.
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13
Q

Presentation of roundworm?

A

**Early phase (4-16days):
Respiratory sx: Fever, non-productive cough, dyspnea, wheezing

**Late phase (6-8wks)
GI symptoms: Passage of worms in BM, Diffuse or epigastric abd. pain, N/V, tingling throat, cough and throat clearing, biliary and SBO, appendicitis, pancreatitis

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14
Q

W/U roundworm:

A

CBC - eosinophilia
Sputum
Stool sample - normal during first 40 days, after that characteristic eggs found.

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15
Q

TX for early infection of roundworm

A

Inhaled beta-agonist
Steroids for pulm are controversial
Anthelminitic tx effectiveness in unclear
**early phase is rarely serious,
GENERAL TX IS TO DELAY UNTIL DIFINITIVE DIAGNOSIS

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16
Q

Established (adult phase) Roundworm infection TX

A

Benzimidazoles - for symptomatic + asymp-low toxicity and poorly systemically absorbed

Bowel Obstruction RX-IV hydration, NG suction, monitor e-lytes, laparotomy, colonoscopy, EGD to remove obstruction

Pilperazine citrate (no longer available in US)

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17
Q

When humans are the primary host adult cestode_______?

A

is limited to the intestinal tract

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18
Q

When humans are an intermediate host the cestode _______?

A

Larvae are within the tissue and migrate to different organ systems

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19
Q

Where do cysticercosis mainly occur?

A

The CNS and skeletal muscles

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20
Q

What do Diphyllobothrium species do?

A

They absorb and interfere with absorption of it Vit B12 causing pernicious anemia

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21
Q

What do Echinococcus species do?

A

Penetrate intestinal mucosa and invade liver, lungs and produce a mass effect

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22
Q

Tx for intestinal tapeworm?

A

Vit B12 in the case of Diphylolobothrium

Praziquantel or niclosamide

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23
Q

Tx for echinococcosis?

A

Albendazole/surgery or albendazole PAIR

Ibendazole recommended for 1-3 most before surgical intervention

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24
Q

Tx for sparganosis and coenurosis

A

Surgical excision for local infections

25
Q

Tx for cysticercosis?

A

No tx is required if asymptomatic
If neuro-antiepileptics and antihelminths
Monitor with Radiographic imaging
Some pt’s require surg.

26
Q

Complications of Malaria

A 
Cerebral malaria-coma
Seizures secondary to hypoglycema or cerebral malaria
Hemoglobinuria
Noncardio-pulmonary edema
Profound hypoglycemia
Lactic acidosis
Hemolysis
bleeding
27
Q

Presentation of malaria

A 
hx of exposure/travel
HA
Cough
fatigue
Malaise
Shaking/chills
Arthralgia
Myalgia
Paroxysm of fever (Every 40/72 hours)
28
Q

W/u for Malaria

A

Watch for Triad if present malarial smear
Blood cultures on a febrile pt
Hemoglobin
PCR

29
Q

Triad that prompts for malarial smear

A

Thrombocytopenia
Elevated lactate dehydrogenase
Atypical Lymphocytes

30
Q

Tx for Malaria

A

If considerilg Primaquine a G-6PD level is needed
Sulfate plus doxycycline or clindamycin, pyrimethamine-sulfa (quinine based)
Choloroquine
Primaquine

31
Q

What is the common name for Enterobius vermicularis?

A

Pinworms

32
Q

What is the most common helminthic infection in the US?

A

Pinworms

33
Q

Where do Pinworms reside in humans?

A

Cecum, appendix, and ascending colon

34
Q

Are pinworm infections symptomatic/asymptomatic?

A

Asymptomatic

35
Q

How are pinworms transmitted?

A

Direct contact with contaminated object

36
Q

w/u for pinworms?

A

Cellophane swab/cellophane tape to detecpt

37
Q

Special information about tx pinworms:

A

eradication requires at least 3 doses of meds;separated by 3 weeks
simultaneously tx all other family members/ classmates who are infected
Personal and group hygiene must be improved.

38
Q

Meds for pinworm?

A

Antihelminitics are active against E vermicularis
Mebendazole
Pyrantel pamoate
Albendazole

39
Q

What infection is caused by Toxoplasma gondii?

A

Toxoplamsosis-an obligate intracellular parasite

40
Q

Toxoplasmasma gondii infects a large population of the worlds population and (commonly/uncommonly) causes clinically significant disease?

A

Uncommonly

41
Q

What might reactivation of congenital infection of toxoplasmosis cause?

A

Retinochoroiditis

42
Q

What are most common signs of congenital toxoplasmosis?

A

lymphadenopathy and fever

43
Q

T/F a mother who was infected with toxoplasmosis prior to pregnancy runs a severe risk of passing this to her unborn child?

A

F-If a mother is infected prior to pregnancy with toxoplasmosis there is virtually no risk of fetal infection

44
Q

What is the risk of and untreated prenatal infection of toxoplasmosis?

A

1st trimester: 14-17% and the toxoplasmosis in the infant is usually severe.
3rd trimester: 59-65%

45
Q

When might it become apparent that a baby has congenital toxoplasmosis?

A

This infection may remain subclinical for many years and may appear completely healthy at birth but develop clinical symptoms later in life.

46
Q

Presentation of toxoplasmosis

A

Generally asymptomatic unless immunocompromised:
Seizures (and neuro. issues)
Dysequilibrium
Pna

47
Q

W/u for Toxoplasmosis

A

T Gondii organism of blood, body fluid, or tissue
PCR assay
Tachyzoites
IgG (within 2 weeks)
Delayed skin hypersensitivity to T gondii antigens

48
Q

Tx for Toxoplasmosis

A

unnecessary in asympt. (except in children

49
Q

Meds for Toxoplasmosis:

A

Primethamine for 6 weeks
Leucovorin to prevent bone marrow suppression
second drug should be added unless circumstances won’t allow.

50
Q

What is the most common protozoal intestinal parasite worldwide?

A

Giardia intestinalis (Giardiasis)

51
Q

What can Giardia cause?

A

either asymptomatic colonization or

acute/chronic diarrheal illness

52
Q

Where is Giardia found?

A

water supplies (lakes, streams, ponds)

53
Q

How much ingestion of Giardia is needed to cause infection?

A

as few as 10 cysts (not much)

54
Q

r/f for symptomatic giardia

A

Malnutrition
Hypochylorydria
Immune system defficiency
Blood Group A

55
Q

Symptoms of Giardia

A

Diarrhea (MC)

abd. bloating, cramping, flatulence

56
Q

w/u for Giardia

A

3 samples from different days

O&P

57
Q

TX for Symptomatic Giardia

A

Metronidazole-MC

Manage fluid and electrolyte

58
Q

Asymptomatic Giardia?

A

Generally don’t treat except to prevent transmission

Clin Med - ID (6 decks)

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