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POD Exam 4 > Parasites > Flashcards

Parasites Flashcards

1
Q

Nematodes that live in human host

A 
pinworm
whipworm
roundworm
hookworm 
threadworm 
Trichinella spiralis 
filariasis
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2
Q

Aberrant nematodes - Can’t complete life cycle in humans

A

Cutaneous larva migrans (Ancylostoma caninum , braziliensis)

Visceral larva migrans (Toxacara cati, canis)

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3
Q

Nematodes that cause Eosinophilic meningitis

A

Baylisascaris - raccoon ascaris

Angiostrongylus cantonensis

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4
Q

Round worm

A

Ascaris lumbricoides

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5
Q

Ascaris

A
  • no animal reservoir
  • Ingest → hatch in SI, penetrate lining into bloodstream → heart then to lung → trachea to larynx → swallowed - esophagus → develop in SI
  • Loffler’s syndrome
  • pulmonary infiltrates
  • aberrant migration
  • Dientamoeba flagilis
  • inc in blood eosinophils seen - bc seen in the blood
  • Ova n Parasite x3 - stool samples for 3 days
  • eggs seen after 2 - 3 months
  • Albendazole
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6
Q

Loffler’s syndrome

A

Pneumonitis-like condition with transient pulmonary infiltrates, cough, occasional fever and peripheral blood eosinophilia

  • Ascaris
  • Strongyloides stercoralis
  • hookworm
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7
Q

Toxocariasis results from

A

Visceral larva migrans

Toxocara canis - dog
Toxocara cati - cat
ascarid Baylisascaris procyonis - raccoon

Ocular toxocariasis

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8
Q

Visceral Larva Migrans

A
  • Dog/cat feces contains eggs- incubation in soil - ingested by dirt eating children
  • hatch in SI → liver → lung → pulmonary veins → throughout body to organs
  • eggs don’t mature in humans - larvae
  • Asthma-like attacks, Urticarial rashes, Enlarged liver
  • Ocular toxocariasis - vision loss - use serum Elisa test to avoid INcorrect diagnosis of Retinoblastoma
  • ~80% eosinophila
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9
Q

Whipworm

A

Trichuriasis

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10
Q

Trichuriasis

A
  • Whipworm
  • ingesting eggs in soil contaminated by human feces
  • Larvae hatch in SI - stays in large intestine (attach to mucosa)
  • Asymptomatic infections - usually diarrhea
    Rectal prolapse
  • NO eosinophilia - stays in the mucosa
  • Barrel shaped eggs in stool
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11
Q

Capillariasis

A
  • eggs confused with Trichuris
  • it has striations - trichuris is smooth
  • Northern philippines
  • autoinfection
  • death from heart failure
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12
Q

Rat lungworm

A

Angiostrongyliasis

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13
Q

Angiostrongyliasis

A
  • rat lungworm
  • Snails - intermediate hosts
  • Hawaii
  • Eosinophilic meningitis
  • GI symptoms - mimics appendicitis
  • Inc eosinophils in blood and CSF
  • Patients recover completely
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14
Q

Hookworm

A

Ancylostoma duodenale

Necator americanus

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15
Q

Ancylostoma duodenale

Necator americanus

A
  • Hookworm
  • penetration of bare skin - feet - by filariform larvae (infective) in contaminated soil
  • travels from venous system to the right side of the heart and then to the lungs → trachea → esophagus → SI
  • mature + proliferate in SI - eggs produced – deposited to soil and forms rhabditiform (noninfective) → filariform larvae
  • Loffer’s syndrome
  • palpitations of the heart
  • check stool for eggs
  • hypochromic anemia - Oral iron therapy
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16
Q

Cutaneous Larva Migrans

A

non-human dog or cat hookworm

  • Ancylostoma braziliense
  • Ancyclostoma Caninum
17
Q

Cutaneous Larva Migrans

A
  • Ancylostoma braziliense
  • Ancyclostoma Caninum
  • eggs in feces - diagnostic stage
  • Adults in SI of animals
  • animal larvae cannot complete their normal life-cycle in the accidental human host - persists without developing further
  • serpinginous, slightly elevated red track as the larvae migrate - creeping eruptions
  • Moves slowly - few mm each day
  • itchy papulo-pustules (eosinophil rich) in butt/back (nude sunbathers)
  • “hookworm folliculitis”
18
Q

Threadworm

A

Strongyloides stercoralis

19
Q

Strongyloidiasis

A
  • threadworm
  • fecally transmitted - larvae (not eggs) in stool
  • entry through skin - feet (cycle similar to hookworm)
  • “autoinfection” - re-infection - adult in SI → egg → circulation via endogenous reinfection or skin penetration of buttocks after defecation → lungs
  • Hyperinfection with dissemination - high eosinophil count
  • Urticarial rash - itchy with hives
  • Larva currens - diagnostic - hours to days - the rash moves rapidly: 1-2 cm/hr
  • use PCR
  • Ivermectin - drug of choice
  • seen in patient taking high corticosteroids (in WV) has asthma
20
Q

Pinworm

A

Enterobius vermicularis

21
Q

Enterobius vermicularis

A
  • pinworm
  • Humans are the only host - can be transferred from fomites
  • Scotch tape test
  • Adolescent females - vaginal itch and UTI
  • Insomnia
  • Dientamoeba fragilis - flagellate - can be transmitted in eggs
  • retroinfection
  • if one person has it, everyone in family should be treated
  • nothing to do with cleanliness
  • convex/flat shape
  • Pyrantel pamoate - treatment
22
Q

Trichinellosis

A
  • larva ingested - uncooked pig meat/bear
  • cook at 77°C ; freeze at -15°C for 30 days (arctic animals may be resistant to freezing)
  • goes from stomach → SI → bloodstream → muscle, heart, CNS
  • degree of illness reflects number of larva ingested
  • intestinal phase - mucosal irritation
  • muscle phase, larva complexes with nurse cells: Masseters, diaphragm, gastrocnemius
  • muscle biopsy
  • some neuro, cardiac problems
  • Splinter hemorrhage under nails, bilateral periorbital edema
  • Therapy: steroids + mebendazole
23
Q

Scabies

A
  • found between fingers/wrists, flexor surface
  • Human reservoir
  • skin-skin contact; transferred from undergarments, bedclothes
  • Diagnostic: two or more people in the same household complaining of nocturnal itching
  • Treat family members simultaneously
  • wash clothes with HOT water, dryer
  • 5% permethrin, ivermectin
24
Q

Scabies Crustosa

A
  • highly contagious
  • immunodeficient patients in nursing homes
  • misdiagnosed as psoriasis
  • itching may be absent
25
Q

Treatment for head lice? body lice?

A

Permethrin

Malation

26
Q

Jigger flea

A

Tungiasis

27
Q

Tungiasis

A
  • Jigger flea
  • Central, South America, Africa, India
  • soles of feet, around toenails
  • white papule with a central black dot
  • prevention: wear shoes
  • Scratching helps expel eggs from jigger (avoid)
  • use scalpel/pluck out the jigger intact so no rupture occurs
28
Q

Botfly

A

Myiasis
Dermatobia hominis
Cordylobia anthropoghaga

29
Q

Myiasis

A

Cordylobia anthropophaga:

  • Africa
  • eggs on soil contaminated with urine, clothes laid out on ground to dry
  • iron clothes

Dermatobia hominis:

  • central, south america
  • fly –> mosquito –> egg drops on skin
  • penetrates skin and burrows into the subcutaneous tissues
  • larvae of the “higher flies”
  • use petroleum jelly - helps pull the maggot out
  • greater risk in: demented, homeless, alcoholics, pre-existing wounds from diabetic ulcers/stasis ulcers
30
Q

Bed bugs

A

Cimex lectularius

31
Q

Cimex lectularius

A
  • bed bugs

bites in lines or cluster

bite at night - drawn to warmth and CO2

itching papules

dark specks on mattress seams

32
Q

Chagas

A

American Trypanosomiasis

- T. cruzi

33
Q

Sleeping sickness

A

African Trypanosomiasis

34
Q

American Trypanosomiasis

A
  • Chagas
  • Mexico, Central and South America, some in US
  • sudden death in brazilian athletes
  • imported into US by visitors, immigrants from south america
  • T. cruzi carried by “kissing bugs” Reduviid bug
  • bug bites → takes dump on skin of man. Man rubs the feces with bug/infective parasite “Contamination”
  • Transmission via placenta, blood transfusion, organ transplant
  • Kissing bug lives in thatch roof, mud walls
  • Romana sign: UNILATERAL swelling of eyelid on one eye
  • Swollen nodule of the skin - Chagoma
  • T. cruzi - parasite in blood. T. rangeli is non-pathogenic look alike
  • Megacolon/esophagus/cardio (right bundle branch block)
  • Xenodiagnosis
  • Nifurtimox and benznidazole
35
Q

African Trypanosomiasis

A
  • Sleeping sickness
  • Tsetse fly - bites - neurologic sequelae
  • Gambian (tropical, west/central africa, man as reservoir) vs Rhodesian (drier, east/southern africa, bushbuck, nagana) Nagana variety
  • Hyperexcitability → Insomnia → sleeping sickness
  • Winterbottom sign - nodes in the back of the neck - Gambian
  • Parasite found on blood/lymph from aspirated gland juice or lumbar puncture
  • Mott cells (eosinophilic plasma cells) in CSF - pathognomonic
  • Trypanosomal chancre - boil
  • Trypanosomal rash - skin eruption
  • Kerandel sign - delayed sensation to pain
  • Xeno-diagnosis
  • Treatment: early: iv suramin, iv melarsoprol
36
Q

Leishmaniasis

A
  • bite of the Sand fly (phlembotomus, Lutzomyia)
  • Cutaneous, Mucocutaneous, Visceral
  • chiclero ulcer - eats away the ear: new world, cutaneous
  • Cutaneous: diagnosis: scrapings/needle aspiration - under the margin of the ulcer, NOT the center of the lesion
  • in Central, south Americas: wet. all three seen
  • Cutaneous seen in US
  • mediterranean and middle east: dry. only cutaneous and visceral
  • Mucocutaneous - central, south ameria: ulcerative lesions on/in nose or mouth. Tapir nose
  • Visceral - asia, africa, south america, mediterranean - us soldiers from gulf war: Black fever
  • Spleen and liver enlarge, grayish skin, lower than normal wbc
  • Treatment: injections of pentavalent antimonials, Amphotericin B

POD Exam 4 (3 decks)

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