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TCM Exam 2 > Parasites > Flashcards

Parasites Flashcards

1
Q

Organisms from what groups are considered “parasites?”

A

Protozoa and Animalia

Protozoa- amoeba, flagellates, ciliates and sporozoa pathogens

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2
Q

2 fungi sometimes listed as protozoa

A

Pneumocystis jirovicii (pneumonia in immunocompromised)

Microsporidia (spores of numerous fungal species associated with numerous different infections in immunocompromised)

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3
Q

Ectoparasites

A

near the skin surface (most arthropods)

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4
Q

Endoparasites

A

“inside” the body

Most GI and respiratory mucosal surfaces are still in contact with the external environment

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5
Q

Entamoeba histolytica

A

Asymptomatic or invasive intestinal amebiasis (bloody diarrhea, colitis, appendicitis) with possible extraintestinal amebiasis (liver abscess)

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6
Q

Free Living Amoeba

A

Acanthamoeba castellanii can cause keratitis in contact wearers
A. castellanii and Balamuthia mandrillaris cause granulomatous encephalitis
Naegleria fowleri can cause meningoencephalitis, usually via cribriform plate fracture
Dx – culture for amoeba

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7
Q

giardia lamblia

A

Causes diarrhea with “fatty” stools .

under microscope looks like kites with eyes

swallowed string test

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8
Q

Leishmania donovani, etc.

A

Vector is the sand fly

Cutaneas, visceral (=kala azar), and mucocutaneous exist.

promastigotes in sandfly and in culture
kinetoplastid amastigotes in macrophages in lesions of human tissues

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9
Q

Trypanosoma cruzi

A

Chagas disease = American trypanosomiasis

Vector is the kissing=reduviid=triatomine bug feces,

Romana sign– big swollen eye at the beginning of the infection

Kinetoplastid amastigotes in muscle tissue (heart, etc.)

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10
Q

Trypanosoma brucei

A

Sleeping sickness = African trypanosomiasis
Fulminant East African
chronic West African

Vector is tsetse fly

Parasite initially forms chancre, gets into blood evading host response via VSG glycoprotein gene rearrangements (recurrent fevers) and causes lymphadenopathy; later crosses into CNS (demyelinating panencephalitis) and can lead to coma and death if not treated

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11
Q

Trichomonas vaginalis

A

Sexually transmitted can be asymptomatic or cause urethritis in males or vaginitis in females

smells “fishy”

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12
Q

Plasmodium spp

A

Malaria
–> febrile hemolytic illness during merozoite release from RBCs that causes hemoglobinemia and hemoglobinuria (blackwater fever)

sometimes cerebral malaria = cerebral ischemia

Anopheles spp. mosquitoes is final host and humans the intermediate hosts of malaria

Vector (female mosquito) injects sporozoites

Sporozoites infect hepatocytes which reproduce asexually forming schizonts filled with merozoites
Merozoites infect RBCs forming ring forms that grow into trophozoites that can produce gametocytes

Mosquitos ingest male microgametocytes and female macrogametocytes from human blood

Dx – thick and thin blood smears

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13
Q

plasmodium spp. life cycle

A

mosquito takes up blood meal

pre-erythrocytic (exoerythrocytic) schizogony

Schizonts are filled with asexual haploid merozoites

dormant in hepatocytes (hypnozoites) –> recur years later

Erythrocytic schizogony (24-72 hours): immature trophozole (ring stage)–> mature–> schizont–> rupture–) immature trophozole

can continue from that phase to gametocytes

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14
Q

histology of plasmodium falciparum

A

1- Malaria has hemozoin (iron- brown pigment)

2- the falciparum gamteocyte is elongated/ banana shaped

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15
Q

treatment of malaria

A

Quinoline drugs (quinine, etc.) thought to inhibit heme transformation to hemozoin, which is required by the parasites as heme is toxic to the parasite

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16
Q

Different types of plasmodium spp

A

P. flaciparum- malignant tertian presentation. Crescent (banana) shape

P. vivax- benign tertian

P. malariae- Quartan

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17
Q

Toxoplasma gondii

A

Toxoplasmosis is usually asymptomatic with infectious cysts in meats or cat feces

worse in immunocompromised

TORCH syndrome with fetomaternal transmission

Definitive host is the cat

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18
Q

Cryptosporidium parvum

A

Cryptosporidiosis - watery diarrhea and gastroenteritis, especially in immunocompromised

Dx- stool exam w/ AFB stain

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19
Q

Cystoisopora belli

A

diarrhea, commonly in immunocompromised people

dx: acid-fast oocysts

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20
Q

Babesia spp.

A

hemolytic anemia; in immunocompromised can lead to DIC and death

Vector is Ixodes scapularis (blacklegged = deer tick)

** No hemozoin pigment

dx- ring forms (esp. tetrad maltese cross)

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21
Q

inflammatory response to helminths

A

Th2 –> cytokines –> eosinophils -> IgE

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22
Q

Platyhelminthes

A

blood flukes, lung fluke, sheep liver fluke, fish liver fluke, intestinal fluke

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23
Q

-Cestoda

A

various tapeworms

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24
Q

Schistosoma spp.= Blood Flukes

A

get it from the water
–> itchy rash

Chronically can lead to liver (pipe-stem fibrosis and ascites), intestinal (bloody diarrhea), pulmonary, bladder (hematuria) and CNS inflammation and fibrosis from misplaced eggs
S. haematobium involves urinary bladder and can lead to squamous cell carcinoma

dx- eggs in urine for H. haematobium, eggs in stool for others

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25
Q

different schistosoma by egg descriptions

A

lateral spine– mansoni
terminal spine- haematopium
no spine- japonicum

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26
Q

cercarial dermatitis

A

Cercaria intended for other species can cause an itchy rash (swimmer’s itch) which is self-limited as human is an incidental dead-end host

normal host is ducks

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27
Q

Paragonimus westermani, etc.

A

Lung Flukes

Causes paragonimiasis – asymptomatic to acute syndrome with cough, abdominal pain, and low-grade fever

Spread by consumption of undercooked shellfish, crabs and crayfish
Dx – eggs in sputum or lung biopsy;

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28
Q

Fasciola hepatica, etc

A

= Common/Sheep Liver Fluke

in undercooked sheep/goat liver

RUQ abdominal pain, cholecystitis, pancreatitis

not associated with liver cancer

29
Q

Clonorchis sinensis

A

Chinese/Oriental Liver Fluke

undercooked fish–> travel to liver and feed on bile

–> RUQ abdominal pain
chronically can lea to biliary tract cholangiocarcinoma

30
Q

Taenia spp.

A

Taenia solium from pork, Taenia saginata from beef

from ingestion of animal flesh with cysticercosis

cyticerci in undercooked flesh

mild GI symptoms

Ingestion of eggs in human fecal material from T. solium can cause cysticercosis

dx- imaging for cysts in neurocysticercosis

humans are final host

Scolex have little hooks to grab onto your intestine

Proglottid = eggs

31
Q

Diphyllobothrium latum

A

Fish/Broad tapeworm

Asymptomatic to symptoms of intestinal obstruction or gallbladder disease

B12 deficiency

From raw/undercooked freshwater fish

humans are final host

32
Q

Hymenolepis nana

A

= dwarf tapeworm
mild intestinal symptoms

world from ingestion of eggs in human feces or ingestion of infected microscopic crustaceans (copepods), beetles or mealworms

33
Q

Echinococcus spp.

A

causes cysts within numerous organs (liver, lungs, CNS)

Cystic (hydatid) disease occurs from eggs obtained from dogs (definitive host) or larval stages from sheep

feels like hepatitis

34
Q

Onchocerca volvulus

A

roundworm

Causes onchocerciasis (river blindness) – skin onchocercoma nodules 
corneal scarring

immature larvae introduced by blackfly

35
Q

Loa loa

A

African Eye Worm

Causes loiasis - itching, localized (Calabar) skin swelling, joint pain, renal failure, ocular problems from migrating microfilariae and can occlude lymphatics

dx- midday blood smear examination

36
Q

Dirofilaria immitis, etc.

A

granulomas in skin, lungs (asymptomatic, cough, pleural effusions,

human is incidental host bitten by infected mosquito; DOG is the main host

37
Q

Wuchereria bancrofti/ Brugia malayi/B. timori

A

Cause lymphatic filariasis
can cause elephantiasis

dx- nocturnal blood smears

38
Q

Gongylonema pulchrum

A

presenting as a moving “worm” in the oral cavity mucosae,

Infection is caused by ingestion larvae from intermediate hosts (cockroaches or dung beetles)

39
Q

Trichinella spiralis

A

causes GI symptoms plus muscle pain

from larvae in undercooked meat

40
Q

Trichuris trichiura

A

= Whipworm Infection

Soil transmitted helminth that causes trichuriasis – asymptomatic to frequent, painful defecation of watery stool with mucus and blood which can lead to rectal prolapse

from ingestion of human feces

barrel-shaped eggs with two polar caps

41
Q

Dracunculus medinensis

A

Guinea Worm Disease

GI symptoms with diarrhea, boil with severe burning pain where adults exit skin

from ingestion of water containing larvae infected copepods (water fleas)

42
Q

A. duodenale & N. americanus

A

= Hookworms

soil transmitted helminths Ancylostoma duodenale & Necator americanus cause hookworm infections worldwide– asymptomatic to GI symptoms with abdominal pain, diarrhea, and anemia

from touching infected human excrement

43
Q

Ancylostoma braziliense

A

= Zoonotic Hookworms

cutaneous larva migrans with inflamed worm tunnels in the skin
Cat and dog feces may have Ancylostoma brazilense

44
Q

Ascaris lumbricoides

A

= Giant Roundworm

#1 soil transmitted helminth and causes ascariasis worldwide – asymptomatic or GI symptoms (blockage); occasionally disseminates throughout the body (cough)
Introduced by consuming human fecal material
45
Q

Toxocara canis or T. cati

A

Ocular larva migrans when larvae migrate to the eye (ophthalmitis, retinal damage, blindness)
Visceral larva migrans when larvae migrate systemically (cough, fever, abdominal pain)
Humans are incidental hosts from ingesting eggs in cat or dog feces, or ingesting larvae in undercooked meat

46
Q

Strongyloides stercoralis

A

= Threadworm

Worldwide soil-transmitted helminth

In HTLV-1 infected people, get severe disseminated strongyloidiasis
Larvae in fecal material enter through feet

may autoinfect via larvae exiting eggs and invading intestines or perianal skin and lead to hyperinfection

47
Q

Trichostrongylus spp.

A

GI symtoms (pain diarrhea), from feces from an herbivorous host

48
Q

Enterobius vermicularis

A

1 worm infection in U.S. - live in large intestine and females migrating and laying eggs at anus may cause itching at night

= Pinworm Infection

dx- cellophane tape test

49
Q

Copepods (Microscopic)

A

microscopic little arthropods

Transmit Diphyllobothrium latum (fish/broad tapeworm), Dracunculus medinensis (dracunculiasis = Guinea worm),

50
Q

Decapods

A

(Lobster, Crabs, Etc.)

Transmit Paragonimus spp. (lung flukes)

51
Q

scorpions

A

venemous sting

occasionally cause death via action of toxins on numerous different ion channels

52
Q

spiders

A

venemous bites causing necrosis (brown recluse) or neurotoxicity (black widow)

53
Q

ticks

A

bites can cause tick paralysis via toxin

soft ticks transmit borrelia –> tick-borne relapsing fever

hard ticks transmit a variety of diseases

54
Q

stuff transmitted by rocky mtn wood tick

A

tularemia, rocky mountain spotted fever, colorado tick fever, tick paralysis

55
Q

stuff transmitted by blacklegged (deer) tick

A

anaplasmosis, babesiosis, lyme disease, febrile illness, powassan disease

56
Q

stuff transmitted by itch mite (sarcoptes scabiei)

A

scabies “itch”, mange

57
Q

stuff transmitted by follicle mites (demodex follicularum & D. brevis)

A

Folliculitis, blepharitis, rosacea

Dermatitis

58
Q

Anoplura

A

(Sucking Lice)

Body louse transmits 
Rickettsia prowazekii (epidemic typhus) 
Bartonella quintana (trench fever)
Borrelia recurrentis (louse-borne relapsing fever)

Pediculosis capitis
Head lice infestation

Pediculosis corporis

Pediculosis pubis (crabs)

59
Q

Siphonaptera

A

= fleas

transmit cat scratch disease, plague, rickettsia typhi

60
Q

Hemiptera

A

bed bugs

Kissing (reduviid bug) transmits American typanosomiasis = Chagas disease

61
Q

Diptera- flies

A

flies

Flies bite and larvae infest human flesh (myasis, botfly

Transmit typhoid, paratyphoid, cholera, bacillary and amebic dysentery, giardiasis, helminths, trachoma, conjunctivitis, yaws, anthrax, tularemia, African sleeping sickness, leishmaniasis, onchocerciasis, loiasis, bartonellosis, and sandfly fever

62
Q

diptera- mosquitos & midges

A

aedes- chikungunya, yellow fever, zika

culex- west nile

anapholes- malaria, west nile

63
Q

hymenoptera (bees, ants, etc.)

A

sting

64
Q

cockroaches

A

can trigger asthma via droppings

65
Q

Coleoptera (Beetles)

A

Can be flour/grain beetles can be intermediate hosts for thorny headed worms or rat tapeworm

blister beetles - cause blistering via cantharidin

66
Q

Lepidoptera (Moths, Etc.)

A

some caterpillars can cause chemical burns

67
Q

centipedes

A

can have a venemous bite

68
Q

milipedes

A

can exude vesicating venom

TCM Exam 2 (15 decks)

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