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ID exam 2 > Parasites > Flashcards

Parasites Flashcards

1
Q

parasites are…

A

protozoa or helminth that lives on or in a host and gets food from or at expense of host :(

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2
Q

protozoa are….

A

unicellular eukaryotes.

  • amoebas –> pseudopod mobility
  • sporozoans–> NO pseudopod, falgellar, ciliary motility
  • flagellates –> whip like flag motility
  • ciliates –> hairlike motility
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3
Q

entamoeba histolytic (amoeba)

A
  • dz= ameobiasis
  • transmission= fecal oral, cysts in water
  • dx= trophozoites with engulfed RBCs, cysts in stool
  • tx= metronidazole, iodoquinol for asyx, paramycin
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4
Q

infectious process of entamoeba hitolytica, stages of infection

A

-cysts ingested and differentiate in ileum –> trophozoites –> invade colon epi –> local necrosis, HEMATOG spread –> intestinal/extraintestinal amebiasis

1) trophozoite stage= pseudopods, move along intestine wall, invade, liver
2) infective cyst stage

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5
Q

presentations of entamoeba histo

A

1) asyx carrier (most common –> cysts in stool, contagious, can survive outside host
2) intestinal AMEBIASIS (subacute) –> bloody diarrhea, invasive, abd pain, n/v
3) liver abcesses –> dull RUQ pain, elevated LFT, anchovy paste liver abcesses

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6
Q

primary amoebic meningoencephalitis

A

NAEGLERIA FOWLERI

  • rapidly fatal
  • nuchal rigidity, fevers, n/v, AMS
  • fresh water lakes, summer
  • enters cribiform plate –> olfactory n –> frontal lobe
  • dx= amoebas in CSF
  • tx= ampho B, if you’re lucky
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7
Q

acanthamoeba

A 
trans= nasopharyngeal, breaks in skin
granulomatous amebic encephalitis 
-ha, n/v
-keratitis (contact lenses)
-death
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8
Q

cryptosporidium (sporozoan)

A
  • mild, watery diarrhea in immunocompetent
  • severe diarrhea in AIDS
  • transmission by OOCYSTS in water –> think pools and recreational water supply
  • *can survive chlorination**
  • dx= stool samples with ACID FAST oocsyt
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9
Q

how do you treat cryptosporidium?

A

healthy person: self limiting, nitazoxanide for children

AIDS: antiretrovirals for CD4>100

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10
Q

Where does crypto replicate? Where does entamoeba replicate/ invade?

A

crpyto: intracellular in SMALL I
entemoeba: can replicate in ileum, invades COLON

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11
Q

toxoplasma gondii (sporozoan), modes of transmission (3)

A

1) undercooked meat
2) kitty poop
3) transplacentally to fetus

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12
Q

who is at risk for toxo infx?

A

immunocompromised, pregnant ladies

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13
Q

toxo

A
  • obligate intracellular parasitic protozoa
  • chorioretinitis
  • encephalitis
  • pneumonitis
  • MOST common cause of encephalitis in HIV
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14
Q

congenital toxo triad

A
  • woman WITHOUT previous exposure
    1) chorioretinitis
    2) intracranial calcifications
    3) hydrocephalus

TORCHES yo

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15
Q

Toxo encephalitis in HIV? How do you distinguish from CNS lymphoma?

A

brain abcsess seen as ring enhancing lesion on CT/MRI -_> usually MULTIPLE
TMP/SMX proph for CD4<100

Lymphoma is usu single lesion.

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16
Q

tx of toxo

A

pyrimethamine-sulfadiazine

use pyr-clinda if sulfa allergy

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17
Q

Plasmodium epi

A

> 0.5 million deaths/ year

half are children under 5 in africa

resistance to medications

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18
Q

plasmodium diagnosis/ transmision/life cycle (this might be wrong)

A
  • dx= parasites in RBC
  • transmission= anopheles mosquito
  • life cycle= release sporozoites into bloodstream –> liver, infect hepatocytes –> sporos divide –> merozoites –> merozoites leave liver and infect RBC –> develop into trophozoites –> RBCs get stiff, destroyed by RES –> burst –> release parasite

also, something about schizonts?

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19
Q

sx of malaria/ fever patterns: 1) p malariae 2) p. vivax.ovale 3) p. falciparum

A

sx= fever, HA, anemia, splenogmegaly
-9-14 day incubation
paroxyms= cold, hot fever, sweattttttt it all out

1) malarquatran, every 3 days
2) tertain, every 2 days
3) random, irregular

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20
Q

p. falciparum

A

WORST
cerebral malaria –> insert “sticky” protein into RBC membrane –> CYTOADHERENCE
-clogs up capillaries in brain, kidneys, lungs
-sickle cell trait/ thalassemia, G6PD confers PROTECTION

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21
Q

p. vivaxe/ovale

A
  • relapsing infx (tertian pattern)
  • hypnozoites= dormant form in liver
  • *treat with primaquine
  • only infects reticulocytes
  • schuffner dots –> brick red dots in host erythrocyte
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22
Q

diagnosis:
1) p malariae
2) p. vivax.ovale
3) p. falciparum

A

1) p malariae –>
- trophozoite= band or rectangular
- gametocyte= round
2) p. vivax.ovale
- trophozoite= LARGE, irregular rings
- gametocyte= round
3) p. falciparum
- trophozoite= small ring
- gametocyte= banana like

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23
Q

treatment of malaria

A
  • primaquine for vivax/ ovale hypnozoites –> TEST G6PD
  • chloroquine –> blocks plasmodium heme plymerase
  • *lots of resistance
  • mefloquine/atovaquone for choloroquine resistant regions
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24
Q

what can you tx malaria with in patients with G6Pd

A

IV quinidine, artesunate

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25
giardia lamblia
- foul smelling, steatorrhea, bloating, flatulence - cysts in water - dx with multinucleated trophozoites or cysts in stool - tx= METRO
26
giardiasis
fecal oral - 10-25 cycts req for dz - cysts ingested --> become trophozoites in duodenum, attach to duodenal villi - malabsorption and hypersecretion of Cl- - dx= TEAR shaped cysts in tool, owl eye nuc, four flagella
27
diarrhea of giardia
NON inflammatory - can cause secondary lactose intolerance - most common cause of nonbacterial diarrhea in US
28
trichomonas vaginalis
-sexually transmitted (no cysts, rarely leaves host) -asymtomatic carrier -acute vaginitis -urethritis (men) dx= vaginal wet mount shows MOTILE pear shaped flagellated trophooites -tx= metro
29
acute vaginitis presentation
- burning, itching, dysuria - STRAWBERRY cervix - green, foul smelling vaginal discharge - pH > 4.5
30
leishmania
- intracellular parasite in macrophages - transmission by sandfly - leads to visceral , cutaneous, mucocutaneous - dx= bx with AMASTIGOTES in macs - tx= amphotericin B, sodium stibogluconate
31
visceral leishmaniasis
BLACK FEVER - spiring fevers, HSM, pancytopenia - skin hyperpigmentation (black fever)
32
cutaneous leishmaniasis
braziliensis --> skin ulcers | -erythematous papule at sandfly bite that ulcerates
33
mucocutaneous leish
lesions confined to skin, mucous membranes and cartilage
34
trypanosoma cruzi
CHAGAS - kissing bug --> painless bite/ defecation of reduviid bug - acute vs chronic
35
acute chagas
- chagoma= inflammatoin at bite site - romana's sign --> swelling inflammation around eyelids from bug in conjunctiva - dx= flagellated trypomastigotes on blood smear - tx= bendizole, nifurtimox
36
chronic chagas
``` dilated cardiomyopathy cardiac arrhythmias megacolon megaesophagus achalasia ``` dx= chronic infection= parasitemia below detecable range
37
trypanosoma brucei
AFRICAN SLEEPING SICKNESS - tsetse fly - enlarged lymphonodes - cycling fever --> many different serotypes --> exhausts immune system - tx= suramin for blood, melarsoprol for CNS
38
general info about cestodes
segmented organization with scolex (round head) and proglottids (body segments) type of platyhelminthes (flat worms)
39
taenia solium (flatworm)
PORK - intestinal tapeworm --> ingest larvae in pork - cysticercosis/neurocysticercosis --> ingest eggs contaminated with feces - dx by proglottids/ eggs in stool or calcifications on CT/MRI (brain or muscle) - SWISS CHEESE PATTERN - tx= praziquentel, albendazole, corticosteroids
40
taenia saginata (tapeworm)
``` BEEF -attach to small I, pass eggs in feces -asymptomatic usu -malnutrition, abd discomfort tx= praziquantel ```
41
difference in appearance between t. saginata and t. solium?
solium has circle of HOOKLETS saginata has no hooklets both have four suckers
42
echinococcus granulosus (tapeworm)
DOG - hydatid cysts in liver, lung, brain --> cause anaphylaxis if ag are released from cyst rupture - organ displacement/ dysfunction from cyst growth - "eggshell" calcification - tx= albendazole
43
precatuionary (necessary) measure in removal of echinococcus cysts?
inject larvicidal solution before removal!! ethanol or hypertonic saline --> will kill daughter cysts before removal
44
diphyllobothrium (tapeworm)
FISH (also largest) - larvae mature into adults in small I - consume food and B12 - megaloblastic anemia - tx= praziquantel
45
what are trematodes?
flukes - non segmented - mature in LIVER - incomplete digestive tubes - schistomsoma - clonorchis sinesnsis
46
schistosoma
snails= host - excrete cercariae into fresh water --> penetrate skin --> enter blood - adults flukes migrate AGAINST PORTAL VENOUS FLOW - dx= eggs in stool/urine - tx= praziquantel
47
which part of the schistosoma life cycles causes infection? how does it evde the immune system?
- eggs | - molecular mimicry
48
presentations of schistosoma (6) (maddy)
1) cercarial dermatitis (swimmer's itch) --> days 2) ACUTE SCHISTOSOMIASIS --> 1-2 months post infx 3) chronic schisto --> mo-years post infx 4) intestinal schisto --> pain, diarrhea, bleeding, Fe defic 5) hepatosplenic schisto --> HSM, periportal fibrosis, portal HTN 6) GU schisto --> #1 cause of squamous cell carc of bladder
49
what are nematodes like?
round worms - non segmented organization with complete digestive tube - dx is made by eggs in stool - tx is benzimidazoles
50
enterobius vermicularis (pinworms)
- most common US helminth - intestinal roundworm - perianal itching - trans= fecal oral - females migrate out of butt hole to lay eggs - dx= scotch tape test (gross) - tx= benzimidiazoles, pyrantel pamoate
51
why do we do the scotch tape test? for what org?
enterobius vermicularis bc eggs are NOT found in stool
52
ascaris lumbricoides
giant roundworm - more common worldwide, tropical - transm= fecal oral - dx= stool microscopy - tx= benzimidazoles, ivermectin
53
describe transmission/ infection with ascaris lumbricoides
intestinal infection -ingest ova --> hatch in SI --> larvae penetrate intestinal wall --> migrate hemato/ lymphatic to LUNGS larvae mature in alveoli --> ascend bronchial trea --> swallowed back into SI
54
sx/ presentation of lumbricoides?
-most are asymptomatic..... but.... - Loeffler's syndrome --> hypersensitivity eos pneumonitis - obstruction of bowel lumen - can cause biliary obstruction
55
trichuris trichiura
whipworm - intestinal parasite - assoc with poor hygiene + tropical climates - fecal oral - stool examination shows eggs football/ barrel shaped
56
strongyloides stercoralis (threadworm)
- fecal cutaneous - penetrates the skin on FEEEEEET --> enter blood stream - eggs mature in SI, swallowed, reinfect - autoinfection
57
sx/dx/tx of strongyloides
``` sx= pneumonia+ gastroenteritis dx= larvae in stool (not eggs), eosinophilia tx= benzimidazoles, ivermectin ```
58
necator americanus (hookworm)- symptoms
pneumonia gastroenteritis Fe def anemia --> secrete anticoag, worm eats your blood
59
necator americanus (hookworm)- tranmission
fecal cutaneous - penetrate skin of feel - enter bloodstream - go to lungs, enter alveoli - cause PNA - swallow larvae, mature in small intestine
60
onchocerca volvulus (tissue roundworm)
river blindness - human= definitive host - female black fly - mature into adult form subq --> release microfilariae --> can cause allergic rxn - LIZARD SKIN-> hyperpigmented pruritc rash
61
river blindness
onchocerca volvulus -microfilariae get to eye -major cause of blindness tx= ivermectin
62
wuchereria bancrofti
- obstruction of lymphatics - mosquito transmission - obstructs lymphatics - dx= blood with microfilariae - tx= DIETHYLCARBAMAZINE
63
elephantiases
-wuchereria bancrofti -lymphatic filariasis --> lymphedema -scrotum, arms, breast ONLY ADULTS DO ELEPHANTIASIS tx= diethylcarbamazine
64
tropical pulmonary eosiniphilia
wuchereria bancrofti - microfilariae in lung - immediate hypersensitivity reaction (increased IgE, eos) - wheezing at night - tx= diethylcarbamazine
65
whats the time frame of infection of wuchereria bancrofti
female mosq deposits larvae in skin --> go to lymph nodes after ONE YEAR larvae mature into adult worms --> trigger inflammation!
66
s mansoni vs s haematobium
s mansoni= eggs have LATERAL spine --> fibrosis, inflammation s haematobium= eggs with terminal spine --> BLADDER CANCER
67
differentiate a smear of trypnosoma cruzi vs leishmania donovani
t. cruzi= chagas --> TRYPOMASTIGOTE, extracellular, flagella that begins at one end of org and comes out the other leishmania --> AMASTIGOTE, intracellular, no flag
68
romana's sign
periorbital edema seen in acute chagas
69
clonorchis sinensis
trematode - undercooked fish - snail= intermediate host - causes biliary tract inflammation --> pigmented gallstones - CHOLANGIOCARCINOMA - tx= praziquental

ID exam 2 (16 decks)

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