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Foundations of Disease and Therapy > Parasites > Flashcards

Parasites Flashcards

1
Q

Artemisinin

A

a prodrug that’s converted to dihydroartemisinin (DHA), which generates reactive oxygen species (ex: Plasmodium)

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2
Q

Babesia microti treatment and prevention

A

Treatment: Atovaquone (inhibits mitochondrial function) and Azithromycin (disrupts protein synthesis); Clindamycin (inhibits protein synthesis) and Quinine (disrupts food vacuole)

Prevention: Avoid tick bites

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3
Q

Leishmania diseases and pathogenesis

A

Variety of Leishmaniasis:

  1. Cutaneous (least severe) - skin ulcers, black spots
  2. Mucocutaneous
  3. Visceral (most severe) - spiking fevers, hepatosplenomegaly, pancytopenia

Leishmania has a protease that destroys complement components

It is an intracellular parasite that destorys phagocytes

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4
Q

Leishmania treatment, resistance, and prevention

A

Treatment: Amphotericin B, Miltefosine (interferes with lipids and disrupts mitochondria)

Resistance: Amphotericin B resistance due to altered membranes and drug efflux pumps.

Prevention: Avoid sandlfy bites

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5
Q

Cryptosporidium hominis treatment and prevention

A

Treatment: Nitazoxanide

Prevention: Clean food/water, filter water, boil water, avoid swimming in contaminated water sources

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6
Q

Plasmodium vivax/ovale infection and diagnosis

A

Infection: Sporozoites injected into bloodstream from bite of Anopheles mosquito

Diagnosis: Trophozoite rings within RBC’s on peripheral blood smear, Schizont containing merozoites - red granules throughout RBC cytoplasm

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7
Q

Albendazole, Mebendazole

A

Binds to beta-tubulin of microtubules; broad spectrum against helminths (ex: Ascaris, hookworms)

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8
Q

Entamoeba histolytica treatment, resistance, and prevention

A

Treatment: Metronidazole, Diloxanide

Resistance: Decreased drug uptake or increased extrusion

Prevention: Filter or boil water; can survive harsh water treatments

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9
Q

Plasmodium malariae disease/pathogenesis

A

Follow quartan fever cycle (72 hr - 1st and 4th day)

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10
Q

Parasites that form metabolically inactive cysts

A

Giardia, Cryptosporidium, Cyclospora, Toxoplasma, Naegleria

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11
Q

Benznidazole

A

generates free radicles that damage parasite DNA and proteins (ex: Trypanosoma cruzi)

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12
Q

Amphotericin B

A

damages egosterol-rich parasite membranes (ex: Naegleria, Leishmania)

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13
Q

Schistosoma pathogenesis and disease

A

Schistosoma mansoni larvae coat themselves in ABO blood group antigens and MHC molecules to avoid immune detection

In early stage, Schistosoma penetrates skin and migrates to liver

  • S. mansoni* leads to portal hypertension, liver cirrhosis, and granulomas
  • S. haematobium* can lead to carcinoma of the bladder
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14
Q

Plasmodium vivax/ovale disease and pathogenesis

A

Remain dormant in liver as hypnozoites

Follow tertian fever cycle (48 hr - fever on 1st and 3rd day)

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15
Q

Plasmodium falciparum infection and diagnosis

A

Infection: Sporozites injected by bite of Anopheles mosquito

Diagnosis: Banana-shaped gametocytes seen on peripheral blood smear with trophozoite rings forming within RBC’s

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16
Q

Naegleria fowleri pathogenesis and symptoms

A

Enters CNS through cribiform plate where proteases rapidly degrade brain cells for nutrients to replicate; rapidly fatal meningoencephalitis

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17
Q

Trypanosoma brucei treatment, resistance, and prevention

A

Treatment: Melarsoprol for CNS infection (binds parasite pyruvate kinase and inhibits energy production), Suramin for bloodborne disease

Resistance: Altered transporters leaving it unable to take up drug

Prevention: avoid insect bites

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18
Q

Trypansoma cruzi infection and diagnosis

A

Infection: Kissing bug has painless bite and poops on your face. The poop contains trypomastigote and you scratch that into the bite. Common in Central and South America

Diagnosis: Trypomastigote on peripheral blood smear

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19
Q

Ascaris lumbricoides pathogenesis

A

After ingestion, eggs hatch and larvae penetrate intestinal mucosa, enter bloodstream, and pass through liver, heart, then lungs

Can rupture into alveolar spaces where they are coughed up and swallowed

Adults mature in small intestine

Can cause ileoceccal obstruction or biliary obstruction

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20
Q

Entamoeba histolytica disease and pathogenesis

A

Bloody diarrhea, “anchovy paste” liver abscesses, RUQ pain, flask-shaped mucosal ulceration

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21
Q

Naegleria fowleri infection and diagnosis

A

Infection: Trophozoite gets into brain through cribiform plate; Affects people who swim in freshwater rivers/lakes in Southern states

Diagnosis: Amoebas in spinal fluid

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22
Q

Giardia intestinalis disease and pathogenesis

A

Causes smelly yellow diarrhea

Colonizes upper part of small intestine and causes intestinal malabsorption due to damage to microvilli

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23
Q

Trypanosoma cruzi disease and pathogenesis

A

Parasites replicate and form cysts in heart, esophagus, and GI tract

Chagas Disease - dilated cardiomyopathy with apical atrophy, megacolon, megaesophagus

Unilateral periorbital swelling (Romana sign) characteristic of acute stage

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24
Q

Chloroquine

A

disrupts parasite waste disposal and causes accumulation of free heme (ex: Plasmodium)

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25
Q

Merozoites

A

Released into bloodstream upon lysis of Plasmodium-infected RBC’s

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26
Q

Trypanosoma cruzi treatment, resistance, and prevention

A

Treatment: Nifurtimox, Benznidazole “Cruzing in by Benz with a fur coat”

Resistance: Loss of function mutations in enzymes that activate prodrugs

Prevention: Vector control

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27
Q

Taenia solium treatment and prevention

A

Treatment: Praziquantel, Albendazole

Prevention: Good hygeine, treat tapeworm carriers

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28
Q

Babesia microti disease and pathogenesis

A

Causes fever and hemolytic anemia; asplenia increases risk of severe disease

Parasite replication destroys RBC’s

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29
Q

Ascaris lumbricoides treatment and prevention

A

Treatment: Mebendazole or Albendazole

Prevention: don’t use poop as fertilizer

30
Q

Cryptosporidium hominis infection and diagnosis

A

Infection: Ingestion of oocysts from contaminated water

Diagnosis: Oocysts seen in feces

31
Q

Definitive Host

A

host in which parasite reaches adulthood and where sexual reproduction occurs

32
Q

Diagnostic indicator of parasitic infection

A

Eosinophilia and high IgE count

33
Q

Trypanosoma brucei infection and diagnosis

A

Infection: Bite of Tsetse fly injects metacyclic trypomastigote into bloodstream

Diagnosis: Trypomastigote in blood smear

34
Q

Trypanosoma brucei pathogenesis and disease

A

Causes African Sleeping Sickness - enlarged lymph nodes, recurring fever (due to antigenic variation), somnolence, coma, death

Parasite replicates in bloodstream, lymph, and spinal fluid where it enters CNS

35
Q

Trichomonas vaginalis disease and pathogenesis

A

Causes persistent inflammation in vagina because it produces mechanical stress on host cells until their death

Vaginitis - foul-smelling, greenish discharge; itching and burning; do NOT confuse with Gardnerella (gram-variable bacterium)

36
Q

Trichomonas vaginalis treatment, resistance, and prevention

A

Treatment: Metronidazole, Tinidazole

Reistance: loss of ability to activate prodrug

Prevention: Condoms

37
Q

Trichomonas vaginalis infection and diagnosis

A

Infection: Trophozoite transmitted sexually; cannot exist outside humans because it cannot form cysts

Diagnosis: Motile trophozoites on wet mount; “strawberry cervix”

38
Q

Treatments and resistance for Pasmodium species

A

Treatment: 1st line - Chloroquine (blocks heme polymerase), 2nd line - Mefloquine or Atovaquone/progranil. For serious infections use Artemisinin

Resistance: Plasmodium is has high resistance to all agents. Chloroquine resistance due to pumps. Artemisinin resistance due to decreased degradation of parasite kinase that activates protective cellular pathways.

39
Q

Entamoeba histolytica infection and diagnosis

A

Infection: Cysts are ingested from contaminated water

Diagnosis: Trophozoites with engulfed RBC’s are seen in stool

“Entamoeba eats Erythrocytes”

40
Q

Giardia intestinalis infection and diagnosis

A

Infection: Cysts transmitted via fecal/oral route; associated with camping or water sports Diagnosis: Cysts or live characteristic trophozoite seen in stool

41
Q

Ascaris lumbricoides infection and diagnosis

A

Infection: Ingestion of eggs via fecal/oral route; especially those who use human feces as fertilizer

Diagnosis: oval eggs with rough coat seen in feces

42
Q

Enterobius vermicularis infection and pathogenesis

A

Infection: Adult female migrates down colon at night and deposits eggs on anus. These eggs infect via fecal/oral route.

Diagnosis: Scotch tape test shows eggs

43
Q

Naegleria fowleri treatment adn prevention

A

Treatment: Amphotericin B, Miltefosine (disrupts mitochondrial function)

Prevention: Don’t get water up your nose if swimming in freshwater

44
Q

Praziquantel

A

increases permeability of parasite cell membranes, causing rapid calcium influx and paralysis in worms (ex: Schistosoma, Taenia)

45
Q

Schistosoma infection and diagnosis

A

Infection: Snails are intermediate host; infectious stage is free-swimming and penetrates skin of humans swimming in water

Diagnosis: Eggs with spines seen in feces

46
Q

Cyclospora prevention

A

avoid contaminated water, wash fruits and veggies, boil water

47
Q

Cyclospora (general)

A

similar overall features to Cryptosporidium

48
Q

Strongyloides stercoralis infection and diagnosis

A

Infection: Contains free-living stage that does not require host. Larvae in the soil penetrate skin in people who walk barefoot. Larvae migrate to the lungs where they are coughed up and swallowed. They can also migrate directly to intestines via connective tissues.

Diagnosis: Larvae seen in feces

49
Q

Taenia solium disease and pathogenesis

A

Cysticerosis - Occurs by ingesting food contaminated with tapeworm eggs. The eggs hatch and get into tissues, including your brain. May lead to “swiss cheese brain” with seizures and hydrocephalus.

Taeniasis - Occurs when you ingest the larval form; larvae get into your intestines, mature, and lay eggs. May lead to Autoinfection and Cysteicerosis

50
Q

Taenia solium infection and diagnosis

A

Infection: Ingestion of larvae from undercooked pork, or ingestion of eggs in food contaminated with human feces.

Diagnosis: Eggs or gravid proglottids in feces

51
Q

Antifolates, Pyrimethamine

A

inhibit folic acid biogenesis (ex: Toxoplasma gondii)

52
Q

Strongyloides stercoralis pathogenesis

A

Cause vomiting, diarrhea, epigastric pain (mimic peptic ulcer)

Hyperinfection can lead to heavy worm burden

Disseminated disease with septic shock due to bacteremia from translocation of gut lumen bacteria due to larval invasion across gut wall

53
Q

Toxoplasma gondii treatment and prevention

A

Treatment: Sulfonamides and Pyrimethamine

Prophylaxis: Sulfonamides for HIV patients when T Cell count is below 100

Prevention: Wash hands after handling raw meat, avoid unpasteurized milk, avoid cleaning liter box if pregnant

54
Q

Enterobius vermicularis treatment, resistance, and prevention

A

Treatment: Mebendazole or Albendazole, Pyrantel pamoate

Resistance: mutations in beta-tubulin

Prevention: Don’t bite nails, wash hands thoroughly, change bed sheets

55
Q

Plasmodium falciparum disease and pathogenesis

A

Most severe form of malaria; irregular fevers; parasitized RBC’s can occlude capillaries in brain, kidneys, and lungs. This is the cause of cerebral malaria

56
Q

Schistosoma treatment and prevention

A

Treatment: Praziquantel (calcium influx causing paralysis)

Prevention: Avoid fecal contamination of water sources

57
Q

Giardia intestinalis treatment and resistance mechanisms

A

Treatment: Metronidazole, Tinidazole, Quinacrine hydrochloride

Resistance: loss of ability to convert prodrugs to active form

58
Q

Toxocara canis pathogenesis and disease

A

Visceral larva migrans - nematodes migrate to blood through intestinal wall causing inflammation and damage. Often affects the heart, liver, eyes (visual impairment and blindness), and CNS (seizures, coma)

59
Q

Toxocara canis infection and diagnosis

A

Infection: Over 200k eggs/day released in feces; Eggs mature in soil and are ingested by canines and humans

Diagnosis: Larvae seen in tissue

60
Q

Ivermectin

A

disrupts helminth nerves and muscles by binding to chloride channels causing hyperpolarization and paralysis/death of worm (ex: Strongyloides, Onchocera)

61
Q

Leishmania donovani infection and diagnosis

A

Infection: Sandfly bite injecte promastigote into the skin, which are phagocytized by macrophages

Diagnosis: Macrophages containing amastigotes

62
Q

Cryptosporidium hominis disease and pathogenesis

A

Severe diarrhea in AIDS patients (CD 4 < 100)

Sporozoites invade epithelial cells and damage microvilli in a 7-10 day cycle, so classic symptom is diarrhea once every 7-10 days

63
Q

Toxoplasma gondii infection and diagnosis

A

Infection: Cysts in meat, oocytes in cat feces, or crossing placenta

Diagnosis: Trophozoites on serology or cysts in tissues

64
Q

Toxoplasma gondii disease and pathogenesis

A

Toxoplasma gondii resides in immunoprivileged sites like brain and eye

Congenital toxoplasmosis is the classic triad of Chorioretinitis, Encephalitis, and Intracranial Calcifications. Can also cause hearing loss

Reactivation in AIDS leads to multiple ring-enhancing brain lesions

65
Q

Toxocara canis treatment and prevention

A

Treatment: Albendazole or Mebendazole

Prevention: De-worm household pets, wash hands

66
Q

Cyclospora treatment

A

Antifolates: TMP-SMX

67
Q

Strongyloides stercoralis treatment, resistance, and prevention

A

Treatment: Ivermectin (inhibits nerves and muscles by binding chloride channels)

Resistance: increased membrane transporter activity to remove drug

Prevention: Avoid contaminated soil, medical professionals should wear gloves and gowns

68
Q

Accidental host

A

host cannot support any stage of parasite’s development

69
Q

Babesia microti infection and diagnosis

A

Infection: Ixodes tick bite transfers sporozoite into bloodstream; typically infects people who have been hiking in Northeast. Often co-infection with Lyme Disease

Diagnosis: Peripheral blood smear shows ring form and “Maltese Cross” within RBC’s

70
Q

Metronidazole

A

inhibits nucleic acid synthesis in anaerobic cells (ex: Trichomomas, Entamoeba, Giardia)

Foundations of Disease and Therapy (12 decks)

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