Parasites - Block 3

Question 1

What are the presnetation of acute giardia?

Answer 1

Diarrhea: foul smelling, copious, light colored, fatty stool
Cramps, bloating, flatulence
Malaise, anorexia, N, belching

Question 1

How is giardia transmitted?

Answer 1

Fecal oral

Question 2

What are the presentation of chronic giardia?

Answer 2

1. Periods of diarrhea alternating with constipation
2. Weight loss, lactose intolerance, Vit B12 and ADEK def

Question 4

Non pharm for giardia?

Answer 4

Hydration and electrolyte replacement

Caution with antidiarrheal

Question 5

Pharm for giardia?

Answer 5

1. Tinidazole 2g 1 dose with food
2. Metronidazole for 5-7 days (safe in 2nd and 3rd trimester)
3. Nitazoxanide 500 mg every 12 hours with food × 3 days
4. Paromomycin 25 to 35 mg/kg/day in three divided oral doses for 1 week

Diarrhea should stop within 3-6 days

Question 6

What are the types of amebiasis?

Answer 6

1. Intestinal disease
2. Amebic liver abscess

Microscopic examination of stool is usually negative in patients with extraintestinal amebiasis

Question 7

What are the presentation of intestinal dx amebiasis?

Answer 7

1. Dysentry
2. Vague ab discomfort
3. Eosinophilia

Question 8

What are the presentation of amebic liver abscess?

Answer 8

1. High fever, rigors and profuse sweating, leukocytosis, elevated Alk phos
2. Right upper quadrant pain, hepatomegaly, and liver tenderness

Question 9

Amebiasis prevention?

Answer 9

Avoid local tap water, ice, salads, unpeeled fruits

Question 10

Tx for intestinal amebiasis?

Answer 10

Tissue
1. Metronidazole 7-10 days
2. Tinidazole 3-5 days

Question 11

Tx for asymptomatic cyst passers?

Answer 11

Luminal
1. Paromomycin x 7days
2. Iodoquinol x 20 days

Question 12

Tx for amebic liver abscess?

Answer 12

Tissue acting tx followed by luminal regimen

Question 13

Describe the presentation of acute chagas dx?

Answer 13

Indurated, erythematous skin lesion
* Romana’s sign

Question 14

What are the presentation of chronic trypanosomiasis?

Answer 14

Caused by dissemination of trypomastigotes in blood
* Ivade cardiac tissue (cardiomyopathy) and smooth muscles (uncoordinated peristalsis)

Question 15

Tx for Chagas?

Answer 15

1. Benznidazole x 60 days
2. Nifurtimox x 90 days: GI disturbances may affect adherence

Question 16

Tx for Chagas in pregnancy?

Answer 16

Tx is typically delayed until after delivery and infant is treated

Question 17

What are predominant Plasmodia species that cause malaria?

Answer 17

1. P. falciparum
2. P. vivax
3. P. knowlesi
4. P. malariae
5. P. ovale

Question 18

Manifestation of malaria?

Answer 18

1. Feverm rigors
2. Anemia
3. Jaundice
4. Splenomegaly
5. Hepatomegaly
6. Malarial paroxysm

Question 19

What is malarial paroxysm?

Answer 19

1. Starts with malaise, abrupt chills and fever rising to 102.2 to 105.8 F, rapid and thready pulse, polyuria, headache, myalgia, and nausea
2. After 2 to 6 hours, fever falls, and profuse sweating occurs for 2 to 3 hours
3. Followed by extreme fatigue