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micro unit 6 > parasitic diseases of the GI > Flashcards

parasitic diseases of the GI Flashcards

1
Q

protozoa

A

single celled organism that can multiply inside a human host

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2
Q

what are the best known protozoans in the US

A

giardia intestinalis, duodenalis, cryptosporidium parvum

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3
Q

what organism is the cause of intestinal amebiasis

A

entamoeba histolytica

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4
Q

where is entamoeba histolytica most common

A

mexico, central america, south america, south asia, egypt, the middle east, parts of africa. where sanitation is poor and where the food and water supplies are contaminated with fecal matter

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5
Q

is entamoeba histolytica common in the US

A

no. its rare

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6
Q

helminths

A

multicellular organisms (worms) that cannot multiply in their adult form within the human body

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7
Q

what is a cestode

A

flat worm with multiple segmented body consisting of rounded head, and a flat body with many segments.

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8
Q

what is the rounded head of a cestode called

A

scolex

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9
Q

what are the segments of a cestode called

A

proglottid

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10
Q

what are the medically important cestodes

A

taenia solium, saginata; diphyllobothrium latum and echinococcus granulosus

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11
Q

what is the common name of taenia solium

A

pork tape worm

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12
Q

what is the common name of the taenia saginata

A

beef tape worm

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13
Q

what is the common name of diphyllobothrium latum

A

fish tapeworm

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14
Q

what is the common name of echinococcus granulosu

A

dog tape worm

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15
Q

what are nematodes

A

round worms with a cylindrical body and a complete digestive tract with mouth and anus.

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16
Q

what are the important nematodes

A

enterobius vermicularis, trichuris trichiuria, ascaris lumbricoides, necator americanus, ancylostoma duodenale, strongyloides atercoralis

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17
Q

what is the common name of enterobius vermicularis

A

pin worm

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18
Q

what is the common name of trichuris trichiuria

A

whipworm

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19
Q

what is the common name of ascaris lumbricoides

A

giant round worm

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20
Q

what is the common name of necator americanus

A

hook worm

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21
Q

what is the common name ancylostoma duodenale

A

another hookworm

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22
Q

what is the common name of strongyloides atercoralis

A

small round worm

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23
Q

what symptoms do many of the multicellular organisms cause?

A

they can live their for many years and not cause any symptoms. if they do: abdominal pain, diarrhea, N/V, passing worm, gas/bloating, dysentery, rash or itching around anus, stomach pain/tenderness, feeling tired, weight loss.

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24
Q

where does giardiasis occur?

A

worldwide.

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25
Q

who are the high-risk groups for giardiasis

A

infants and children. international adoptees, travelers, immunocompromised, hypochlorhydria, cystic fibrosis

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26
Q

where is giardiasis especially common?

A

poor sanitary conditions and insufficient water treatment plants.

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27
Q

what other animals are affected by giardiasis

A

beavers and raccoons

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28
Q

what are the two morphological forms of giardia lamblia

A

cysts and trophozoites

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29
Q

what are morphology is infectious for giardia lamblia

A

cysts. they can live in the environment for long periods.

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30
Q

how are the cysts of giardia lamblia transmitted

A

water, food, fecal material, between infected individuals.

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31
Q

what is the infectious dose of giardia lamblia

A

10-25 cysts

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32
Q

what happens after a giardia lamblia cyst is ingested

A

excystation occurs in the proximal small bowel with release of the trophozoites.

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33
Q

what percentage clear a giardia lamblia infection?

A

50%

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34
Q

what percentage of people shed the giardia lamblia cysts asymptomatically

A

5-15%

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35
Q

what percentage have a giardia lamblia symptomatic infection?

A

35-45%

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36
Q

how long does the asymptomatic shedding of giardia lamblia occur

A

6 months

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37
Q

why is it difficult to identify a water supply that is infected with giardia lamblia

A

because the shedding can occur for 6 months.

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38
Q

what are the symptoms of giardia lamblia infection

A

diarrhea, malaise, foul-smelling and fatty stools, abdominal cramps and bloating, flatulence, nausea, weight loss, vomiting (30), fever (low percentage)

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39
Q

what is average incubation period for giardia lamblia

A

7 to 14 days.

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40
Q

what is the range for giardia lamblia days to symptom

A

1-45 days.

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41
Q

how long with symptoms of giardia lamblia last

A

2-4 weeks

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42
Q

what percentage and how much weight is lost during giardia lamblia infection

A

10-20 percent in 50% of cases

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43
Q

how often is giardia lamblia chronic

A

sometimes as high as 50%. although studies suggest much less. the symptoms may wax and wane for many months.

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44
Q

what are the symptoms of chronic giardia lamblia

A

loose stools, steatorrhea, weight loss, malabsorption, malaise, abdominal cramping, borborygmi, flatulence, burping, fatigue, depression.

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45
Q

how do we diagnose giardia lamblia

A

stool microscopy. although immunoassays have a higher sensitivity

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46
Q

cryptosporidiosis (cryptosporidium parvum)

A

intracellular protozoan parasite associated with GI diseases found everywhere except Antartica

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47
Q

when do infections with cryptosporidium parvum peak in the US

A

july through september

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48
Q

how common is cryptosporidium parvum

A

one of the most common human GI pathogens.

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49
Q

where do cryptosporidium parvum infect and reproduce

A

in the respiratory tract and the GI epithelial cells

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50
Q

what are the cryptosporidium parvum infections cause patholgoically>

A

diarrhea and biliary disease

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51
Q

what is common link for cryptosporidium parvum infections

A

drinking water

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52
Q

are fecally passed cryptosporidium parvum oocysts infectious

A

yes immediately. this is how this is spread through fecal contamination

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53
Q

what common summer recreations are associated with cryptosporidium parvum infections?

A

swimming and animal contact. also drinking supplies and travel.

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54
Q

how many cryptosporidium parvum cause infection?

A

4

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55
Q

what is the asexual cycle of cryptosporidium parvum

A

oocyst > sporozoite > trophozoite > type 1 meront > back to trophozoite

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56
Q

what is the sexual cycle for cryptosporidium parvum

A

oocyst > sporozoite > trophozoite > type 1 meront > morozoite > type II meront > merozoites > undifferentiated gamont > microgamont/microgamont > zygote > oocyst

57
Q

what are three presentations of cryptosporidium parvum

A

asymptomatic, mild dirrheal, severe enteritis w/wo/ biliary tract involvement.

58
Q

what is the incubation period for cryptosporidium parvum

A

7-10 days. the number ingested is related to the time and duration of infection

59
Q

what other symptoms do the cryptosporidium parvum diarrheal illness patients have?

A

malaise, nausea, anorexia, crampy abdominal pain, low grade fever

60
Q

are there fecal blood or leulocytes for cryptosporidium parvum infection?

A

rarely unless there is coinfection

61
Q

how long until the cryptosporidium parvum infections resovle

A

10-14 days. although it can progress or relapse

62
Q

diagnosing cryptosporidium parvum

A

microscopy or immunoassays. organism present in stool, duodenal aspirates, bile secretions, biopsy or respiratory

63
Q

entamoeba histolytica

A

mostm asymptomatic but can be amebic dysentery, extraintestinal disease. there are many cases of colitis and even death.

64
Q

what are the extraintestinal manifestations of entamoeba histolytica

A

liver abscess, pulmonary, cardiac, brain involvement

65
Q

what two forms does entamoeba histolytica have

A

cyst stage, trophozoite

66
Q

what is the infectious form of entamoeba histolytica

A

cystic form.

67
Q

what form of entamoeba histolytica causes the invasive disease

A

the trophozoite

68
Q

how does infection of entamoeba histolytica occur

A

through ingestion of the cyst or through fecal-oral contact.

69
Q

what happens to the entamoeba histolytica cysts once ingested>

A

they are viable for months. they pass through the stomach and the small intestine where they excyst to form trophozoites. trophozoites can invade and penetrate the mucous barrier of the colon causing damage or persistent secretion and thus bloody diarrhea

70
Q

what is the infectious dose for entamoeba histolytica

A

a single cyst.

71
Q

how common is entamoeba histolytica

A

third most

72
Q

who is most at risk for entamoeba histolytica

A

travelers to and immigrants from endemic areas. also institutionalized individuals.

73
Q

what is the most common presentation of entamoeba histolytica

A

diarrhea without dysentery.

74
Q

what is entamoeba histolytica dysentery

A

amebic colitits. diarrhea with mucous or blood. occurs in 15-33%. 70% have a gradual onset.

75
Q

what is the primary complaint of amebic dysentery

A

progressively worsening diarrhea and abdominal pain

76
Q

what is the most common extraintestinal manifestation of entamoeba histolytica

A

hepatic abscess. they ascend the portal venous system,.

77
Q

how long before the symptoms arise for entamoeba histolytica

A

8-20 weeks

78
Q

how long before liver abscess with entamoeba histolytica

A

1-2 weeks and presents with RUQ pain and fever

79
Q

RUQ pain in entamoeba histolytica infection

A

usually dull and aching epigastrum, right chest, right shoulder

80
Q

other symptoms of entamoeba histolytica

A

coughing, sweating, malaise, weight loss, anorexia,

81
Q

are humans definitive and intermediate hosts for cestodes?

A

can either or, not both

82
Q

why is T. solium an exception to the cestodes?

A

because it can infect humans in two forms: the cysticercus and the worm or even both

83
Q

T solium stage of infection

A

larvae in undercooked pork, eggs in food or water contaminated by human feces

84
Q

T solium stage most associated with disease

A

adult tapeworm in intestine, cysticercus (esp. in brain)

85
Q

T solium stages outside human

A

larvae in muscle of pig

86
Q

taenia saginata stage of infection

A

larvae in undercoooked beef

87
Q

taenia saginata stages associated with human disease

A

adult tapeworm in intestine

88
Q

taenia saginata stages outside of human

A

larvae in the muscle of cow

89
Q

diphyllobothrium latum stage for infection of human

A

larvae in undercooked fish

90
Q

diphyllobothrium latum most associated with disease

A

adult tapeworm in the intestine can cause b12 def.

91
Q

diphyllobothrium latum outside of human

A

larvae in the muscle of fresh water fish

92
Q

E. granulosus stage that infects humans

A

eggs in food or water contaminated with dog feces

93
Q

E. granulosus stage most associated with disease

A

hydatid cysts especially in the liver and lung

94
Q

E. granulosus outside of human

A

larvae in the muscle of freshwater fish

95
Q

cysticercosis

A

infection with T solium eggs -tissue infection of parasite cyst. the patient is the intermediate host for the parasite. eggs transmitted fecal-oral. there is autoinfection through this route.

96
Q

who gets T solium

A

people that eat raw or undercooked pork.

97
Q

what do the worms look like

A

they are 2-8m and live 10-20 years

98
Q

what should you suspect if tapeworm of T solium is diagnosed

A

concomitant cysticercosis

99
Q

how is t solium diagnosed

A

diagnosed by eggs in stool

100
Q

neurocysticercosis

A

larval cysts infect the brain, muscle, other tissues, and are a major cause of adult onset seizures. can effect any part, but usually intracerebral lesions that cause seizure, mass effect or both. seizures occur in 70%.

101
Q

how does one contract cysticercosis

A

by ingesting a t solium egg via fecal oral transmission

102
Q

can you get cysticercosis from eating raw or undercooked pork?

A

NO. you get the intestinal tapeworm. if it consists of larval cysts.

103
Q

tissue cysticerci occur when after eating stool

A

3-8 weeks. can occur in one or multiple sites, initially does not cause inflammation. n

104
Q

when is there a lack of inflammation for the cysticercosis

A

upon the initial infection. this is the asymptomatic phase and can last a long time (years)

105
Q

what is the intermediate host for T saginata

A

cattle

106
Q

what dishes are associated with saginata infection

A

rare steak, or kababs, and steak tartare.

107
Q

what are the other intermediate hosts of saginata

A

buffalo, llamas and giraffes

108
Q

what do saginata worms look like?

A

they are long 10m and have 1000s of proglottids -each capable of producing thousands of eggs

109
Q

what are the symptoms of saginata infections

A

most absent. although some have cramping. or malaise.

110
Q

are the proglottids of saginata motile?

A

yes, they can move outside of the anus and be found on clthing or in the perineum.

111
Q

D. Latum

A

acquired by eating freshwater fish containing the plerocercoid cysts. raw fish bars have increased the incidence

112
Q

endemic areas for D latum

A

europe, siberia, north america, japan, chile

113
Q

what do the D latum look like>

A

large. 25 m with 3000-4000 proglottids

114
Q

how long until d latum matures and hoe long to live

A

3-6 weeks to mature and can live for 30 years

115
Q

can a patient have multiple d latum worms?

A

yes, common

116
Q

what are the symptoms of d latum

A

usually asymptomatic. but can be nonspecific: weakness, dizziness, salt-craving, diarrhea, abdominal discomfort.

117
Q

what can prolonged d latum infection lead to.

A

vit b12 def. and thus megaloblastic anemia. can also lead to CNS malfunction

118
Q

what are the mechanism of b12 def in d latum infections

A

use of the vitamin by the parasite, and dissociation of the vit-intrinsic factor complex.

119
Q

ascaris lumbricoides

A

most common helminthic infection. white pinkish adult worms. 15-35 cm. live and mate in the jejunum. most people are asymptomatic.

120
Q

what is a common symptom of ascaris lumbricoides

A

HSR to lung parenchymal infection around the second week. nonproductive cough, chest discomfort, fever, eosinophilia.

121
Q

what are severe infections with ascaris lumbricoides

A

eosinophilic pneumonia (loffler syndrome) with transient patchy infiltrates

122
Q

ascaris lumbricoides life cycle

A

adult worms in the lumen of small intestine > females produce 200,000 eggs/day in the feces > fertilized become infective after 18 days. > swallowed fertilized become imbedded in the mucosa carried by portal and systemic circulation to the lungs. > larvae mature in lungs and penetrate the alveolar walls > ascend to the bronhcial tree to the throat and are swallowed > develop into adults in the intestine.

123
Q

are unfertilized ascaris lumbricoides eggs infective

A

NO

124
Q

what are the complications of chronic ascaris lumbricoides

A

obstruction of the intestinal, bile, pancreatic, appendicitis, and intestinal perforation. entanglement of a large number of worms in the ileocecal region provokes spasmotic contractions and obstruction especially children. this can be partial or complete.

125
Q

enterobius vermicularis (pin worm)

A

highly prevalent throughout the world. small white worm about 1 cm.

126
Q

life cycle of enterobius vermicularis (pin worm)

A

inhabits the cecum, appendix and adjacent gut. > graivd females migrate out of the anus at night to the perianal regions and lay their eggs and die. > the eggs embryate for 6 hours and then are carried by air, clothes, hands.

127
Q

clinical symptoms of enterobius vermicularis (pin worm) infections

A

most are asymptomatic, largely perianal pruritis. local itching and restless sleep

128
Q

diagnosis of enterobius vermicularis (pin worm)

A

picked up from the perianal region in the moring

129
Q

T trichiuria

A

very prevalent whipworm. children living in poverty in the tropics. many host coinfections with lumbricoides

130
Q

symptoms of T trichiuria

A

recurrent rectal prolapse.

131
Q

diagnose T trichiuria

A

lemon-shaped eggs in the stool. prolapsed rectum.

132
Q

ancylostoma duodenale and necator americanus

A

hookworm, causes iron deficiency. inhabit only areas that have long standing warmth for several months and have minimum annual rainfall of 50-60 inches because the larva are susceptible to environment.

133
Q

what increases the risk for transmission of ancylostoma duodenale and necator americanus

A

defecation and then people walking through it. children

134
Q

what are the symptoms of ancylostoma duodenale and necator americanus

A

most harbor light infections and are asymp. iron deficiency and protein energy malnutrition. previously sensitized pepl might get a pruritic skin rash at the site of injury -ground itch. migration through the lungs causes transient pneumonitis.

135
Q

strongloides stercoralis

A

tropics/subtropics, US and europe. endemic in appalacia southe eastern US, japan, europe, australia.

136
Q

syndromes of strongloides stercoralis

A

more than 50% are asymp. greater than 75% have fluctuating eosinophilia. macropapular and urticaria on the buttocks, perineum and thighs.

137
Q

hyperinfection of strongloides stercoralis

A

severe, complicated. this is increased generation of filariform larvae or accelerated auto infection typically occurs with an immunocompromised host.

138
Q

disseminated strongloides stercoralis

A

found in the CNS, kidney, liver.

139
Q

life cycle of strongloides stercoralis

A

poop > step in it > lungs > migrates to the intestines.

micro unit 6 (7 decks)

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