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CMBM exam 4 > Parasitic Infections in Blood and Lymph > Flashcards

Parasitic Infections in Blood and Lymph Flashcards

1
Q

What are the blood and lymph infective protozoans?

A

Plasmodium sp.
Babesia sp.
Trypanosoma sp.

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2
Q

What are the blood and lymph filarial nematodes?

A

Wuchereria bancrofti
Brugia malayai
Onchocerca

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3
Q

Which trematode infects the blood?

A

Schistosomes

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4
Q

What cause malaria?

A

Plasmodium

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5
Q

Where does plasmodium live in the host?

A

Inracellular in hepatocytes and RBCs

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6
Q

Which species of plasmodium effect humans?

A

P. vivax
P. ovale
P. malariae
P, falciparum

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7
Q

What is the life cycle pattern of plasmodium?

A

A mosquito uptake a exflaggellated gamete which grows into a zygote, oocyst and then sporozoite
A female mosquito goes to drink blood from a human releasing the sporozite into the blood where it becomes a liver schizont
It will cycle between schizont and trophocyte by way of merozoites
It will become a gametocyte from a merozoite that does’t hate you and a mosquito drink it up

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8
Q

What is the incubation period for malaria?

A

1 to 2 weeks

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9
Q

What are the clinical signs of malaria?

A

Flu-like illness, headache, anorexia

Classic sighs of cycled fever, chills and rigor

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10
Q

Why is fever caused due to hemolytic anemia in malaria?

A

RBCs explode so hemoglobin and debris release the parasite antigen (GPI) leading to host secretion of TNF and IL-1

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11
Q

What are the fever cycles for the different types of plasmodiums?

A

Vivax and ovale: 48 hours
Malariae: 72 hours
Falciparum: at random

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12
Q

Which plasmodium can cause CNS or renal involvement?

A

Falciparum

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13
Q

Which plasmodium enjoy killing baby RBCs to breed their nastiness?

A

Vivax and ovale

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14
Q

Which plasmodium replicates in mature RBCs?

A

Malariae

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15
Q

Which plasmodium can form hypnozoites in the liver?

A

Vivax and ovale

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16
Q

What drug is needed if hypnozoites are present?

A

Primaquine

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17
Q

Which is the most severe plasmodium infection? Why?

A

Falciparum
Many strain are resistant to chloroquine
Replicates in erthrocytes at any age
More parasite replication

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18
Q

What is the parasite antigen of P. falciparum expressed on infected RBCs and what does it bind to?

A

pfEMP-1

ICAM-1

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19
Q

Due to the antigen presentation in P.falciparum, what happens when the RBCs block small vessels?

A

Block blood supply to organs leading to organ damage

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20
Q

What are the severe clinical manifestations of P.falciparum?

A

Cerebral malaria
Blackwater fever (renal damage)
Fetal and mother death in pregnancy

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21
Q

What is used for indication of malaria and what can you see?

A

Giemsa stained blood smears

Ring form, gametocytes, trophozoites, schizonts

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22
Q

If you happen across a chloroquine-resistant form of P. falciparum, what can you use instead?

A

Mefloquine
Quinine+doxycycline
Quinine+clindamycin

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23
Q

What drugs would you use for P. falciparum and P. malariae?

A

Chloroquine

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24
Q

What drug would you use for P. vivax and P. ovale?

A

Chloroquine+primaquine

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25
Q

How can malaria be prevented?

A

Mosquito control
Avoid mosquito bites
Chemoprophylaxis

26
Q

In chemoprophylaxis use, what drugs should be taken to avoid malaria?

A

The same as the drug taken if you get malaria

P falciparium: same as previously mentioned plus atovaquone+proguanil = Malarone

27
Q

What type of parasite causes babesiosis?

A

Babesia microti - protozoan

28
Q

What is the vector for Babesia microti?

A

Ticks (Ixodes dammini)

29
Q

What is the reservoir for babesia microti?

A

Mice
Immature ticks feed on mice, adults feed on deer
Nymphs and adults will also feed on humans

30
Q

What is the pathogenesis of babesiosis?

A

Bite of infected tick, babesia replicates in erythrocytes, RBC lysis to release merozoites, 1-4 week incubation, fever chills head ache fatigue weakness, hemolytic anemia or renal failure

31
Q

How is babesiosis diagnosed?

A

Demonstration of parasite in thick and thin blood smears

32
Q

What is the treatment for babesiosis?

A

Clindamycin plus quinine

Atovaquone plus azithromycin

33
Q

What is the cause of Chaga’s disease?

A

Trypanosoma cruzi (prorozoan)

34
Q

What is the vector and reservoir for T. cruzi?

A

Triatomid bugs

Armadillos, rodents, dogs

35
Q

What are the acute clinical manifestations of Chaga’s disease

A

Generally asymptomatic
Fever, anorexia, lymphadenopathy, mild hepatosplenomegaly, myocarditis
Chagoma - nodular lesion at inoculation site
Romana’s sign - chagoma near eye (unilateral periocular swelling)

36
Q

What are the chronic manifestations of Chaga’s disease?

A

Amastigotes replicate in various cell types
Megaesohagus or megacolon
Cardiomyopathy

37
Q

What is antigenic mimicry?

A

The parasite mimics the antigens of the heart muscle causing the immune system to attack to parasite but become confused and being attacking the heart as well

38
Q

How is Chaga’s disease diagnosed?

A

Finding trypomastigotes in blood or amastagotes in biopsies of lymph nodes, spleen, liver or bone marrow

39
Q

What is the treatment for Chaga’s disease?

A

Chronic not reversible

Some drugs for acute

40
Q

What causes African sleeping sickness?

A

Trypanocomes brucei

41
Q

What is the vector and reservoir of T. brucei?

A 
Tsetse fly
Wild ungulates (antelopes)
42
Q

What are the two species of T. brucei in Africa?

A

T. brucei gambiense (West and Central)

T. brucei rhodesiens (East and South)

43
Q

What is the the pathogenesis of sleeping sickness?

A

Bit of Tsetse fly, T. brucei replicates in blood and lymph, fever-lymphpadenopathy-pruritus, enters CNS after weeks/month, alter mental and sensory status, difficultly walk and talk, coma and death

44
Q

How is T. brucei diagnosed?

A

Detection of trypomastigotes in blood, CSF and lymph films

45
Q

How is T. brucei treated?

A

Suramin for blood and lymph phases

Malarsoprol for CNS

46
Q

What are the different species of Schistosoma (blood flukes?

A

S. haematobium
S. manosi
S. japonicum

47
Q

What is the life cycle of a Schistosoma?

A

Eggs hatch in the water as miracidum enter cell which develops into a cercaria released from the snail and burrow through skin which then develops into an adult and lays eggs in the blood and eventually are released in urine or feces

48
Q

Where is S. haematobium found, where are adults found and where are eggs expelled from?

A

Africa and Middle East
Bladder vessels
Urine

49
Q

Where are the adults of S. mansoni and S. japonicum found as adults and where are the eggs expelled from?

A

Venous plexus of intestines

Stool

50
Q

What are the clinical manifestations of schitosomiasis?

A 
Allergic dermatitis associated with cercarial penetration of skin
Katayama fever (immune rxn to egg production) 
Granulomatoud lesions interfere with organ function
51
Q

What is the treatment for Schitosomiasis?

A

Praziquantel

52
Q

How can Schitosomiasis be controlled?

A

Education, improved snaitation, bio-control agents, molluscicides, drain marshes

53
Q

What are the filariasis parasites?

A

Wuchereria bancrifti
Brugia malayi
Onchocerca volvulus
Loa loa

54
Q

Which Filariasis causes elephantiasis?

A

Wuchereria bancrifti

Brugia malayi

55
Q

What does Onchocercosis cause and what is the vector?

A 
River blindness due to microfilariae in eye 
Black fly (Simulium)
56
Q

What are the clinical manifestations of Onchocercosis?

A

Due to inflammatory response to microfilariae

Nodules on skin, depigmentation, thickening, itching

57
Q

How do you diagnose Onchocercosis?

A

Demonstration of microfilariae in skin snip prep

58
Q

What is the treatment of Onchocercosis?

A

Surgical removal of nodules containing adult worms

Ivermectin

59
Q

What can be used for prophylaxis against Onchocercosis?

A

Ivermectin and diethylacarbanizine

60
Q

What is Loiasis (loa loa) transmitted by?

A

Mango flies or deer flies (chrysops)

61
Q

What is the pattern of movement of the Loa loa?

A

Adult worms live in connective tissue under the skin and between facial layer over somatic muscle
Thousands of microfilariae produced daily
Adult migrate frequently and can pass across the eye

CMBM exam 4 (27 decks)

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