Parasitic Infections- Schoenwald

Question 1

All of the following are protozoan parasitic infections except:

a. giardia
b. amoeba
c. helminths
d. cryptosporidia

Answer 1

c. helminths (it is a true worm)

Question 2

This protozoan parasite is the most common cause of epidemic water borne diarrheal disease in US

Answer 2

Giardia - Most frequently identified protozoan in US, especially Rocky Mountain region (people drinking from streams)

Question 3

Giardia typically colonize in the __________ & ________ and disrupt the epithelial fxn leading to ________-

Answer 3

Colonize duodenum and jejunum

Malabsorption

Question 4

Giardia is spread by what transmission?

Answer 4

Fecal to oral

Question 5

This infection causes sudden onset explosive diarrhea 1-3 weeks after exposure

Answer 5

Giardia

Question 6

How do you diagnose giardia (this is the GOLD STANDARD)?

Answer 6

Stool & ova parasite testing

Question 7

What is a more common way to dx giardia?

Answer 7

ELISA stool antigen test (more common)

Question 8

How do you treat giardia?

Answer 8

metronidazole or tinidazole (azole for protozoan)

Question 9

“falling leaf motility” should make you think of what protozoan parasite?

Answer 9

Giardia

Question 10

This pathogenic amoeba has trophs that invade intestinal epithelium, can penetrate venules and lymphatics to gain access to liver

Answer 10

entamoeba histolytica

Question 11

What is the primary site of extraintestinal disease from entamoeba histolytica?

Answer 11

liver

Question 12

This disease causes

• Prodrome of symptoms-diarrhea, abdominal cramping, nausea, vomiting, tenesmus
• Malaise, loss of appetite, weight loss, mental apathy
• Watery stool containing mucus and blood
• Tender liver enlargement-liver abscess
• Meningeal signs-brain abscess

Answer 12

entamoeba histolytica

Question 13

“chocolate milk appearance of the liver”

Answer 13

entamoeba histolytica

Question 14

entamoeba histolytica can cause what two major problems?

Answer 14

liver abscess and meningitis (brain abscess)

Question 15

How do you dx entamoeba histolytica?

Answer 15

O & P

Question 16

How do you dx entamoeba histolytica for brain abscesses or liver abscesses?

Answer 16

Serology

Question 17

Treatment for entamoeba histolytica?

Answer 17

metronidazole

Question 18

Is entamoeba histolytica pathogenic?

Answer 18

No. Some people carry it and it doesnt cause problems

Question 19

This comes from contaminated fruit and berries and is a BIIIG problem in the immunocuppressed/HIV patients

Answer 19

Cryptosporidium

Question 20

This disease is asymptomatic in immune comptent people but causes diarrhea, dehydration and lung/gallbladder invovlement in the immunosuppressed

Answer 20

Cryptosporidium

Question 21

How do you dx Cryptosporidium?

Answer 21

Stool AFB stain, stool antigen, or stool PRC

*Stool antigen is best test

Question 22

What is Ascaris lumbricoides?

Answer 22

intestinal roundworm

Question 23

What is Trichinella spirosis?

Answer 23

trichinosis

Question 24

What is Enterobius vermicularis?

Answer 24

pinworm

Question 25

What is Ancyclostoma and Necatur?

Answer 25

hookworm

Question 26

________ ________ is the largest and most common round worm infection

Answer 26

Ascaris lumbricoides

Question 27

Ascaris lumbricoides inhabit the _____ _______ then eggs passed into the ______ and then larvae from ingested eggs enter the bloodstream and cause issues in the _______-

Answer 27

small intestine, passed through feces, pass through alveoli, blocked at pulmonary capillaries, rupture into alveolar spaces

Question 28

Symptoms of ascaris lumbricoides depends on the _____ _____

Answer 28

worm load

Question 29

A high worm load causes what symptoms?

Answer 29

cough, fever, wheezing, SOB, oxy desat (because hurting the lungs)

Question 30

What is a major contributor to eosinophilia?

Answer 30

ascaris lumbricoides

Question 31

How do you dx ascaris lumbricoides?

Answer 31

O & P

Question 32

In ascaris lumbricoides, you will show _____ and ______ in sputum

Answer 32

Eosins and larvae in sputum

Question 33

How do you treat ascaris lumbricoides?

Answer 33

Mebendazole or albendazole "bendazoles"

Question 34

when you see "coricated eggs" you should think of what disease?

Answer 34

ascaris lumbricoides

Question 35

This infection is from raw or undercooked meat and causes a muscle infection with muscle paralysis

Answer 35

Trichinella spirosis

Question 36

What labs will be elevated with trichinella spirosis?

Answer 36

Elevated CK, LDH, Eosinophils

Question 37

How do you treat trichinella spirosis?

Answer 37

Mebendazole or albendazole "bendazoles"

Question 38

This is a pinworm that usually affects kids at bedtime and causes anal pruritis

Answer 38

Enterobius vermicularis

Question 39

How do you dx Enterobius vermicularis?

Answer 39

Scrotal scotch tape

Question 40

A mothers kid presents with Enterobius vermicularis. How should you treat the kid and how should you treat the mother?

Answer 40

Treat with mebendazole, all in family should be treated

Question 41

These are hookworms that can "hook" onto the colon wall and cause anemia. Can also infect pulmonary, dermal, and GI systems

Answer 41

Necatur and Ancyclostoma

Question 42

Treatment for Necatur and Ancyclostoma?

Answer 42

Mebendazole or albendazole