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Parasitology Flashcards

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1
Q

Name the helminth that causes perianal pruritus

A

Enterobius

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2
Q

What findings on blood smear confirm a diagnosis of malaria?

A

Trophozoite ring forms within red blood cells and schizonts containing merozoites

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3
Q

A patient has unilateral, nontender periorbital swelling after recent travel to Bolivia. What is the likely diagnosis?

A

Acute Chagas disease (Romaña sign)

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4
Q

How can Cryptosporidium infection be prevented?

A

With water filtration

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5
Q

What is the treatment for Loa loa infection?

A

Diethylcarbamazine

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6
Q

What lab finding might be expected on complete blood count in a patient with hookworm infection?

A

Microcytic anemia

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7
Q

In what region of the world is Babesia infection most common?

A

Northeastern United States

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8
Q

What organism causes scabies?

A

Sarcoptes scabiei

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9
Q

What is the treatment for leishmaniasis?

A

Amphotericin B, sodium stibogluconate

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10
Q

Which fluke (trematode) is transmitted in undercooked fish?

A

Clonorchis sinensis

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11
Q

All intestinal nematodes can be treated with which medication?

A

Bendazoles

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12
Q

What is the specific treatment for a dormant form of malaria?

A

Primaquine

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13
Q

What 2 methods are used to diagnose an Entomoeba histolytica infection in a blood sample?

A

Serology and serum antigen testing

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14
Q

How is Naegleria fowleri transmitted?

A

Acquired from warm freshwater lakes; enters the central nervous system through the cribriform plate

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15
Q

How are diarrhea-causing protozoans transmitted?

A

Via oocysts/cysts in contaminated water

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16
Q

What is the most appropriate diagnostic test for Naegleria fowleri?

A

Test for amoebas in the cerebrospinal fluid

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17
Q

Before using chloroquine to treat malaria, what should be verified about the patient’s particular strain of malaria?

A

Sensitivity to chloroquine; some have developed resistance to this drug

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18
Q

What are the commonly seen symptoms in patients infected withToxocara canis?

A

Myocarditis, hepatitis, visual impairment/blindness, seizures, and coma (patients also often asymptomatic)

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19
Q

On what continent is Chagas disease predominantly found?

A

South America

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20
Q

Why should pregnant women avoid cat litter boxes?

A

Cat feces may contain Toxoplasma oocysts, which can cross the placenta and cause birth defects

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21
Q

What are the common symptoms of Strongyloides stercoralis infection?

A

Duodenitis, dry cough, hemoptysis, and cutaneous symptoms

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22
Q

Where on the body are Pediculus humanus and Phthirus pubis commonly found?

A

Scalp/neck (head lice), waistline/axillae (body lice), or pubic/perianal regions (pubic lice)

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23
Q

How do you treat an infection with Strongyloides stercoralis?

A

Ivermectin or bendazoles

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24
Q

How does the fever pattern differ in malaria caused by Plasmodium vivax, P ovale, P falciparum, and P malariae?

A

P malariae: every 72 hours (quartan); P vivax/P ovale: every 48 hours (tertian); P falciparum: irregular

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25
Q

What is the common name for Ancylostoma duodenale and Necator americanus?

A

Hookworms

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26
Q

What are 2 other classic findings associated with the infection causing river blindness?

A

Skin changes and loss of elastic fibers (Onchocerca volvulus infection)

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27
Q

How is Cysticercosis transmitted?

A

By ingestion of food contaminated with human feces containing Taenia solium eggs

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28
Q

How is Entamoeba histolytica transmitted?

A

Via cysts in the water

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29
Q

How is Toxoplasma gondii acquired?

A

Either by ingesting meat infected with cysts or from exposure to oocysts in cat feces

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30
Q

A man bitten by a female black fly experiences skin hyperpigmentation and blindness. What is the diagnosis?

A

Onchocerca volvulus infection (black flies, black skin nodules, “black sight”)

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31
Q

How does Cryptosporidium present in immunocompromised hosts with AIDS?

A

Severe diarrhea

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32
Q

How is Ascaris lumbricoides transmitted?

A

Fecal-oral route

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33
Q

How is Schistosoma transmitted to humans?

A

Through penetration of the skin by cercariae (larval form) in contaminated freshwater

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34
Q

What is the treatment for Diphyllobothrium latum?

A

Praziquantel, niclosamide

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35
Q

What is the common name for Ascaris lumbricoides?

A

Giant roundworm

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36
Q

What are the characteristics of a clinically significant infection with Trichuris trichiura?

A

Loose stools, rectal prolapse (usually in children), and anemia

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37
Q

How is babesiosis treated?

A

With atovaquone and azithromycin together

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38
Q

What are the 4 tissue nematodes?

A

Toxocara, Onchocerca, Loa loa, Wuchereria

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39
Q

What 2 treatments are used in life-threatening forms of malaria?

A

IV quinidine or artesunate

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40
Q

What is the mechanism of anemia in hookworm infestations?

A

The worms suck blood through the intestinal walls, leading to a microcytic anemia

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41
Q

How are acute infections of Trypanosoma cruzi treated?

A

Benznidazole or nifurtimox (cruzing in my Benz in my fur coat)

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42
Q

How are Necator americanus and Ancylostoma spp transmitted?

A

Larvae enter through the skin (usually from soil to soles of the feet)

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43
Q

How is Trypanosoma cruzi transmitted?

A

Fecal transmission from “kissing bug” that bites and defecates near the mouth or eyes

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44
Q

How can you diagnose babesiosis?

A

With a blood smear (look for “Maltese cross” or ring forms) or polymerase chain reaction test

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45
Q

What parasite causes brain cysts and seizures?

A

Taenia solium (neurocysticercosis)

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46
Q

What is the appropriate treatment for visceral larva migrans caused by Toxocara canis infection?

A

Bendazoles

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47
Q

How are infections with Clonorchis sinensis treated?

A

Praziquantel

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48
Q

What is visceral larva migrans?

A

A clinical syndrome where Toxocara canis nematodes migrate to the blood via the intestinal wall causing inflammation of heart, liver, eyes, and central nervous system

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49
Q

Name the parasite that is associated with the development of hematuria and squamous cell bladder cancer

A

Schistosoma haematobium

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50
Q

A woman from a rural area has new-onset skin swelling and conjunctival worms. What is the causative organism?

A

Loa loa nematode

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51
Q

How is Trichomonas vaginalis transmitted?

A

Sexually (Trichomonas vaginalis exists only in the human body due to inability to form cysts)

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52
Q

How can you distinguish Schistosoma mansoni from Schistosoma haematobium?

A

S mansoni = egg with a lateral spine; S haematobium = egg with a terminal spine

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53
Q

What is the typical treatment for infections from Ancylostoma spp and Necator americanus (hookworms)?

A

Bendazoles or pyrantel pamoate

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54
Q

What symptoms are associated with infection by Schistosoma mansoni?

A

Liver and spleen enlargement, fibrosis, inflammation, portal hypertension

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55
Q

What 3 infectious organisms can Pediculus humanus and Phthirus pubis transmit to humans?

A

Rickettsia prowazekii (typhus), Borrelia recurrentis (relapsing fever), and Bartonella quintana (trench fever)

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56
Q

How does hyperinfection syndrome occur with Strongyloides stercoralis?

A

Via autoinfection by larvae entering the bloodstream through the colonic wall

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57
Q

A patient with a past medical history of a trematode infection has painless hematuria. Why is this concerning?

A

Chronic Schistosoma haematobium infection is associated with squamous cell carcinoma of the bladder

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58
Q

What is the treatment of choice for Wuchereria bancrofti infection?

A

Diethylcarbamazine

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59
Q

A man is bitten by a sandfly and develops spiking fevers, hepatosplenomegaly, and pancytopenia. What is the likely diagnosis?

A

Visceral leishmaniasis (kala-azar)

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60
Q

What group of people are at risk for severe infections of babesiosis?

A

Patients with asplenia

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61
Q

What symptoms are typical of infection by Sarcoptes scabiei?

A

Pruritis that is worse at night and with serpiginous burrows between fingers and toes

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62
Q

Name the helminth that causes vitamin B12 deficiency.

A

Diphyllobothrium latum

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63
Q

How does an infection with Diphyllobothrium latum cause megaloblastic anemia?

A

The tapeworm competes for vitamin B12 in the intestines

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64
Q

Which 5 nematodes are transmitted by fecal-oral route?

A

Enterobius, Ascaris, Toxocara, Trichinella, Trichuris (don’t EATTT these!)

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65
Q

What form of the nematode is excreted in the stool of an individual infected with Strongyloides stercoralis?

A

Rhabditiform larvae

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66
Q

What is the mode of transmission of intestinal Taenia solium?

A

Consumption of undercooked pork containing encysted larvae

67
Q

How is an Entamoeba histolytica infection diagnosed from a stool sample?

A

Stool antigen testing and/or presence of trophozoites or cysts

68
Q

How is Strongyloides stercoralis transmitted?

A

Larvae from soil penetrate skin

69
Q

What is the treatment of choice for a blood-borne Trypanosoma brucei infection (African sleeping sickness)?

A

Suramin (versus melarsoprol for CNS disease); “I sure am mellow when I’m sleeping”

70
Q

With which 3 anti-malarials is it important to screen for glucose-6-phosphate dehydrogenase (G6PD) deficiency prior to use?

A

Quinidine, artesunate, primaquine

71
Q

How is Trichuris trichiura transmitted?

A

Via fecal-oral route

72
Q

What are the 6 intestinal nematodes?

A

Enterobius, Ascaris, Strongyloides, Ancylostoma/Necator, Trichinella, Trichuris

73
Q

How do you treat Onchocerca volvulus infections?

A

Ivermectin (for river blindness)

74
Q

What is the pathogensis of lympatic filariasis?

A

Elephantiasis: worms invade lymph nodes → inflammation → lymphedema over the course of 9-12 months

75
Q

Name the parasite that forms hydatid liver cysts.

A

Echinococcus granulosus

76
Q

What disease is associated with a Clonorchis sinensis infection?

A

Cholangiocarcinoma

77
Q

What will a blood smear show of a patient diagnosed with visceral leishmaniasis?

A

Macrophages containing amastigotes

78
Q

How is African sleeping sickness transmitted?

A

Trypomastigotes are transmitted through the bite of a tsetse fly

79
Q

What is the mode of transmission of Diphyllobothrium latum?

A

Ingestion of larvae in uncooked freshwater fish

80
Q

What are the typical complications of chronic Chagas disease?

A

Dilated cardiomyopathy with apical atrophy, megaesophagus, and megacolon

81
Q

Name the 2 helminths that classically cause microcytic anemia.

A

Ancylostoma and Necator

82
Q

What are 3 possible intestinal complications associated with Ascaris lumbricoides infections?

A

Ileocecal valve obstruction, intestinal perforation, biliary obstruction

83
Q

Which 3 nematodes are transmitted cutaneously?

A

Strongyloides, Ancylostoma, Necator (they get into your feet from the SANd)

84
Q

What is the treatment for toxoplasmosis?

A

Sulfadiazine and pyrimethamine

85
Q

What is the mode of transmission of the Plasmodium species that cause malaria?

A

Bite of the female Anopheles mosquito

86
Q

What are 2 different presentations of leishmaniasis?

A

1) Cutaneous: skin ulcers; 2) Visceral (kala-azar): spiking fevers, hepatosplenomegaly, pancytopenia

87
Q

What acid-fast organism causes watery diarrhea in healthy patients?

A

Cryptosporidium

88
Q

What are the presenting signs and symptoms of Pediculus humanus and Phthirus pubis infections?

A

Severe pruritus with excoriations on the head, torso, or pubic regions

89
Q

What is the treatment of choice for African sleeping sickness with involvement of the central nervous system?

A

Melarsoprol (versus suramin for blood-borne disease); “I sure am mellow when I’m sleeping”

90
Q

Which 3 nematodes are transmitted through bites?

A

Loa loa, Onchocerca volvulus, Wuchereria bancrofti (lay LOW to avoid getting bitten)

91
Q

How is an Enterobius vermicularis infection diagnosed?

A

Tape test to look for the presence of eggs stuck to the tape

92
Q

What is the treatment for pinworm infection?

A

Pyrantel pamoate or bendazoles (bendy worms)

93
Q

How is Wuchereria bancrofti transmitted?

A

Via female mosquito

94
Q

How is Toxocara canis transmitted?

A

Via the fecal-oral route

95
Q

How is Babesia transmitted?

A

By Ixodes ticks

96
Q

How do you treat neurocysticerosis?

A

Albendazole

97
Q

How is Cryptosporidium diarrhea treated in immunocompetent patients?

A

Nitazoxanide; otherwise, prevent by water filtration

98
Q

Which 2 species of Plasmodium form dormant hypnozoites in the liver, leading to relapsing malaria?

A

P vivax and P ovale

99
Q

What parasite causes myalgias and periorbital edema?

A

Trichinella spiralis (trichinosis)

100
Q

What is the intermediate host of Schistosoma flukes?

A

Snails

101
Q

How is giardiasis treated?

A

Metronidazole

102
Q

What is noted in the blood smear of patients with African sleeping sickness?

A

Trypomastigotes (Trypanosoma brucei)

103
Q

What are the key aspects of treating Trichomonas vaginalis infections?

A

Metronidazole should be given to both the patient and the sexual partner for prophylaxis; screen for sexually transmitted infections as well

104
Q

What are the findings on colon biopsy of a patient with an Entamoeba histolytica infection?

A

Flask-shaped ulcers

105
Q

How does treatment of amebiasis differ between symptomatic and asymptomatic patients?

A

Symptomatic: use metronidazole; asymptomatic: use paromomycin or iodoquinol

106
Q

How does Trichinella spiralis cause muscle inflammation?

A

Larvae enter the bloodstream and encyst in striated muscle cells

107
Q

How does toxoplasmosis present in immunocompetent adults?

A

As a mononucleosis-like syndrome but without heterophile antibodies

108
Q

In patients with Plasmodium falciparum infections, red blood cells tend to occlude capillaries in which 3 organs?

A

Kidneys, lungs, and brain (cerebral malaria)

109
Q

What are 2 diagnostic findings of Trichomonas vaginalis infection?

A

Motile trophozoites on wet mount and/or punctate cervical hemorrhages (“strawberry cervix”) on exam

110
Q

Infection by what parasite is associated with Chagas disease?

A

Trypanosoma cruzi

111
Q

How is an infection with Schistosoma spp treated?

A

Praziquantel

112
Q

How does African sleeping sickness present?

A

Recurrent fevers, somnolence, coma, lymphadenopathy

113
Q

Taenia solium, Diphyllobothrium latum, and Echinococcus granulosus are examples of what type of organism?

A

Cestodes (tapeworms)

114
Q

What is the mechanism that causes the itching that occurs in scabies?

A

Mites burrow into the stratum corneum, which causes pruritus

115
Q

What are the characteristics of a Clonorchis sinensis infection?

A

Biliary tract inflammation leading to pigmented gallstones

116
Q

Toxoplasma causes severe disease in what 2 patient populations?

A

Patients with AIDS (reactivation) and neonates (congenital toxoplasmosis)

117
Q

What is the treatment for lice infection?

A

Pyrethroids, malathion, or ivermectin lotion; and nit combing

118
Q

What is the classic triad of congenital toxoplasmosis?

A

Chorioretinitis, hydrocephalus, and intracranial calcifications

119
Q

Ixodes ticks transmit which 3 diseases?

A

Babesiosis, Lyme disease (Borrelia burgdorferi), anaplasmosis (Anaplasma spp)

120
Q

Name the 2 helminths that cause portal hypertension.

A

Schistosoma mansoni and Schistosoma japonicum

121
Q

What vaginal infection is characterized by a foul-smelling, itching, burning vaginitis with green discharge?

A

Trichomoniasis (Trichomonas vaginalis)

122
Q

In what populations is scabies common?

A

Children, prison inmates, and nursing home residents (crowded conditions)

123
Q

What protozoan infection is characterized by bloody diarrhea, right upper quadrant (RUQ) abdominal pain, and liver abscesses?

A

Entamoeba histolytica infection

124
Q

What is the common name for Enterobius vermicularis?

A

Pinworm

125
Q

How is Trichinella spiralis transmitted?

A

More often via oral ingestion of undercooked meat, especially pork; less often fecal-oral

126
Q

For school-aged children who are diagnosed with head lice, how is their school attendance generally affected?

A

Minimally; children with head lice can continue to attend school while receiving treatment at home

127
Q

What is the vector of transmission for cysticercosis and neurocysticercosis?

A

Ingestion of food contaminated with human feces containing Taenia solium eggs

128
Q

Ingestion of food contaminated with human feces containing Taenia solium eggs

A

Flies (deer fly, horse fly, mango fly)

129
Q

Where might Plasmodium vivax and P ovale remain dormant in the body?

A

The liver as hypnozoites

130
Q

Which helminth causes biliary tract disease and is associated with cholangiocarcinoma?

A

Clonorchis sinensis

131
Q

What is the treatment for Echinococcus granulosus infection?

A

Albendazole; surgery for complicated cysts

132
Q

What 2 diseases can develop secondary to chronic infection with Schistosoma?

A

Squamous cell bladder cancer and pulmonary hypertension (with Schistosoma haematobium)

133
Q

By what methods is Sarcoptes scabiei treated?

A

Permethrin cream, oral ivermectin; laundering of all bedding and clothing, and treating close contacts

134
Q

How is Enterobius vermicularis transmitted?

A

Fecal-oral route

135
Q

What 2 diagnostic tests can confirm Toxoplasma infection?

A

Serology and biopsy (tachyzoite)

136
Q

A patient presents with chronic pulmonary hypertension. What is the most likely diagnosis based on the microscopy image below?

A

Schistosoma haematobium infection (egg with a terminal spine)

137
Q

What protozoa can cause a ring form or “Maltese cross” on blood smear?

A

Babesiosis

138
Q

What protozoa shown below can cause bloating, flatulence, and fatty diarrhea?

A

Giardia lamblia; these are Giardia cysts; shown are multinucleated trophozoites

139
Q

A patient develops the pruritic rash (image) after walking barefoot at a beach. Which parasite is likely responsible?

A

Hookworm (diagnosis: cutaneous larva migrans)

140
Q

A sheepherder presents with acute-onset anaphylaxis. His abdominal CT scan findings are shown (image). What is the causal organism?

A

Echinococcus granulosus (cestode)

141
Q

What is the structure shown in the blood smear below?

A

Trophozoite ring form of Plasmodium (malaria)

142
Q

A sheep farmer is found to have cysts in his liver. One such cyst is shown (image). How did he likely acquire this infection?

A

Ingestion of food contaminated with dog feces containing Echinococcus granulosus eggs → hepatic hydatid cyst formation

143
Q

Which gastrointestinal infection causes fatty, foul-smelling diarrhea (steatorrhea) and is pictured below?

A

Giardia lamblia cysts (think fat-rich Ghirardelli chocolates for fatty stools of Giardia)

144
Q

A patient ingests an organism (image) after handling dog feces. What clinical conditions can be caused by this organism?

A

Hydatid cysts in liver, anaphylaxis if the cysts rupture (Echinococcus granulosus)

145
Q

What is the treatment for asymptomatic cyst passers of Entamoeba histolytica?

A

Iodoquinol or paromomycin

146
Q

What is the most appropriate treatment for Naegleria fowleri?

A

Amphotericin B

147
Q

How does Trypanosoma brucei shown in the blood smear (image) cause recurrent fevers?

A

Antigenic variation on the surface of the organism

148
Q

What does this blood smear from a recently migrated South American with unilateral periorbital swelling show?

A

A trypomastigote; characteristic of a Trypanosoma cruzi infection (endemic to South America)

149
Q

What organism is shown in the image?

A

Pediculus humanus (lice)

150
Q

A child presents with intense pruritus and rash on the hand (image). How is the causative infection transmitted?

A

Through skin-to-skin contact (more common) and via fomites (Sarcoptes scabiei )

151
Q

Wet mount results from a vaginal culture are shown below. What is the likely infectious entity?

A

Trichomonas vaginalis

152
Q

The egg from this tapeworm (image) is found in the stool of a patient after eating food that was contaminated with dog feces. What are the intermediate hosts for this tapeworm?

A

Sheep (Echinococcus granulosus)

153
Q

What infection is most commonly associated with the findings of Schüffner stippling (image) in the blood smear?

A

Malaria, specifically caused by the Plasmodium vivax/ovale species only

154
Q

A patient has an intestinal infection with the tapeworm shown in the image. What is the treatment?

A

Praziquantel (Taenia solium infection)

155
Q

A patient who recently returned from an international trip developed the ulcerated rash shown below. What is the likely diagnosis?

A

Cutaneous leishmaniasis

156
Q

This egg (image) was found on the anal canal of a child complaining of anal pruritus. Which organism is this?

A

Enterobius vermicularis (pinworm)

157
Q

A recent visitor to Mexico develops fever, vomiting, periorbital edema, and muscle pain. A muscle biopsy is shown (image). What organism has he been infected by?

A

Trichinella spiralis nematodes

158
Q

A man moved to a rural, swampy area with poor health care access. A year later, he presents with the findings shown (image). Which organism causes this presentation?

A

This is elephantiasis caused by Wuchereria bancrofti

159
Q

Name the structure shown below from a patient with Entamoeba histolytica.

A

A trophozoite with engulfed RBCs in the cytoplasm (diagnosis: Entamoeba
histolytica Eats Erythrocytes)

160
Q

A 40-year-old man has new-onset seizures and is found to have cystic brain lesions (image). What is the most likely diagnosis?

A

Neurocysticercosis (Taenia solium)

161
Q

A patient presents with cough, gallstones, and abdominal pain. A microscopic fecal exam is shown (image). What organism is most likely responsible?

A

Ascaris lumbricoides (giant roundworm) characterized by “knobby-coated” eggs visible in feces under a microscope

162
Q

What is the organism shown in the image?

A

Schistosoma mansoni (egg with lateral spine)

163
Q

A blood smear is shown from a patient diagnosed with visceral leishmaniasis. Describe the findings.

A

Amastigotes within a macrophage

Microbiology (7 decks)

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