Parasitology Flashcards
What is a parasite?
Organism that lives on or in a host organism and gets its food from or at the expense of its host
Name the 3 main classes of parasites
- Protozoa
- Helminths
- Ectoparasites
What is a Protozoa?
Microscopic single celled organism that can be free living or parasitic
- are able to multiply in humans and cause disease
Are Protozoa able to multiply in humans?
Yes
How can protozoa transmit and where may they live in the body?
- Intestine (transmitted by fecal-oral route)
- blood or tissue (will usually need a vector)
How do we characterise protozoa?
By their mode of movement
Name 4 different classifications of protozoa
- Amoeba
- Flagellates
- Ciliates
- Sporozoa - organisms whose adult stage is not motile
Describe the different shapes and structures/features of protozoa
Some may have flagella
What are some examples of the medically important Protozoa infections?
- Entamoeba histolytica
- Gordia lambton
- Trichomonas vaginalis
- Malarias
- Toxoplasma gondii
- Cryptosporidium
- Leishmania species
- Trypanosoma Cruzi
- Trypanosoma brucei
What does entamoeba histolyca cause?
Ulcers in the duodenum, dysentery
What does gordia lambton cause?
Diarrhoea
What does trichomonas vaginalis cause?
Infections in the genital tract
What is toxoplasma gondii transmitted through?
Cats
What does cryptosporidium cause?
Diarrhoea
What does leishmania cause?
Ulcers in skin and systemic disease
Describe what Helminths are
Helminths are large, multicellular organisms that are usually visible to the naked eye
Can helminths multiply in humans?
in their adult form they can NOT multiply in humans so the amount in the body are dependant on the amount of eggs
Name the 3 main groups of helminths
- Nematodes (roundworms)
- Trematodes (flukes)
- Cestodes (tapeworms)
Name some medically important N helminths
- Soil - Transmitted helminths
- Ascaris lumbricoides
- Trichuris trichiura
- Hookworm spp.
- Enterobius vermicularis
- Filarial parasites
- Wuchereria bancrofti
- Loa loa
- Onchocerca volvulus
- Dracunculus medinensis
- Others
- Toxocara canis/cati
- Trichinella spiralis
What are the types of nematodes?
Soil transmitted helminths
Filarial parasites
Name some medically important T helminths
- Trematodes
- Schistosoma mansoni/haematobium/japonicum
- Clonorchis sinensis
- Fasciola hepatica
- Paragonimus spp.
What type of worms are nematodes?
Roundworms
What does clonorchis sinensis cause?
Carcinoma of the bladder
Where does fasciola hepatica live?
In the liver
What is special about the male/ female trematodes?
Males are larger and the females live inside them
Name some medically important C helminths
- Cestodes
- Taenia saginata
- Taenia solium
- Echinococcus granulosus
What type of worm are trematodes?
Flukes
Where does paragonimus live?
In the lungs
How long are cestodes?
2-3 metres long
What type of worm are cestodes?
Tapeworms
Describe what ectoparasites are
Blood sucking arthropods such as ticks, fleas, lice and mites that attach or burrow into the skin and remain there relatively long amounts of time (weeks to months)
Name 4 groups of ectoparasites
- Mites
- Ticks
- Lice
- Fleas
Name the medically important mites?
- Scabies
- Trombiculid
Where are scabies found?
Animal infected sand
Where are trombiculid found?
Found in vegetation
What are the types of ticks?
Hard and soft
Name some medically important lice?
- Pediculus humans capitals
- Pediculus humanus
- Pthirus pubis
What are the types of parasitic host?
- Intermediate
or
- Definitive
What is an intermediate host?
Host in which larval or asexual stages develop
What is a definitive host?
Host in which adult or sexual stage occurs
Which factor is correlated strongly to the distribution of parasite infections in humans around the world?
Wealth
Describe some general different modes of transmission of parasitic infections
- Faeco-oral
- Food
- Complex life cycles
- Others
What are DALYs?
- This is one way of measuring morbidity in NTDs (neglected tropical diseases) around the world
- Disability-adjusted life years - One DALY represents the loss of the equivalent of one year of full health
What is Chagas disease and how can we limit it?
- Is Tyrpansoma Cruzi transmitted by bugs that live in thatched rooves and around rubbish, can feed off of animals such as chickens and goats and replicate
- Can be limited by removing thatched roof, move animals away, keep rubbish away etc.
Describe the life cycle of Tyrpansoma Cruzi
- The bug will bite you and then may excrete into the skin
- Tthe bite will be itchy and so if you itch it then you may cause the parasite in the feces to go into your blood - is not transmitted by the bite
- Ttryptomastigotes will move to the midgut and replicate then if another bug bites you it can infect that bug
Describe the acute phase of Chagas disease
- Incubation 1-2 wks after bite
- Up to months after transfusion
- Trypanosomes in blood
Describe chronic ‘indeterminate’ (in terms of Chagas disease)
- Chronic ‘indeterminate’
- Lifelong Infection
- Generally trypanosomes not detectable but often positive for parasite DNA
- Seropositive
- 60-70%
- Normal ECG and X ravs
Describe chronic ‘determinate’ (in terms of Chagas disease)
- Determinate’ Chronic disease
- Seropositive
- 30-40% of infected 10-30 years after infection
- 5-10% develop chronic Chagas immediately after acute disease
Describe the symptoms of acute Chagas disease
- Occurs within 3 weeks
- Generally mild or asymptomatic
- Local swelling (Romaña)
- Nodule or chagoma
- Fever
- Anorexia
- Lymphadenopathy
- 1-2% diagnosed
- Symptoms last 8-10 wks
- Rarely (young and IS)
- Hepatopsplenomegaly
- Acute myocarditis
- Meningoencephalitis
- Fatality <5% of symptomatic
Describe the chronic changes of Chagas disease to the heart
enlarged heart and thin heart wall → heart failure
Describe the effects of Chagas disease on the digestive system
- Severe constipation causes megacolon and ulceration, performation
- Can affect the esophagus, rectum and sigmoid colon
Explain how Chagas disease causes these effects (pathogenesis) in acute, intermediate and chronic Chagas
Acute
- Tissue damage by inflammation due to parasite nests of amastigotes in cardiac, skeletal and smooth muscle
- Parasite killing by antibodies and activated innate immune response - inflammatory cytokines
Chronic inflammatory response to persistent parasites in muscle and nerve cells
- Autoimmune mechanisms
- May vary by parasite strain and tissue tropism
- Predominance of Th1 cytokines and CD8+ T cells
What is the vector of Cutaneous Leishmaniasis?
Sam flies - they are very small (can go through mosquito nets)
- love chickens
Which cells do the amastigotes of Cutaneous Leishmaniasis infect?
Macrophages - they will be packed full of the amastigotes
How does Cutaneous Leishmaniasis present?
People will have lesions with large ulcers (there is a plaque formed that will break down and leave a large ulcer)
What is mucocutaneous Leishmaniasis?
Describe what causes these acute lesions (so the pathogenesis) in cutaneous leishmaniasis
- Acute lesions
- Tissue damage caused by inflammatory response to presence of parasites in
macrophages - Parasite killing by Th1 pro-inflammatory responses and macrophage killing.
- Tissue damage caused by inflammatory response to presence of parasites in
- Latency
- Parasites remain present long-term. Regulatory immune response characterized by
balance of Th1 and anti-inflammatory responses
- Parasites remain present long-term. Regulatory immune response characterized by
- Relapse (rare)
- Alteration in immune response (i.e change in Th1 vs. immune regulation secondary
to HIV, malnutrition) may trigger relapse- Mucocutaneous disease associated with strong but inadequate inflammatory response to parasites that have metastasized to mucosa
- Diffuse cutaneous leishmaniasis associated with uncontrolled parasite replication.
- Recividans - recurrence of lesions at old ulcer site.
- Alteration in immune response (i.e change in Th1 vs. immune regulation secondary
Explain what amastigotes are
- An amastigote is a protist cell that does not have visible external flagella or cilia.
- The term is used mainly to describe an intracellular phase in the life-cycle of trypanosomes that replicates
What are some examples of neglected tropical diseases?
- Lymphatic filariasis
- Onchocerciasis
- Guinea worm disease
What are the types of parasitic vectors?
- Mechanical
- Biological
What is a mechanical vector?
No development of parasite in vector
What is a biological vector?
When some stages of the life cycle occur
What is the life cycle of schistosomiasis?
- Eggs expelled in urine or faeces
- Develop in fresh water
- Invade snails
- Asexual reproduction that amplifies parasite number
- Infect people when they come into contact with the infected water
How can you decrease the faeco-oral transmission of parasites?
- Household sanitation
- Access to clean water
- Personal hygiene behaviours
How can you decrease the food transmission of parasites?
- Animal husbandry
- Surveillance
- Regulations and government controls
What is chagas infected with?
Metacyclic trypomastigotes
What do metacyclic trypomastigotes do?
Multiply in cells and burst them, spreading disease further
What are the phases of chagas?
- Acute
- Chronic indeterminate
- Chronic determinate
What are the organs most affected in chronic chagas?
Heart and intestines
Why does chronic chagas affect the heart and intestines?
Damages the autonomic nervous system
What complications in the mega colon are caused by chronic chagas?
Hecatoma
Obstruction
Sigmoid volvulus
Ulceration
Perforation
What is the pathogenesis of acute chagas?
Tissue damage caused by inflammatory response to parasite
What is the pathogenesis of indeterminate chronic chagas?
Regulatory immune response characterised by IL-10 and IL-17
Where are visceral leishmaniasis found?
- Asia
- Middle East/ Africa
- Latin america
Where (geographically) are cutaneous leishmaniasis found?
- Mediterranean
- Central and South America
What is the lifecycle of a leishmaniasis?
Sandfly bite
Promashyotes enter immune cells and replicate to form amastigotes
What is the old world vector of leishmaniasis?
Sergentomyia
What are the new world vectors of leishmaniasis?
Phlebotomus
What is the reservoir of leishmaniasis?
Domestic dogs and rodents like sloth
How do cutaneous leishmaniasis present?
Small Papule that grows into a plaque
How do you get a sample for cutaneous leishmaniasis?
Scrape from the edge of the plaque onto a slide, then stain with giemsa
Describe the effects of Chagas disease on the digestive system
- Severe constipation causes megacolon and ulceration, performation
- Can affect the esophagus, rectum and sigmoid colon