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FM3_ EB > Parasitology 5 > Flashcards

Parasitology 5 Flashcards

1
Q

Describe the location of Leishmaniasis infection

A

blood and tissues

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2
Q

Which forms of Leishmaniasis cause only cutaneous infection?

A

L tropica

L major

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3
Q

Which forms of Leishmaniasis cause cutaneous and mucocutaneous infection?

A

L mexicana

L brazillensis

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4
Q

Which forms of Leishmaniasis cause visceral infection?

A

L chagasi
L donovani
L infantum

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5
Q

What is the vector of Leishmaniasis?

A

sand fly

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6
Q

Describe the lifecycle of Leishmaniasis

A

Vector borne- sand fly is infected when it takes a blood meal from infected host. Parasites develop in the sand fly, transmitted to a new host when fly bites again
Within humans, the leishmania is adapted to live in WBC and avoid being degraded

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7
Q

_____ and ______ are important reservoirs of Leishmaniasis

A

dogs and rodents

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8
Q

_______ transmission of Leishmaniasis has been documented in dogs

A

vertical

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9
Q

The great majority of ______ cases of Leishmaniasis occur in India, Bangladesh, Nepal, Sudan, and Brazil

A

visceral

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10
Q

Describe the epidemiology of Leishmaniasis

A
  • 350 million at risk
    ~12 million infected
    ~2 million new cases/year
    ~60,000 deaths/year

tropical and subtropical regions

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11
Q

Describe the presentation of cutaneous Leishmaniasis

A
  • Starts as a bump then an ulcerative sore at primary site; satellite lesions
  • abundant amastigotes in lesions
  • spontaneous healing with scarring
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12
Q

______ may reduce the duration of cutaneous Leishmaniasis lesions and help them heal faster

A

Fluconazole

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13
Q

Describe the presentation of mucocutaneous Leishmaniasis

A
  • metastasis months to years after primary lesion heals

- ulceration nasopharynx tissues, amastogotes in lesions

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14
Q

For both mucocutaneous and visceral Leishmaniasis, ________ leads to immunity

A

chemotherapeutic cure

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15
Q

Describe the presentation of visceral Leishmaniasis

A

Onset at 2-12 months, fever and wasting with hepatosplenomegaly

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16
Q

How is Leishmaniasis diagnosed

A

biopsy or aspirate the lesion, stain with Giemsa, look for amastigotes.
In US, CDC does DNA tests

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17
Q

Describe treatment for cutaneous Leishmaniasis

A

typically self-resolves with scarring

L. major treated with fluconazole

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18
Q

Describe treatment for mucocutaneous Leishmaniasis

A

Antimonials- not always effective and side effects

Amphotericin B is an alternate but expensive & iv daily

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19
Q

Describe treatment for visceral Leishmaniasis

A

miltefosine- drug of choice, given for 4 weeks, cures 94% Amphotericin B is an alternate

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20
Q

In eastern and southern Africa, African Trypanosomiasis is caused by Trypanosoma _________

A

rhodesiense

21
Q

In western and central Africa, African Trypanosomiasis is caused by Trypanosoma ________

A

gambiense

22
Q

What is the vector for Human African Trypanosomiasis?

A

tsetse fly

23
Q

Contrast the progression of Western vs Eastern Human African Trypanosomiasis

A

Western: reservoir is human, chronic (years to progresion)

Eastern: reservoir is antelope, cattle; rapid progression in 1-4 weeks

both 100% mortality without treatment

24
Q

The African Trypanosomiasis parasite is free floating in the blood stream and undergoes __________ to avoid host immunity

A

antigenic variation

25
Q

Describe the epidemiology of HAT

A

Exclusively sub-Saharan Africa
Re-emerging
60 million people at risk

26
Q

How is HAT diagnosed?

A

direct examination of blood, lymph, and CSF (rhodesiense)

27
Q

What is Winterbottom’s sign?

A

Enlargement of posterior cervical lymph nodes seen in African Trypanosomiasis

28
Q

What drugs are used to treat early stage trypanosomiasis?

A

Pentamidine: useful for gambiense, well tolterated

Suramin: useful for rhodesiense

29
Q

What drugs are used to treat late stage trypanosomiasis?

A

Melarsoprol: discovered in 1949, used against both forms. Arsenic derivative with many side effects including fatal encephalopathy (3% to 10%).

Eflornithine: Only effective against T.b. gambiense. Less toxic but infusion every 6 hr for 14 days.

30
Q

What organism causes Chagas disease?

A

Trypanosoma cruzi

31
Q

What is the reservoir for Trypanosoma cruzi?

A

rats, cats, dogs, wild animals

32
Q

What is the location of Trypanosoma cruzi?

A

blood, lymphatics & tissues (intracellular)

33
Q

What is the vector of Trypanosoma cruzi?

A

reduviid bug

34
Q

How is Trypanosoma cruzi transmitted?

A

Bite of infected reduviid bug, transfusion, transplantation, IVDU, possibly vertical

35
Q

Contrast the epidemiology of Chagas in rural vs urban settings

A

rural: vector/reservoir in proximity to human dwellings
urban: contaminated blood supplies; IV drug use

36
Q

How is spread of Chagas prevented?

A

Screen blood supply
good housing
vector control

37
Q

Describe the progression of Chagas disease

A

Acute: 2-4 months fever, chagoma, hematogenous spread

Chronic: 10-20 years, damage to nerve, muscle, heart, esophagus, colon. Death from sudden heart attack is common

38
Q

How is Chagas diagnosed?

A

acute: trypomastigotes in blood
chronic: xenodiagnosis
Recently approved strip assay

39
Q

How is acute chagas treated?

A

Benznidazole or Nifurtimox

Neither FDA approved, get from CDC

40
Q

What is the location of Trichomoniasis?

A

Urogenital- luminal

41
Q

There are no ________ or ______ stages in the life cycle of Trichomoniasis

A

free living or encysted

42
Q

How is Trichomonas vaginalis transmitted?

A

direct sexual contact, rarely non-sexual contact

43
Q

70% of females infected with Trichomonas vaginalis are ______

A

asymptomatic

44
Q

Describe signs of Trichomoniasis in women

A

vaginitis, burning and itching
inflammation of squamous epithelia
“frothy” vaginal discharge with unusual odor

45
Q

Describe signs of Trichomoniasis in men

A

itching, irritation inside penis
burning after urination or ejaculation
mild discharge

46
Q

List complications of Trichomoniasis

A

preterm delivery, LBW

increased risk of acquiring HIV

47
Q

People who have been successfully treated for Trichomoniasis can be _______

A

re-infected

48
Q

How is Trichomoniasis diagnosed?

A

microscopic observation of motile parasites

DNA test is available now at major centers

49
Q

What is the treatment for Trichomoniasis?

A

metronidazole or tinidazole

FM3_ EB (25 decks)

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