Parasitology

Question 1

Giardia lamblia disease presentation

Answer 1

Giardiasis: bloating, flatulence, foul-smelling, fatty diarrhea

Often campers/hikers

“fat rich Ghiradelli chocolates for fatty stools of Giardia”

Question 2

Giardiasis transmission

Answer 2

fecal-oral

cysts in water

Question 3

Giardiasis diagnosis

Answer 3

O&P- trophocytes or cysts in stool
Antigen detection
wet mount

Question 4

Giardiasis treatment

Answer 4

metronidazole

Question 5

What is a protozoa cyst?

Answer 5

when exposed to new environments, protozoa secrete a protective coat and shrink down into a circular round armored cyst. it its the infective form when ingested by humans. it converts to motile form once ingested by humans. motile form is called trophozoite

Question 6

Entamoeba histolytica disease

Answer 6

Amebiasis- bloody diarrhea (dysentery), liver abscess, RUQ pain, flank shaped ulcer

Question 7

Amebiasis transmission

Answer 7

fecal-oral

cysts in water- very resistant

Question 8

Amebiasis diagnosis

Answer 8

serology and/or trophocytes (with RBCs in cytoplasm) or multinucleate cysts in stool

Question 9

Amebiasis treatment

Answer 9

Metronidazole: iodoquinol for asymptomatic cyst passer

Question 10

Cryptosporidium disease presentation

Answer 10

severe diarrhea in AIDS
mild watery diarrhea in others
systemic: fever, maliase, N/V

Question 11

Cryptosporidium transmission

Answer 11

fecal-oral
oocysts in water
daycare, hospitals, institiutions

Question 12

Cryptosporidium diagnosis

Answer 12

antigen detection or direct microscopy (acid fast stain)

Question 13

Cryptosporidium treatment

Answer 13

nitazoxanide, octreotide, HAART

prevention-water sources

Question 14

GI infection protozoa

Answer 14

Giardiasis, Amebiasis, Cryptosporidium

Question 15

Toxoplasma gondii disease

Answer 15

congenital toxoplasmosis= triad of chorioretinitis, hydrocephalus, intracranial calcifications

mostly asymptomatic

Question 16

Toxoplasmosis diagnosis

Answer 16

ring enhancing brain lesion
serology- IgM acutely
biopsy (tachyzoite)
PCR amniotic fluid

Question 17

Toxoplasmosis transmission

Answer 17

meat (most common)
cat feces
cross placenta in pregnant women

Question 18

Toxoplasmosis treatment

Answer 18

Sulfadiazine + pyrimethamine
Bactrim prophylaxis
cook meat properly
no litter box in pregnancy

Question 19

What is Neurocysticercosis?

Answer 19

most common parasitic disease of the nervous system

result of accidental ingestion of eggs of Taenia solium (ie, pork tapeworm), usually due to contamination of food

Question 20

Cyclospora disease

Answer 20

watery diarrhea, N/V

systemic symptoms

Question 21

cyclospora transmission

Answer 21

fecal-oral
stool on food-water
oocysts that sporulate

Question 22

Cyclospora diagnosis

Answer 22

acid-fast staining, autoflorescence, safranin

Question 23

Cyclospora treatment

Answer 23

Bactrim

Question 24

Babesia 
reservoir:
vector:
diagnosis:
presentation:
management:

Answer 24

reservoir: small mammal
vector: Ixodes tick–> our RBCs
diagnosis: blood smear, serology, PCR
presentation: fever, hemolytic anemia (asplenic at risk)
management: clinda-quinine or atovaquone-azithromycin

Question 25

Malaria
reservoir:
vector:
diagnosis:
presentation:
management:

Answer 25

reservoir: humans
vector: mosquito
diagnosis: blood smear, antigen detection
presentation: invades RBCs, fever, fatigue, anemia, splenic rupture. cold, hot, sweating stage
management: chloroquine, IV quinidine if life threatening, Primaquine, atovaquone-proguanil if resistant

Question 26

List the 5 plasmodium species

Answer 26

Enterobius, Ascaris, Hookworm, Schistosomes, Strongyloides

Question 27

Enterobius vermicularis (pinworm)
Epi:
Transmission:
Diagnosis:
Presentation:
Treat:

Answer 27

Epi: young children and their parents
Transmission: ingest/ inhale eggs that lay on perianal skin
Diagnosis: Scotch tape prep on anus
Presentation: extreme perianal itching, sleep loss, irritability
Treat: Bendazoles for bendy worms. repeat in 2 wks

Question 28

Ascaris lumbricoides
Epi:
Transmission:
Diagnosis:
Presentation:
Treat:

Answer 28

Epi: largest, most prevalent nematode
Transmission: ingest eggs- big city kids
Diagnosis: Eosinophilia, Ova in stool
Presentation: intestinal infection w obstructed ileocecal valve. granulomatous pneumonitis
Treat: Bendazoles for bendy worms

Question 29

Ancylostoma, duodenale, Cecator americanus (Hookworms!)
Epi:
Transmission:
Diagnosis:
Presentation:
Treat:

Answer 29

Epi: children
Transmission: larvae penetrate skin and suck blood from intestinal walls
Diagnosis: Eosinophilia, Ova in stool
Presentation: iron-def anemia, liver malfunction, malnutrition
Treat: Bendazoles or pyrantel pamoate

Question 30

Strongyloides stercoralis
Epi:
Transmission:
Diagnosis:
Presentation:
Treat:

Answer 30

Epi: tropical moist soil
Transmission: larvae penetrate skin, autoinfection
Diagnosis:
Presentation: intestinal infxn, vomit, diarrhea, epigastric pain
Treat: Ivermectin or bendys

Question 31

What are trematodes?

Answer 31

flatworms without a true gut with snails in their life cycle. aka “flukes”

Question 32

Nematodes you eat and become infected by:

Answer 32

EAT
Enterobius
Ascaris
Tricuris

Question 33

Nematodes you step on that penetrate your skin:

Answer 33

SANd
Strongyloides
Ancylostoma
Necator

Question 34

Schistosomes
Transmission:
Diagnosis:
Presentation:
Treat:

Answer 34

Transmission: contact water harboring infected snails, sex forever in your bloodstream
Diagnosis: O&P stool, serology
Presentation: periprotal fibrosis, portal HTN, liver/spleen enlargement, pulm HTN, painless hematuria, SCC bladder
Treat: Praziquantel

Question 35

I’m having brain cysts and seizures

Answer 35

taenia solium (pork) (cysteicerocosis)

Question 36

I have hematuria and SCC bladder

Answer 36

schistosoma haematobium

Question 37

I’m having perianal prutitus

Answer 37

Enterobius

Question 38

I have portal hypertension

Answer 38

Schistosoma mansoni, Schistosoma japonicum