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Parasitology Flashcards

1
Q

Causative organisms of malaria

A

Plasmodium falciparum – the bad one!!
Plasmodium vivax
Plasmodium malariae
Plasmodium ovale

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2
Q

Transmission of malaria

A

bite of infected female Anopheles mosquito

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3
Q

Incubation of malaria

A

7-30 days

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4
Q

Geographic distribution of malaria

A

tropical/subtropical regions

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5
Q

Malaria rates of transmission are highest in…

A

Sub-Saharan Africa and New Guinea

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6
Q

Will not find malaria in…

A
  • high altitudes
  • in deserts
  • during cold seasons
  • effective mosquito eradication programs
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7
Q

Mild Disease of malaria

A
  • Paroxysmal fevers and chills
  • Tachycardia and tachypnea
  • Fatigue and malaise
  • Headaches
  • Cough
  • Abdominal pain with nausea and vomiting
  • Arthralgia and myalgia
  • Splenomegaly
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8
Q

Severe disease of malaria

A

BIG PICTURE: it all shuts down

  • Unarousable coma/cerebral malaria: failure to localize or respond to noxious stimuli
  • Convulsions: >2 generalized seizures in 24 hours
  • severe normochromic, normocytic anemia
  • renal failure: no improvement with rehydration
  • Pulmonary edema
  • Hypoglycemia
  • Hypotension
  • Bleeding/DIC
  • Hemoglobinuria
  • Jaundice
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9
Q

Children common manifestations of malaria

A

anemia, convulsions, hypoglycemia

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10
Q

Adult common manifestations of malaria

A

jaundice, renal failure, pulmonary edema

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11
Q

Pregnancy common manifestations of malaria

A

Hypoglycemia, Jaundice, renal failure, pulmonary edema

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12
Q

Poor prognosis of malaria infections

A
  • marked agitation
  • hyperventilation (respiratory distress)
  • hypothermia
  • bleeding
  • deep coma
  • anuria
  • shock
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13
Q

Biochemistry poor prognosis indicators of malaria

A
  • hypoglycemia
  • hyperlactatemia
  • acidosis
  • elevated serum creatinine, total bilirubin, AST/ALT
  • elevated muscle enzymes, urate
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14
Q

Hematology poor prognosis indicators of malaria

A
  • leukocystosis
  • severe anemia
  • thrombocytopneia
  • prolonged PT, PTT
    decreased fibrinogen
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15
Q

Prophylactic regimens for malaria

A
  • chloroquine
  • mefloquine
  • doxycycline
  • malarone
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16
Q

Mefloquine prophylactic for malaria

A
  • taken once per week
  • long duration of use
  • has a lot of psychiatric side effects
  • contraindicated in patients with seizures/psychiatric conditions
  • best for long duration travelers
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17
Q

Doxycycline prophylactic for malaria

A
  • cheap, available
  • taken for a month after travel
  • PHOTOSENSITIVITY & heartburn (GI side effects)
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18
Q

Malarone prophylactic for malaria

A
  • combo of atovaquine & proguanil
  • taken every day
  • shortest duration of use required
  • few SDE
  • contraindicated in pts with renal dz and pregnancy
  • expensive
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19
Q

Chloroquine prophylactic for malaria

A

ONLY USED FOR HAITI

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20
Q

Treatment for malaria

A
  • Artemether and lumefantrine

- atovaquone and proguanil

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21
Q

Treatment for uncomplicated malaria in Haiti

A
  • chloroquine phosphate

- hydroxychloroquine

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22
Q

Severe/falciparum malaria treatment

A

artesunate

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23
Q

Transmission of schistosomiasis

A

blood flukes entering skin from contaminated water

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24
Q

Geographic distribution of schistosomiasis

A

S. haematobium: Africa and middle east
S. japonicum: China, Thailand, Indonesia
S. mansoni: S. america, Caribbean, Africa

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25
Schistosomiasis infection clinical manifestations
- most ASx - more flukes, more severe disease - Swimmer's Itch: dermatitis with urticaria, pruritus, macular rash - Katayama fever
26
Katayama fever
Several weeks after exposure: fever, chills, hematochezia, chest pain, cough, diarrhea, hepatosplenomegaly
27
Walking on the beach barefoot
schistosomiasis
28
Chronic infections of schistosomiasis
colonic polyposis portal hypotension cystitis and urethritis glomerulonephritis
29
Diagnostic testing of schistosomiasis
eosinophilia | serial stool/urine samples to ID eggs
30
Treatment of schistosomiasis
praziquantel
31
Prevention of schistosomiasis
avoid standing in water in endemic areas
32
Toxoplasmosis transmission
- ingestion of oocysts in raw pork - inhalation of oocysts from cat feces - vertical transmission from mother to fetus
33
Distribution of Toxoplasmosis
worldwide
34
Incubation of toxoplasmosis
ingested takes longer than inhaled
35
Toxoplasmosis and HIV/AIDS
Toxoplasmosis is an opportunist infection in immunocompromised - MC presentation is encephalitis with multiple necrotizing brain lesions
36
Clinical manifestations of toxoplasmosis
``` Fever HA Sore throat Malaise/myalgias HSM ```
37
Rare findings of toxoplasmosis
``` pneumonitis menigoencephalitis hepatitis myocarditis polymyositis ```
38
Congenital infection of toxoplasmosis
- Risk of transmission increases with trimester - Risk of severe fetal dz decreases with each trimester - retinochoroditis is MC late finding of congenital toxoplasmosis - hydrocephalus - intracranial calcifications
39
Diagnostics of toxoplasmosis
CT/MRI: multiple ring-enhancing lesions
40
Treatment of toxoplasmosis
pyrithemaine and sulfadiazine with leucovorin
41
Prevention of toxoplasmosis
education | gloves/masks when cleaning litter box
42
Scabies transmission
close personal contact
43
Scabies geographic distribution
worldwide
44
Scabies clinical manifestations
- INTENSE pruritus - papular rash in infected areas - burrows - common places: interdigital, wrist, elbow, popliteal - Usually spares face/scalp
45
Scabies diagnostics
skin scrape
46
Flea bites vs. Scabies
flea bites: flat, distinct bites | scabies: confluence
47
Scabies treatment
- permethrin: apply to whole body (spare face), leave on for 8-14 hours and repeat in 2 weeks - lindane can also be used except NOT ON CHILDREN (due to neurotoxicity)
48
Pediculosis transmission
- Head lice: fomites (hats, combs, towels) | - Body lice: clothing or direct contact
49
Special characteristics of body louse
Vector of several human diseases: Rickettsia (epidemic typhus)
50
Pediculosis clinical manifestations
- main sx is intense pruritus from saliva sensitization - excoriations from scratching - Nits fluoresce under UV light
51
Pediculosis treatment
permethrin: first line ivermectin: alternative Treat clothing, towels, combs, hair brushes, bedding, etc. Body lice do not require treatment - clothing does
52
Bedbug transmission
fomite contact: mattresses, cushions, pillows, crevices of wooden beds
53
Bedbug facts
- actively seek blood during the night - bite is painless - no known human disease transmitted
54
Bedbug management
malathion lindane calamine lotion for itch relief - methlyprednisone or prednisone for itch inflammation
55
Ascariasis transmission
fecal-oral route | eggs in warm moist contaminated soil
56
Geographic distribution of ascariasis
worldwide; higher in underdeveloped, tropical nations with poor sanitation
57
Ascariasis adult female worm can produced...
200,000 eggs in a day
58
Ascariasis lifecycle
Enter through GI, go to lungs, enter into the mouth | get swallowed and enter GI tract again
59
Ascariasis clinical manifestations
Most ASx Early phase: SOB, cough, fever Loeffler's syndrome: eosinophilic pneumonia obstruction of biliary tree
60
Children with chronic ascariasis infection
malabsorption of proteins, fats, Vitamin A, iodine leading to malnutrition, growth and developmental delays
61
Diagnostic testing of ascariasis
eosinophilia | stool samples with eggs
62
treatment of ascariasis
mebendazole albendazole ivermectin
63
prevention of ascariasis
sanitation and proper hygiene
64
Enterobiasis (pinworms) transmission
ingestion of eggs from perianal area of infected individuals
65
geographic distribution Enterobiasis (pinworms)
worldwide MC helminth in US/Western Europe MC in kids 5-10
66
Lifecycle of Enterobiasis (pinworms)
- Ingested eggs hatch in duodenum - Adult male/female mate in terminal ilececal region - males die in cecum and pass in stool - females move to perianal area and lay eggs
67
Diagnostics of Enterobiasis (pinworms)
scotch tape test/paddle test for several days
68
Management of Enterobiasis (pinworms)
albendazole mebendazole pyrantel pamoate use two rounds two weeks apart as only kills adults and need to wait till eggs mature
69
Prevention of Enterobiasis (pinworms)
sanitation, handwashing, trimming fingernails
70
Necatoriasis (hookworm) transmission
dermal exposure to fecal contaminated soil
71
Geographic distribution of Necatoriasis (hookworm)
worldwide
72
Necatoriasis (hookworm) clinical manifestations
- causes intestinal inflammation leading to loss of iron/blood/protein - IDA - acute infection: "ground itch" with GI sx of N/V/D
73
Diagnostic testing of Necatoriasis (hookworm)
Eosinophilia Microcytic anemia IDA
74
Management of Necatoriasis (hookworm)
mebendazole albendazole pyrantel pamoate iron supplements
75
prevention of Necatoriasis (hookworm)
sanitation and proper hygiene
76
Pork tapeworm/cysticercosis transmission
ingestion of infected "measly" pork containing cysticerci
77
Geographic distribution of Pork tapeworm/cysticercosis
tropical areas and mexican immigrants
78
Clinical manifestations of Pork tapeworm/cysticercosis
- MC ASx - Cysticerciosis: cysts degrade and activate the immune system and migrate to brain/eyes/striated muscle - Neurocysticerosis: altered mental status and seizures are MC findings
79
Diagnostics of Pork tapeworm/cysticercosis
eggs in stool
80
Management of Pork tapeworm/cysticercosis
praziquantel
81
Prevention of Pork tapeworm/cysticercosis
Pickling will not work Deep freeze pork Fully cook pork
82
Beef tapeworm transmission
beef
83
Beef tapeworm general
humans are only definitive host | cows are intermediate hosts
84
Beef tapeworm diagnostic testing
eggs in stool
85
Beef tapeworm management
praziquantel
86
Prevention of Beef tapeworm
sanitation, proper cooking, deep freezing
87
Transmission of trichinellosis/trichinosis
ingestion of undercooked pork or bear meat
88
Geographic distribution of trichinellosis/trichinosis
endemic in japan china
89
Clinical manifestations of trichinellosis/trichinosis
muscle stage of pain/swelling, weakness, fever, periorbital edema, splinter hemorrhages myocarditis is rare, but MCC of death in this disease
90
trichinellosis/trichinosis vs. pork / beef tapeworm
trichinellosis/trichinosis shows muscle sx
91
trichinellosis/trichinosis diagnostics
leukocytosis, increased creatinine phosphokinase, muscle BX is dx
92
management of trichinellosis/trichinosis
mebendazole albendazole prednisone
93
prevention of trichinellosis/trichinosis
cook pork to 160degrees

Infectious Disease (8 decks)

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