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Infectious Disease > Parasitology > Flashcards

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
Q

Schistosomiasis infection clinical manifestations

A
  • most ASx
  • more flukes, more severe disease
  • Swimmer’s Itch: dermatitis with urticaria, pruritus, macular rash
  • Katayama fever
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26
Q

Katayama fever

A

Several weeks after exposure: fever, chills, hematochezia, chest pain, cough, diarrhea, hepatosplenomegaly

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27
Q

Walking on the beach barefoot

A

schistosomiasis

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28
Q

Chronic infections of schistosomiasis

A

colonic polyposis
portal hypotension
cystitis and urethritis
glomerulonephritis

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29
Q

Diagnostic testing of schistosomiasis

A

eosinophilia

serial stool/urine samples to ID eggs

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30
Q

Treatment of schistosomiasis

A

praziquantel

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31
Q

Prevention of schistosomiasis

A

avoid standing in water in endemic areas

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32
Q

Toxoplasmosis transmission

A
  • ingestion of oocysts in raw pork
  • inhalation of oocysts from cat feces
  • vertical transmission from mother to fetus
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33
Q

Distribution of Toxoplasmosis

A

worldwide

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34
Q

Incubation of toxoplasmosis

A

ingested takes longer than inhaled

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35
Q

Toxoplasmosis and HIV/AIDS

A

Toxoplasmosis is an opportunist infection in immunocompromised
- MC presentation is encephalitis with multiple necrotizing brain lesions

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36
Q

Clinical manifestations of toxoplasmosis

A 
Fever
HA
Sore throat
Malaise/myalgias
HSM
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37
Q

Rare findings of toxoplasmosis

A 
pneumonitis
menigoencephalitis
hepatitis
myocarditis
polymyositis
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38
Q

Congenital infection of toxoplasmosis

A
  • 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
Q

Diagnostics of toxoplasmosis

A

CT/MRI: multiple ring-enhancing lesions

40
Q

Treatment of toxoplasmosis

A

pyrithemaine and sulfadiazine with leucovorin

41
Q

Prevention of toxoplasmosis

A

education

gloves/masks when cleaning litter box

42
Q

Scabies transmission

A

close personal contact

43
Q

Scabies geographic distribution

A

worldwide

44
Q

Scabies clinical manifestations

A
  • INTENSE pruritus
  • papular rash in infected areas
  • burrows
  • common places: interdigital, wrist, elbow, popliteal
  • Usually spares face/scalp
45
Q

Scabies diagnostics

A

skin scrape

46
Q

Flea bites vs. Scabies

A

flea bites: flat, distinct bites

scabies: confluence

47
Q

Scabies treatment

A
  • 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
Q

Pediculosis transmission

A
  • Head lice: fomites (hats, combs, towels)

- Body lice: clothing or direct contact

49
Q

Special characteristics of body louse

A

Vector of several human diseases: Rickettsia (epidemic typhus)

50
Q

Pediculosis clinical manifestations

A
  • main sx is intense pruritus from saliva sensitization
  • excoriations from scratching
  • Nits fluoresce under UV light
51
Q

Pediculosis treatment

A

permethrin: first line
ivermectin: alternative

Treat clothing, towels, combs, hair brushes, bedding, etc.

Body lice do not require treatment - clothing does

52
Q

Bedbug transmission

A

fomite contact: mattresses, cushions, pillows, crevices of wooden beds

53
Q

Bedbug facts

A
  • actively seek blood during the night
  • bite is painless
  • no known human disease transmitted
54
Q

Bedbug management

A

malathion
lindane
calamine lotion for itch relief

  • methlyprednisone or prednisone for itch inflammation
55
Q

Ascariasis transmission

A

fecal-oral route

eggs in warm moist contaminated soil

56
Q

Geographic distribution of ascariasis

A

worldwide; higher in underdeveloped, tropical nations with poor sanitation

57
Q

Ascariasis adult female worm can produced…

A

200,000 eggs in a day

58
Q

Ascariasis lifecycle

A

Enter through GI, go to lungs, enter into the mouth

get swallowed and enter GI tract again

59
Q

Ascariasis clinical manifestations

A

Most ASx
Early phase: SOB, cough, fever
Loeffler’s syndrome: eosinophilic pneumonia
obstruction of biliary tree

60
Q

Children with chronic ascariasis infection

A

malabsorption of proteins, fats, Vitamin A, iodine leading to malnutrition, growth and developmental delays

61
Q

Diagnostic testing of ascariasis

A

eosinophilia

stool samples with eggs

62
Q

treatment of ascariasis

A

mebendazole
albendazole
ivermectin

63
Q

prevention of ascariasis

A

sanitation and proper hygiene

64
Q

Enterobiasis (pinworms) transmission

A

ingestion of eggs from perianal area of infected individuals

65
Q

geographic distribution Enterobiasis (pinworms)

A

worldwide

MC helminth in US/Western Europe

MC in kids 5-10

66
Q

Lifecycle of Enterobiasis (pinworms)

A
  • 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
Q

Diagnostics of Enterobiasis (pinworms)

A

scotch tape test/paddle test for several days

68
Q

Management of Enterobiasis (pinworms)

A

albendazole
mebendazole
pyrantel pamoate

use two rounds two weeks apart as only kills adults and need to wait till eggs mature

69
Q

Prevention of Enterobiasis (pinworms)

A

sanitation, handwashing, trimming fingernails

70
Q

Necatoriasis (hookworm) transmission

A

dermal exposure to fecal contaminated soil

71
Q

Geographic distribution of Necatoriasis (hookworm)

A

worldwide

72
Q

Necatoriasis (hookworm) clinical manifestations

A
  • causes intestinal inflammation leading to loss of iron/blood/protein
  • IDA
  • acute infection: “ground itch” with GI sx of N/V/D
73
Q

Diagnostic testing of Necatoriasis (hookworm)

A

Eosinophilia
Microcytic anemia
IDA

74
Q

Management of Necatoriasis (hookworm)

A

mebendazole
albendazole
pyrantel pamoate
iron supplements

75
Q

prevention of Necatoriasis (hookworm)

A

sanitation and proper hygiene

76
Q

Pork tapeworm/cysticercosis transmission

A

ingestion of infected “measly” pork containing cysticerci

77
Q

Geographic distribution of Pork tapeworm/cysticercosis

A

tropical areas and mexican immigrants

78
Q

Clinical manifestations of Pork tapeworm/cysticercosis

A
  • 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
Q

Diagnostics of Pork tapeworm/cysticercosis

A

eggs in stool

80
Q

Management of Pork tapeworm/cysticercosis

A

praziquantel

81
Q

Prevention of Pork tapeworm/cysticercosis

A

Pickling will not work
Deep freeze pork
Fully cook pork

82
Q

Beef tapeworm transmission

A

beef

83
Q

Beef tapeworm general

A

humans are only definitive host

cows are intermediate hosts

84
Q

Beef tapeworm diagnostic testing

A

eggs in stool

85
Q

Beef tapeworm management

A

praziquantel

86
Q

Prevention of Beef tapeworm

A

sanitation, proper cooking, deep freezing

87
Q

Transmission of trichinellosis/trichinosis

A

ingestion of undercooked pork or bear meat

88
Q

Geographic distribution of trichinellosis/trichinosis

A

endemic in japan china

89
Q

Clinical manifestations of trichinellosis/trichinosis

A

muscle stage of pain/swelling, weakness, fever, periorbital edema, splinter hemorrhages

myocarditis is rare, but MCC of death in this disease

90
Q

trichinellosis/trichinosis vs. pork / beef tapeworm

A

trichinellosis/trichinosis shows muscle sx

91
Q

trichinellosis/trichinosis diagnostics

A

leukocytosis, increased creatinine phosphokinase, muscle BX is dx

92
Q

management of trichinellosis/trichinosis

A

mebendazole
albendazole
prednisone

93
Q

prevention of trichinellosis/trichinosis

A

cook pork to 160degrees

Infectious Disease (8 decks)

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