Parasitology - Protozoa Flashcards

1
Q

What are the 3 protozoan that infect the GI tract?

A

1) Giardia lamblia
2) Entamoaba histolytica
3) Cryptosporidium

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2
Q

What are the symptoms of Giardiasis?

A

Bloating, Flatulence, Foul-smelling + FATTY diarrhea

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3
Q

Who is Giardiasis seen in? What is it’s “street name”?

A

Campers/hikers; Beaver Fever

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4
Q

How is Giardia lamblia transmitted?

A

Cysts in water; animals (beavers) shit in the river, you drink the water down stream

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5
Q

How do you diagnose Giardia lamblia?

A

Trophozoits or cysts in stool

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6
Q

What is the treatment for Giardia lamblia?

A

Metronidazole

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7
Q

What are the symptoms of Amebiasis?

A

(Entamoaba histolytica) Amebiasis: BLOODY diarrhea (dysentery), liver abcess (w/ “anchovy paste” exudate), RUQ pain

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8
Q

What will histology show if a submucosal abscess of the colon ruptures in Amebiasis?

A

A flash-shaped ulcer

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9
Q

How is Entamoeba histolytica transmitted?

A

Cysts in water (active trophozoite found only in host and fresh feces; cysts live outside host in water, soil, and food - especially in moist conditions)

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10
Q

How do you diagnose Amebiasis?

A

Serology and/or trophozoite (with RBC’s in the cytoplasm) or cysts (with up to 4 nuclei) in stool

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11
Q

Treatment for Amebiasis?

A

Metronidazole; use iodoquinol for asymptomatic cyst passers

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12
Q

What are the symptoms of a Cryptosporidium infection?

A
Severe diarrhea in AIDS
Mild disease (WATERY diarrhea) in immunocompetent
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13
Q

How is Cryptosporidium transmitted?

A

Oocysts in water

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14
Q

What is unique about Cryptosporidium lifecycle?

A

Does not need to use an insect host and can complete an entire lifecycle inside a single host which results in cyst stages that are excreted and can be transmitted to a new host

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15
Q

How do you diagnose Cryptosporidium?

A

Oocysts on acid-fast stain

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16
Q

What is the treatment for a Cryptosporidium infection?

A

Mainly symptomatic (hydration therapy, electrolyte management, pain management, etc.)
Prevent by filtering city water supplies
Use Nitazoxanide in immunocompetent patients

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17
Q

What are the 3 protozoan CNS infections?

A

1) Toxoplasma gondii
2) Naegleria fowleri
3) Trypanosoma brucei

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18
Q

What are the symptoms of Toxoplasma gondii infection?

A

Brain abscess in HIV (ring enhancing lesions on CT/MRI)

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19
Q

What are the symptoms of congenital toxoplasmosis? (another triad…)

A

“Classic triad” of

1) Chorioretinitis
2) Hydrocephalus
3) Intracranial calcifications

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20
Q

How is toxoplasmosis transmitted?

A
Cysts in meat or oocysts in cat feces;
Crosses placenta (classic presentation is a pregnant woman who is taking care of a cat)
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21
Q

How do you diagnose toxoplasmosis?

A

Serology, biopsy (see tachyzoite)

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22
Q

How do you treat toxoplasmosis?

A

Sulfadiazine + Pyrimethamine

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23
Q

What happens with a Naegleria fowleri infection?

A

Rapidly fatal meningoencephalitis

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24
Q

How is Naegleria fowleri transmitted?

A

By swimming in freshwater lakes

Nalgene bottle filled with Fresh Water contains Naegleria

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25
Q

What part of the body does Naegleria fowleri enter through?

A

Cribiform plate

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26
Q

How do you diagnose a Naegleria fowleri infection?

A

Amoebas in spinal fluid

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27
Q

How do you treat Naegleria fowleri?

A

Amphotericin B (effective for few)

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28
Q

What is a Trypanosoma brucei infection called?

A

African Sleeping Sickness

29
Q

What are they symptoms of African Sleeping Sickness (T. Brucei)?

A

Enlarged LNs, recurring fever, somnolence, coma

30
Q

How does T. Brucei cause recurring fever?

A

Antigenic Variation

31
Q

What are the two subspecies of T. Brucei?

A

Rhodesiense

Gambiense

32
Q

What is the difference between Rhodensinse and Gambiense?

A

Rhodesience - fast onset/acute; most common in southern and eastern africa = game animal and livestock reservoir
Gambiense - slow onset/chronic; most common in central and western africa = human reservoir

33
Q

How is T. Brucei transmitted?

A

Tsetse fly, painful bite

34
Q

How do you diagnose african sleeping sickness?

A

Blood smear

35
Q

How do you treat African Sleeping Sickness?

A

SURamin for blood-borne disease
MELArsoprol for CNS penetration
(It SURe is nice to go to sleep; MELAtonin helps with sleep)

36
Q

What are the 2 hematologic parasitic infections?

A

Plasmodium and Babesia

37
Q

What are the subtypes of Plasmodium?

A

P. Vivax/Ovale
P. Falciparum
P. malariae

38
Q

What are the symptoms of malaria?

A

Fever, headache, anemia, splenomegaly

39
Q

What are the symptoms of a P. vivax/ovale infection? Where does it lie dormant?

A

48 hr cycle = tertain = fever on first and third day so fevers are 48 hours apart; lies dormant in liver (hypnozoite form)

40
Q

What are the symptoms of a P. Falciparum infection?

A

Severe, irregular fever patterns, parasitized RBC’s occlude capillaries in the brain (cerebral malaria), kidneys, and lungs

41
Q

What are the symptoms of a P. malariae infection?

A

Runs on a quartan (72hr) cycle with fevers

42
Q

How is Plasmodium transmitted?

A

Mosquito

43
Q

How do you diagnose Plasmodium infections?

A

Blood smear, trophozoite ring form within RBC (banana shaped thing)
Schizont containing merozoites

44
Q

How do you treat malaria?

A

Begin with Chloroquine (blocks Plasmodium heme polymerase)

45
Q

How do you treat malaria resistant to chloroquine?

A

Mefloquine or Atovaquone/Proguanil

46
Q

How do you treat a life threatening malaria infection?

A

IV Quinidine

47
Q

African American male that has a history of a splenomegaly, back pain, and hemoglobinuria. You go to start him on IV quinidine for his life-threatening malaria infection when a smarter doctor (someone who got a 260 on boards) stops you and tells you that you can’t because he has a genetic condition. What condition? What will you see on a blood smear? And how is it inherited?

A

G6PD deficiency
Heinz bodies and bite cells
X-linked recessive

48
Q

What do you treat Vivax/Ovale with?

A

Add Primaquine for hypnozoite in liver (also need to check for G6PD here)

49
Q

What are the symptoms of Babesiosis?

A

Fever and hemolytic anemia

50
Q

Where is Babesia found? (geographic and animal)

A

Predominately in the NE US in the Ixodes Tick

51
Q

What else besides Babesia does the Ixodes tick carry?

A

B. Burgorferi (Lyme Disease); they can coinfect

52
Q

What increases the risk of a Babesia infection?

A

Asplenia

53
Q

What will be seen on blood smear with Babesiosis? What else can you do to diagnose?

A

A ring form, “maltese cross”; PCR

54
Q

What is treatment for Babesiosis?

A

Atovaquone + Azithromycin

55
Q

What are the visceral and STD protozoal infections?

A

1) T. Cruzi (Visceral)
2) Leishmania donavani (Visceral)
3) Trichomonas Vaginalis (STD)

56
Q

What is the result of a T. Cruzi infection?

A

Chagas disease

57
Q

What are the symptoms of T. Cruzi?

A

Everything gets BIG!
Cardiomyopathy
Megacolon
Megaesophagus (achalasia)

58
Q

Where is T. Cruzi found?

A

South America

59
Q

What transmits T. Cruzi?

A

Reduvidd bug (kissing); feces deposited in a painless bite

60
Q

How do you diagnose T. Cruzi?

A

Blood smear

61
Q

What is the treatment for T. Cruzi?

A

Benznidazole or Nifurtimox

62
Q

What are the symptoms of Leishmaniasis?

A

A.K.A. (Kala-Azar): Spiking fevers, hepatosplenomegaly, Pancytopenia

63
Q

How is Leishmania transmitted?

A

Sandfly

64
Q

How do you diagnose Leishmania?

A

Macrophages containing amastigotes

65
Q

What is the treatment for Leishmania?

A

Amphotericen B, Sodium Stibogluconate

66
Q

What does Trichomonas Vaginalis cause? Symptoms?

A

Vaginitis; foul smelling greenish discharge; itching and burning (Not the same as Gardnerella Vaginalis = bacterial vaginosis = fishy smell + clue cells)

67
Q

How is Trich transmitted?

A

Sexual (can’t form cysts so it can’t go anywhere else)

68
Q

How do you diagnose Trich?

A

Trophozoites (motile) on a wet mount; “strawberry cervix”

69
Q

What is the treatment for Trich?

A

Metronidazole for patient and partner (prophylaxis)