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Micro Final > Pathogenic Protozoa > Flashcards

Pathogenic Protozoa Flashcards

1
Q

Describe the transmission, symptoms and treatments for: Giardia Lambdia

A

Tsm: unfiltered water, fecal/oral spread;
Cx: Backpacker’s Diarrhea;
Tx: Metronidazole

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2
Q

Define the diagnostic tools to detect Giardia in stool of infected patients?

A

ELISA stool antigen, IFA or Iodine staining

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3
Q

Describe the transmission, symptoms and treatments for: Entameoba histolytica

A

Tsm: fecal/oral spread by water/food;
Cx: Amoebic Dysentery; “anchovy paste abscesses” (no need to drain them)
Tx: Metronidazole, Paramycin, Chloroquine

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4
Q

Describe the diagnostic features someone might find in abscesses of someone infected with Entamoeba?

A

Ingested RBCs within trophozoites under a microscope; ELISA stool antigen or serology for ABs against infection

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5
Q

Describe the transmission, symptoms and treatments for: Toxoplasma gondii

A

Tsm: oocytes shed in cat feces, transplacentally to fetus;
Cx: Severe neurological and ocular disease in fetus;
Tx: Sulfadiazine, Pyrimethamine

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6
Q

An HIV patient presents with chronic watery diarrhea. Specialized microscopy of his stool revealed acid-fast cysts. What parasite is he suspected to be infected with?

A

Cryptosporidium, treated with Nitazoxinide

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7
Q

Briefly describe a key feature of each of the subspecies of Trypanosoma brucei.

A
  1. T. b brucei = disease in livestock, recurrent fevers;
  2. T. b. rhodesiense = East African RAPID-progressing disease;
  3. T. b. gambesiense = West African slowly-progressing disease
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8
Q

Describe the transmission, symptoms and treatments for: Trypansoma brucei

A

Tsm: tsetse fly;
Cx: Cervical and Axillary lymphadenopathy, recurrent fevers;
Dx: Trypomastigotes in blood smear;
Tx: Melarsoprol (CNS infection), Suramin (peripheral blood infection)

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9
Q

What key feature about Trypanosoma brucei enables it to escape the immune system to cause chronic infection?

A

Variable surface glycoprotein coats (VSGs) that undergo constant antigenic variation.

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10
Q

What are the 2 treatments recommended for African Sleeping Sickness?

A

Treatments for Trypanosoma brucei include:

  1. Suramin - peripheral “serum” blood infection
  2. Melarsoprol - CNS infection
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11
Q

Describe the transmission, symptoms and treatments for: Trypanosoma cruzii “Chagas Disease”

A

Tsm: scratched feces of Kissing bug;
Cx: Megacolon, Dilated cardiomyopathy;
Dx: Blood smear, serology, muscle biopsy, PCR;
Tx: Benznidazole, Nifurtimox

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12
Q

What are the 2 treatments recommended for Chagas Disease?

A

Treatments for Trypanosoma cruzii include:

  1. Benznidazole - nitroimidazole derivative;
  2. Nifurtimox - increase oxidative stress
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13
Q

What are the symptoms of Chagas Disease? What of the diagnostic features?

A
  1. Megacolon, Mega-esophagus, Dilated Cardiomyopathy

2. Intracellular amastigotes in heart muscle

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14
Q

Describe the transmission, symptoms, diagnostics and treatments for: Leishmaniasis

A

Tsm: Female sandfly;
Cx: Cutaneous, visceral or mucosal symptoms, hepatosplenomegaly;
Dx: Leishman-Donovan bodies (amastigotes in tissue);
Tx: Miltefosine, Amphotericin B

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15
Q

Describe the transmission, symptoms, diagnostics and treatments for: Naegleria

A

Tsm: freshwater exposure, sinuses to brain via olfactory nerves;
Cx: SEVERE keratitis, FATAL amoebic meningoencephalitis;
Dx: trophozoites in CSF, brain biopsy, immunoflourescence;
Tx: Amphoterecin

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16
Q

Describe the transmission, symptoms, diagnostics and treatments for: Babesia

A

Tsm: Ixodes Tick;
Cx: hemolytic anemia, jaundice; irregularly cycling fevers
Dx: Ring form cell, Maltese-cross RBCs from trophozoites.
Tx: Azithromycin, Atovaquone

17
Q

A patient presents in the clinic with jaundice from a tick bite he got some weeks ago. He’s been feeling fatigued and feverish lately. What disease might he have if Lyme disease is ruled out? What are the recommended treatments?

A

Babesiosis - marked by Maltese-cross RBCs in blood smear. Atovaquone and Azithromycin are recommended treatments.

18
Q

What human alleles result to some resistance against malarial symptoms? (List at least 3).

A
  1. Sickle cell disease (HbS)
  2. G6PD deficiency (heterozygotes)
  3. Duffy-negative (lack of blood group antigen for P. vivax)
19
Q

Out of the 4 plasmodium subspecies, which one is the deadliest and why? Which one has 72-hour interval fevers?

A
  1. P. falciparum = most severe with cerebral involvement

2. P. malariae = 72-hour fever intervals (compared to the other 48-hour intervals)

20
Q

What are the 2 recommended treatments for Plasmodium falciparum?

A

Artemisins and Atovaquone

21
Q

Describe the effect of chloroquine phosphate as an anti-malarial drug.

A

Chloroquine is a low-cost, oral drug that is effective for blood schizonts but not liver stage parasites, P. vivax or P. ovale hypnozoites. “Beaded necklaces” = prevent polymerization of hemoglobin breakdown + heme buildup that’s toxic to parasite.

22
Q

Describe the effect of Primaquin as an anti-malarial drug.

A

Primaquin is effective against the liver stage of ALL 4 PLASMODIA SPECIES, even hypnozoites of P vivax and P ovale. “Fierce primal queen” = Forms quinoline metabolites that acts as cellular oxidants in combo with chloroquine

23
Q

Describe the effect of Mefloquin as an anti-malarial drug.

A

Mefloquin is recommended for CHLOROQUINE-RESISTANT strains of P falciparum. It is not effective against hepatic stages of gametocytes. “Me-fly-queen on the palanquin”

24
Q

What antimalarial drug acts as a First-line drug for P falciparum?

A

Quinine and Quinidine from the Cinchona tree = highly effective against blood schizonts of all 4 types of plasmodia and gameticidal against P vivax and ovale. Prevents DNA replication and RNA transcription.

25
Q

Describe the effect of Malarone as an anti-malarial combination drug.

A

Malarone = atovaquone + proguanil that is highly effective against persistent liver stages of P vivax or P ovale. Disrupts mitochondrial electron transport of the parasite.

26
Q

What are the 5 antibiotics used to treat all erythrocytic forms of all species.

A
  1. Tetracycline
  2. Doxycycline
  3. Clindamycin
  4. Azithromycin
  5. Fluoroquinolones
27
Q

What stage of the malaria lifecycle is most susceptible to the host’s immune response, which involves the release of antibodies? What is the clinical significance of this?

A

Sporozoite stage which starts the initial round of infections within RBCs only lasts 30 minutes at a time but is most susceptible. Malarial vaccines are impractical (since sporozoites cannot grow well in culture)

28
Q

Describe the transmission, symptoms, diagnostics and treatments for: Cyclospora

A

Tsm: fecal/oral, outbreaks from contaminated fruits/veggies;
Cx: Diarrhea (hospitalization if severe);
Dx: Acid-fast stained cysts
Tx: TMP-SMX, supportive care

29
Q

Describe the transmission, symptoms, diagnostics and treatments for: Cryptosporidium parvum

A

Tsm: contaminated water;
Cx: chronic watery diarrhea in AIDS patients, fever and GI pain;
Dx: Acid-fast oocysts in fecal smear
Tx: Nitazoxinide, Spiramycin, chlorination/filtration removes cysts from water

30
Q

Describe the transmission, symptoms, diagnostics and treatments for: Microsporidia

A

Tsm: contaminated water, in compromised patients;
Cx: intestinal, eye and systemic infections;
Dx: stained specimens, hard to detect/distinguish;
Tx: Albendazole (MT inhibitor), Fumigillin (methionine aminopeptidase inhibitor)

31
Q

Describe the transmission, symptoms, diagnostics and treatments for: Trichomonas vaginalis

A

Tsm: most common pathogenic protozoan in industrialized countries;
Cx: Vaginitis in females; Urethritis/ Epididymitis in males;
Dx: Motile trophozoite on wet mount (no cyst stage!)
Tx: Metronidazole, Tinidazole (treat both partners)

32
Q

Describe the mode at which Chloroquine works as an anti-malarial drug.

A

Kills erythrocytic schizonts/ merozoites. Administer 4 weeks after leaving endemic area so ALL stages revert to more sensitive forms (sporozoites) in the blood.

Micro Final (12 decks)

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