Pathophys/Path 3

Question 1

African Trypanosomisasis

Answer 1

T. brucei
Transmitted by Tsetse flies
West: gambiense
East: rhodesinse
enlarged lymphnodes, neurologic (personality, irritability, somnolence, restlessness, insomnia)

Question 2

Onchocerciasis

Answer 2

“River Blindness”

• Fliarial infestation that predominantly affects cutaneous and ocular tissue
• Cause by Onchocerca volvulus
• Transmitted by Simulium black fly
• Only in humans living in tropical African belt and South America

Question 3

American Trypanosomisasis

Answer 3

Central/South America
T. cruzi through infected reduviid bugs/infected blood
-serious systemic disease that primarily affects the autonomic nervous system, heart GI track

Question 4

Nails Lecture

Answer 4

LOOK IN NOTEBOOK

Question 5

Romana Sign

Answer 5

in American Trypanosomiaisis

edema of the palpebral and periocular tissue due to entry through the conjunctiva

Question 6

Chagas Disease

Answer 6

Acute: local erythema, swelling, regional lymphadenopathy, romana sign, fever, malaise, anorexia, edema of face/lower extremities
Chronic: many years later, cardiac manifestation, GI (megacolon, megaesophagus)

Question 7

Chagas Disease Treatment

Answer 7

Nifurtimox

Benzimidazole

Question 8

African Trypanosomiasis Treatment

Answer 8

Suramin
Pentamidine
organic arsenicals
eflornithine

Question 9

Onchocerciasis Clinical

Answer 9

subcut nodules located over bony prominences
-intermittent intensely pruritic dermatitis
Chronic:thickened wrinkled skin, hyperpigmentation
-Microfilariae in conjunctivae in anterior/posterior eye
-conjunctivis, sclerosing keratitis, uveitis, optic atrophy, glaucoma, blindness

Question 10

Onchocerciasis Treatment

Answer 10

Ivermectin
Noculectomy
suramin & DEC - Mazzotti rxn (fever, immune)

Question 11

Tungiasis

Answer 11

sand flea, jiggerflea, burrowing flea (Tunga penetrans)

• Central/South America, Caribbean Islands, Africa, Pakistan, India
• pregnant female flea burrows into skin-1cm nodule & erythema
  rare: gangrene tetanus auto-amputations

Question 12

Tungiasis Treatment

Answer 12

resolve on own
remove with needle (early) cut out (late)
topical 
niridazole
prophylaxis
shoes, don't sit on sand

Question 13

Cutaneous Myiasis

Answer 13

warble, botfly (dermatiobia hominis)
-boil-like lesions
scalp, face, forearms, les
pruritic papules (1-3cm) in 24hrs
painful, tender, crusted, purulent, moving
self-limited, don’t remove forcible, suffocation, lidocaine, surgery
NO BELIZE

Question 14

Cimicids

Answer 14

Bedbugs
flat oval body, tick size, red-brown, blood-sucking at night, linear bites in threes, hide in day
Hep. B? Asthma?
-eliminate cracks, remove birds/bats, insect repellent, insecticides, starving won’t work…

Question 15

Reduviid Bug

Answer 15

Kissing-near lips
spread T. cruzi (chagas disease)
blood meal then poop, trypanosomes spread by scratching

Question 16

Lice

Answer 16

Pediculosis capitis: head
Pediculosis corporis: body
Phthiriasis pubis: pubic
female - 300 eggs, feed on blood every few hours

Question 17

Lice treatment

Answer 17

permethrin cream
combs
malathion lotion (resistant)

Question 18

Body lice

Answer 18

not common
Pruritus only symptom or papules under arms, shoulders, neck
Maculae ceruleae- bluish/brown hemosiderin laden macules

Question 19

Body lice transmit

Answer 19

typhus
trench fever
relapsing

Question 20

Pubic lice

Answer 20

crab, sexual contact/clothes/hair
eyebrows, eyelashes, hair/sclap
cause maculeae ceruleae

Question 21

Scabies

Answer 21

female mite, world wide, lives in epidermis
pruitus, burrow in-primary
interdigital web, flexer of elbow, areola, penis, scrotum, umbilicus
secondary: pustules vesicles

Infant: head and face