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ClinMed1 Exam 4 > Protazoal and Helminth Diseases > Flashcards

Protazoal and Helminth Diseases Flashcards

1
Q

where is malaria an endemic (6)

A 
(mostly tropical places)
South and Central America
Africa
Middle East
Indian subcontinents
Oceania
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2
Q

In which place is the mortality and morbidity the greatest?

A

Africa

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3
Q

What are the four Plasmodium species that cause malaria?

A

P. falciprum
P. vivax
P. ovale
P. malariae

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4
Q

which species causes nearly all the severe cases of malaria in Africa?

A

P. falciprum

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5
Q

how is malaria transmitted?

A

bite from infected female anopheline mosquito

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6
Q

Deaths caused by P. falciprum in the US are typically d/t:

A

not taking prophylaxis correctly or at all (incorrect drug or regimen)

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7
Q

What are the clinical findings of Malaria? (non-severe dz) (4)

A

(shaking chills
fever
diaphoresis) -every other day
splenohepatomegaly

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8
Q

What are the clinical findings of malaria (in severe dz) (4)

A

bleeding
mental disturbances
Acute tubular necrosis (black water fever)
hemolytic anemia

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9
Q

What is the prophylatic tx for malaria?

A

Chloroquine prophylaxis 1 dose q week starting 1-2 weeks prior to entering endemic area and 4 weeks after departure
-If going to chloroquine resistant area – Atovaquone w/ progquanil 1 qd beginning day before entering endemic area and daily for one week after departure

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10
Q

tx for falciparum Malaria

A

Artemether and Lumefantrine

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11
Q

what is the definative host for toxoplasmosis

A

kitties

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12
Q

where are the toxoplasmosis oocysts found?

A

cat feces

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13
Q

how do humans get infected with toxoplasmosis

A
  • ingestion of raw or under cooked meat
  • contaminated food or water
  • careless handling of cat litter
  • transplacental transmittal
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14
Q

what are the four different syndromes of toxoplasmosis

A
  • primary infection in ImmunoComp host
  • congenital infection
  • retinochoroiditis
  • reactivated dz in the immunocomp pt
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15
Q

how does a primary infection of toxoplasmosis present in the immunocomp pt (7)

A

-acute, mild multi-system illness (mono-like)
-lymphadenopathy of the head and neck** (MC finding)
-malaise
myalgia
headache
sore throat
maculopapular rash

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16
Q

Three fun facts about congenital toxoplasmosis infection

A
  • more severe when in 1st trimester**
  • if contracted in 3rd Tri may be born with subclinical dz
  • 85% will develop overt dz later
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17
Q

What is chorioretinitis and when does it happen?

A
  • develops weeks to years after congenital toxoplasmosis infection
  • necrotic retinal lesions
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18
Q

what is the clinical presentation of chorioretinitis? (1 sign, 4 sx)

A
  • yellow/white patches w/ blurred margins on retina

- visual defects: scotoma, central defects, pain and photophobia

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19
Q

What are the MC sites for reactive dz of toxoplasmosis in the immunocomp pt?

A

brain
lungs
eyes

20
Q

lab tests for toxoplasmosis

A

serologic and histopathologic

21
Q

DOC for toxoplasmosis

A

pyrimethamin + sulfadiazine for 3-4 weeks (may casue BM supression) (bactrim)

22
Q

when treating a patient for toxoplasmosis w/ pyrimethamin + sulfadiazine what lab values are important to follow?

A
  • make sure pt has good urine output

* platelet and WBC counts twice weekly (BM suppression)

23
Q

what the most common nematode infection in the US

A

Enterobius vermicularis (pin worms!!) ~~~~~~

24
Q

what is the cycle of a pin worm? (where do adults live/eggs etc.)

A

the adult pin worms live in the cecum, females migrate tot he anus to lay eggs on the perianal skin. Cycle continues when eggs are transmitted to the mouth

25
Q

clinical findings of pin worm infestation

A

asymptomatic

perianal itching- particularly in the PM

26
Q

Lab finding for pin worms

A

scotch tape test- collect eggs for microscopic ID

- do 3 successive tests before you call it negative (only need one positive, no need to repeat)

27
Q

Tx for pin worms

A

Albendazole

1 round of tx, repeat in 2 weeks

28
Q

What are the hosts for hookworms?

A

humans, dogs and cats

29
Q

where is hookworm most prevalent?

A

moist tropical/sub tropical areas

30
Q

what is the path of migration of hookworms in the body?

A

worms enter the skin, usually through foot, migrate to lungs.; cilliary action moves them to the oropharynx where they are swallowed

31
Q

how long does it take hookworms to mature and where do they suck your blood?

A

4-6 weeks, at site of attachment (usu upper small bowel)

32
Q

clinical findings of hookworms (8)

A 
pruitits at site of infection
dry cough
wheezing
blood tinged sputum
low grade fever
vague abd cramps
anorexia
nausea
33
Q

Tx for hookworms

A 
Fe supplementation
Albendazole (1 dose)
pyrantel pamoate (1 dose)
34
Q

What is Entamoeba histolytica and what is it’s only host

A

parasite

humans

35
Q

how do you contract Entamoeba histolytica?

A

contaminated food or water (usu in overcrowded areas w/ poor sanitation and nutrition)

36
Q

clinical findings of Entamoeba histolytica (amebiasis) (3 types w/ sx)

A
  • mild to mod: colitis w/ cramps, usu blood in stool
  • severe colitis: liquid, bloody, mucus stools, fever, colic, prostration, ileus perf/ hemorrhage may occur
  • hepatic amebiasis: fever, hepatomegaly, pain and localized tenderness
37
Q

lab findings of amebiasis

A

amebas in stool
antigens in stool
+ serologic tests
US or CT showing hepatic abcess

38
Q

tx for an asymptomatic carrier of amebiasis (3)

A

luminal agents:
diloxanide furate (10days)
lodoquinol (21 days)
paramomycin (7 days)

39
Q

Tx for mild and severe intestinal Amebiasis (2)

A

metronidazole (10 days)

Tinidizole + luminal agent

40
Q

what is the causative organism for Giardiasis?

A

Giardia lamblia (it’s a flagellate!)~~~~

41
Q

what are 4 fun facts about Giardiasis?

A
  • humans are only reservoirs
  • only cyst form is inactive
  • infectious dose is low**
  • incubation period is 1-3 weeks**
42
Q

what is the incubation period of Giardiasis?

A

1-3 weeks

43
Q

clinical findings of Giardiasis (4 different states/syndromes)

A
  • carriers may be asymptomatic
  • acute diarrhea
  • chronic diarrhea
  • malabsorption
44
Q

lab tests of Giardiasis (4)

A
  • stool sample for ova and parasites
  • duodenal string test
  • endoscopy
  • CBC (it’s normal)
45
Q

Tx for Giardiasis

A

Tinidazole (2 g single dose, has a 90-100% cure rate)
Metronidazole (flagyl) 250mg TID X 5-7 days
(**neither can be taken w/ alcohol)

ClinMed1 Exam 4 (5 decks)

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