protozoa Flashcards by Rawan El gamal

what is the feeding form of a protozoa ?

trophozoite

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what is the more durable form of protozoa that is found in nature?

cysts

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what is the transmission associated with GI protozoa ?

feco oral

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what are the two blood parasites ?

malaria
babesia

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where are giardia cysts found ?

wet environment in mountain stream water

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what effect does giardia have on the body ?

affects the small intestine
bloating foul smell and fatty diarrhea
stools that float

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how is a diagnosis of giardia made ?

cyst in stoll
trophozites in stool
ELISA for giardia antigen in stool

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what is the classic case of giardia ?

camper or hiker that comes complaining of bloating and fatty stools

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what is the immune association with giarda ?

IgA deficiency is associated with a higher rate of giardia infection
brutons ammaglobulinemia
selective IgA deficiency

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how is giardia treated ?

metronidazole

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what is the cause of amebiasis or amebic dysentry ?

entamoeba histolytica

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what is the effect of histolytica n the body ?

invades the tissue of the small bowel - causes bloody diarrhea
abscess in the liver - right upper quadrant pain

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what is special about liver abscess caused by entamoeba ?

anchovy past exudate in surgery

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what is the most probable cause of infection in a traveler with right upper quadrant pain , bloody diarrhea ?

amoebiasis by entamoeba histolytica

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how is a diagnosis of entamoeba ?

stool microscopy
serology
multiple nuclei seen in cyst

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ingested multiple red blood cells on microscopy ?

entaomeba histolytica

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what is the treatment for amoebiasis, and what is the treatment for asymptomatic carriers ?

metronidazole
asymptomatic carriers : idoquinol

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what is sen on biopsy of the small bowel in amoebic dysentery ?

a flask shaped ulcer

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what is the classic case of ameobiasis ?

immigrant
RUQ
bloody diarrhea

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what type of patient is associated with cryptosporidium ?

immunocompromised patients
the more immunocompromised the worst

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what stain is used for cryptosporidium infection ?

acid fast stain - they turn purple

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what is the treatment for cryptosporidium ?

immunocompetent : nitozoxanide
immunocompromised : anti retroviral

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why is it a problem when immunocompromised patients get toxoplasmosis ?

because it may enter a latent phase and reactivate later

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what are tho major disease processes associated with toxoplasmosis ?

HIV CNS disease
congenital toxoplasmosis

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when can toxoplasmosis cause significant CNS disease ?

only in the immunocompromised specifically HIV patients

what is seen on Brain imaging in patients with HIV CNS disease ?

multiple ring enhancing lesions brain abscess

what is the problem with toxoplasmosis and pregnancy and what are the symptoms ?

crosses the placenta the classic triad - chorioretinitis hydrocephalus - enlarged ventricles intracranial calcification

what are the methods of diagnosis of toxoplasmosis and what are the results seen?

serology or biopsy IgG or IgM antibodies IgM if the infection appears within one week IgG antibodies rise within two weeks

what is seen on biopsy of toxoplasmosis?

tachyzoite with a giemsa stain

what is the treatment for toxoplasmosis and what is the mechanism ?

sulfadiazine/ pyrimethamine blocks the THF synthesis pathway

where is naegleria fowleri found and how does it cause disease ?

in contaminated water and ponds it travels up the nose and can reach the cribriform plate causing meningoencephalitis

what is the classic case associated with naegleria fowleri ?

recent history of swimming fever, confusion and a stiff neck often fatal

what is african trypanosomiasis caused by and what is the other name for it ?

all caused by tsetse fly african sleeping sickness

what are the early and late features associated with african trypanosomiasis ?

early : fever and arthalgia late : somnolence, coma

how is. diagnosis of african tryponomiasis made ?

visible in blood smear

why is there a recurring fever in african trypansomiasis ?

antigenic variation variant surface glycoprotein (VSG)

what are the infections carried by ixodes scapularis ?

anaplasma borrelia babesiosis so co infection is common and must check for the other when infected with one

which cells are infected by babesiosis ?

red blood cells

which type of patient is at increased risk of babesiosis ?

asplenic patients

what are the symptoms of babesiosis ?

fever spleenomegaly hemolytic anemia

how is a diagnosis of babesiosis made ?

blood smear , rings form maltese crosses PCR test is also used

what is the treatment of babesiosis ?

azithromycin atovaquone

what is the cause of chagas disease ?

trypanosoma cruzi

how is trypanosoma cruzi transmitted ?

through reduviid bug bite nest in the cracks and holes of housing

what is the presentation of chagas disease ?

acute phase - nonspecific, febrile illness chronic chagas - heart, oesophagus and colon affection

what is the cardiac effect, eosophageal effect, and colonic effect of chagas disease ?

cardiac: right and left heart failure high prevelance of ventricular thrombi pulmonary embolism/stroke edophagus: achalasia, megaesophagus (dilation) colon: megacolon due to severe constipation

how can you diagnose the acute phase and chronic phase of chagas disease ?

acute phase: blood smear trypomastigotes chronic phase : serology IgG antibodies

what is the treatment for chagas disease ?

acute phase only nifurtimox

what is the cause of leishmaniasis and what cell is affected ?

sand fly macrophages are infected

what are the two forms of leishmaniasis ?

cutaneous leishmaniasis - large ulcer with indurated border visceral leishmaniasis - fever, painful splenomegaly, pancytopenia

how is the visceral for of leishmaniasis diagnosed ?

by taking a biopsy of the affected organs bone marrow or spleen

what is found in macrophages infected by leishmania ?

amastigotes

what is the treatment for leishmania ?

amphotericin B sodium stibogluconate

where is trichomonas vaginalis normally found ?

lives in the urogenital tract and is sexually transmitted

what is the presentation of trichomonas vaginalis in men vs in women ?

men: usually asymptomatic women: vaginitis, itching and foul smelling discharge

how is the diagnosis of tichomonas vaginalis made ?

using a wet mount vaginal pH will belevated

what is the treatment for trochomonal vaginalis ?

metronidazole for patient and partner

what are the three possible causes of vaginitis ?

gardnerella vaginalis candida trichomonas

what is the key feature seen in gardnerella vaginalis and what is specific about the odor ?

clue cell seen fishy odor

what test is used to diagnose bacterial vaginitis ?

whiff test : KOH makes a fishy smell

what is the test associated with candida vaginitis ?

KOH prep

what is unique about trichomonas vaginitis ?

strawberry cervix