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LAST EXAMMMMMM Year I > Protozoa > Flashcards

Protozoa Flashcards

1
Q

What are protozoa

A

free living, single eukaryotic cells with cytoplasmic membrane and organelles that have 1 or 2 nuclei, mitochondria, food vacuoles and ER

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2
Q

what are the layers of protozoa

A

outer layer of cytoplasm called ectoplasm and inner layer called endoplasm

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3
Q

How do protozoa ingest human RBC

A

cytostome- small mouth

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4
Q

how do protozoa reproduce

A

asexually by replication and division

also sexually by fusion and division

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5
Q

What is the infective form of protozoa

A

cysts

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6
Q

what is the motile form of protozoa after ingested as cysts

A

trophozoite

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7
Q

What are the 5 intestinal protozoa that cause diarrhea

A

Entamoeba Histolytics- bloody
Giradia lamblia, Cyclospora cayteanensis- non bloody
Cryptosporidium and Isospora belli- immunocompromised

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8
Q

describe the precyst form of Entamoeba Histolytica

A

has aggregates of ribosomes called chromotoid bodies and food vacuoles that are extruded as cell shrinks to mature

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9
Q

What causes the blood in diarrhea from Entamoeba Histolytica

A

when the motile trophozoite invades intestinal mucosa

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10
Q

What suggests active infection of E histolytica

A

trophozoites with RBC in cytoplasm

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11
Q

What is the most sensitive and specific test for E histolytica

A

Ag detection assays of stool or serum

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12
Q

What wil a CAT scan or ultrasound look like of person with E histolytica

A

abscesses of liver sometimes

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13
Q

What does metronidazole kill

A

E histolytica, G lamblia, Trich vaginalis, Baceteroides fragilis, C dificile, Gardnerella vaginalis

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14
Q

What are the adverse effects of metronidazole

A

with alcohol causes stomach upset

metallic taste in mouth

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15
Q

What form of Giradia lamblia looks like a kite

A

the mature throphozoite

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16
Q

What are the signs of G lamblia infection and why?

A

fat in diarrhea with really bad odor
abdominal distention and cramps and gas
the trophozoite adheres to small intestine wall preventing intestinal fat absorption

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17
Q

Describe transmission of Cryptosporidium

A

ingested as round oocyst with 4 motile sporozoites

life cycle in intestinal epithelial cells

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18
Q

What can cryptosporidium cause in immunocompromised patients

A

severe, protracted diarrhea that is life-threatening

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19
Q

How do you Dx isospora and cyclospora

A

stool microscopy because both are acid fast!

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20
Q

What protozoa are flagellated

A

giardia and trich vaginalis

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21
Q

what are symptoms of trich vaginalis in women? men?

A

women: pruritis, burning while peeing, vaginal secretions(thin watery and malodorous)
men: asymptomatic

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22
Q

What are the free-living meningitis causing amoebas

A

Naegleria fowleri, Acanthamoeba and Balamuthia mandrillaris

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23
Q

What is the presentation of Naegleria fowler? how is it acquired?

A

swimming, organisms penetrate nasal mucosa and pass to cribioform plate
fever, HA, stiff neck, nausea and vomiting
CSF shows high neutrophils. high protein and low glucose

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24
Q

What does Acanthamoeba cause

A

chronic, granulomatous brain infection in immunocompromised patients
HA fever, seziures and focal neuro signs

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25
Q

What does Balamuthia mandrillaris cause

A

amebic encephalitis
infects immunocompetent and compromised
chronic granulmoatous skin lesions

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26
Q

What are the 4 common parasites in AIDS patients

A

cryptosporodium, Isospora

Pneumocystis carinii and Toxoplasma gondii

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27
Q

What is the presentation of toxoplasma gondii

A

fever, lymph node enlargement, HSM, pneumonia

infection of brain and meninges

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28
Q

What is the most common CNS infection in AIDS patients? presentation?

A

toxoplasma encephalitis
fever, HA, gait instability, weakness, sensory loss, chorioretinitis with blindness
(white yellof fluffy cotton patches in retina)

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29
Q

What does T gondii cause after crossing placenta

A

still birth if early on

chorioretinitis, seizures, mentral retardation, microcephaly, encephalitis

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30
Q

How do you Dx T gondii

A

CAT of brain showing contrast-enhacning mass
Examination of retina shows retinal inflammation
Inc Ig titers

31
Q

What is the most common opportunistic infection in AIDS patients ? presentation?

A

PCP
fever, SOB nonproductive cough
b/l diffuse infiltrates

32
Q

What would you see in someone with PCP

A

diffuse perihilar interstitial streaking b/l sparing the outer margins
flyer saucer fungi in silver staining

33
Q

What are the organisms that cause malaria

A

Plasmodiums: falciparum, vivax, ovale, malariae and knowlesi

34
Q

What plasmodium burst causing fever every 48 hours

A

ovale and vivax

“tertian malaria”

35
Q

what plasmodium causes fever every 72 hours

A

P malariae

quartan malaria

36
Q

When does P falciparum cause fevers

A

irregular between 36-48 hours

37
Q

What are the thin motile forms of Plasmodia called

A

sporozoites

38
Q

When plasmodium sporozoites enter liver cell what begins

A

pre-erythrocytic cycle because the sporpozoites rounds up to form a trophozoite that undergoes nuclear divisions forming big mass with thousands of nuclei called schizont
cytplasmic membrane forms around each nuclei making merozoites that are let out when the liver cell vursts

39
Q

What is the exo-erythrocytic cycle

A

merozoites that infect another liver cell after initial exposure already happened (some left for blood)

40
Q

what is the erythrocytic cycle of plasmodia

A

when merozoites enter blood cells
trophozoite shaped like a ring with nuclear diamond
RBC lysis causes fevers, chills and sweats

41
Q

What plasmodia form dormant counterparts

A

vivax and ovale

they are called hypnozoites– relapsing malaria

42
Q

Which plasmodia have severe clinical manifestations

A

falciparum and knowles

43
Q

What plasmodium is R to chloroquine

A

faciparum

except in parts of Central America

44
Q

What is cerebral malaria characterized by

A

seizures and impaired consciousness leading to coma

45
Q

What mutation allows resistance to P vivax and falciparum

A

absence of RBC membrane Ag Duffy a and b: vivax

sickle cell for falciparum

46
Q

What phase of P vivax and oval is protected from chloroquine

A

when in exo-erythrocytic cycles in liver

47
Q

What is the main Tx for the exo-erythrocytic cycles of malaria in liver

A

primaquine

48
Q

what drug is used for P falciparum

A

quinine

artemether is the new one

49
Q

What are common features of anti-malarials

A

oral
cause GI upset
cause hemolysis in those with G6PD deficiency
safe in all trimesters of pregnancy

50
Q

What is Babesiosis and what carries it

A

infection like malaria from a tick that invades RBCs causing fever and hemolytic anemia

51
Q

What is different from babesiosis and malaria besides mode transmission

A

babesiosis does not infect liver cells

52
Q

what is the shape of the babesia trophozoite

A

X shaped tetrad of 4 merozoites

53
Q

What are the shapes of leishmania and trypanosomas

A

round cell w/o flagella: amastigotes

flagellated motile forms: promastigotes, epimastigotes and trypomastigotes

54
Q

How is leishmania transmitted

A

sandfly

South and central america, Africa and middle east

55
Q

where does the sandfly infect

A

promastigote invades macrophages then changes to amastigote and replicates in lymph nodes, spleen, liver and bone marrow

56
Q

What are the 3 clinical forms of leishmania

A

cutaneous
mucocutaneous
Visceral

57
Q

Presentation of cutaneous leishmania

A

site of bite there is a skin ulcer called “oriental sore”
heals after a year leaving pale scar
invokes DTH so can use PPD like test

58
Q

Where is diffuse cutaneous leishmania seen? presentation?

A

Venezuela and Ethiopia with patients that have deficient immune systems
concentration of nodular lesions near nose
no DTH because defective immune system

59
Q

Presentation of mucocutaneous leishmania

A

dermal ulcer that heals

months and years later ulcers in mucous membrane arise and could cause erosion of nasal septum, palate and lips

60
Q

Presentation of visceral leishmania

A

malnourished children
abdominal discomfort and distention
low grade fever, anorexia and weight loss

61
Q

What leishmaniasis has massive splenoegaly

A

L donovani’s

62
Q

Is the leishmanin skin test useful during active disease

A

no because cell mediated immunity is deficient

63
Q

What do you use to Tx leishmania

A

stibogluconate

64
Q

What transmits AFrican sleeping sickness

A

tsetse fly

trypanosoma

65
Q

what is presentation of african sleeping sickness

A

har red painful skin ulcer that heals in 2 weeks
systemic: fever, HA, dizzyness and lymph node swelling
goes away and returns weeks later
then drowsiness, behavioral change, difficulty walking, slurred speech, coma and death

66
Q

What are the two forms of african sleeping sickness and pathogens

A

West is caused by Trypanosoma brucei gambiense: slowly progressing wasting
East is caused by T brucei rhodesiense: more severe and rapid

67
Q

Why do the trypanosomes cause intermittent fvers

A

from variable surface glycoproteins that they continueally change

68
Q

How can you Dx trypanosome infection

A

visualization of trypomastigoes in peripheral blood, lymph nodes, spinal fluid
rapid card agglutination for anti-T brucei gambiense Ab is available

69
Q

How do you Tx trypanosome infection

A

suramin or pentamidine if CNS not involved yet

CNS involvement- use eflornithine or nifurtimox when melarsoprol

70
Q

What is Chagas disease caused by and presentation

A

Trypanosoma cruzi (American)
hardened red area(chagoma) with fever, malaise and swollen lymph nodes
HEart inflammation causing tachycardia and EKG changes
CNS- meningoencephalitis
resolves in a month and enters intermediate phase

71
Q

Describe presentation of chronic chagas disease

A

hear arrhythmias and dilated cardiomyopathy

megadisease of colon and esophagus

72
Q

How do you Dx Chagas

A

direct examination of blood for motile trypomastigotes

Xenodiagnosis: bugs feed on patient and one month later intestinal contents of bugs examined for parasite

73
Q

What could you get from intake of material infected with pig feces

A

Balantidium Coli
diarrhea
Tx with tetracycline

LAST EXAMMMMMM Year I (24 decks)

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