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Infectious diseases > protozoa > Flashcards

protozoa Flashcards

1
Q

Parasites are divided to

A
  1. Protozoa

2. Helminthes

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2
Q

Protozoa infections are divided to

A
  1. GI infections
  2. CNS infections
  3. Hematologic infections
  4. other infections (visceral infections and STD)
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3
Q

Protozoa GI infections - bugs and diseases

A
  1. Giardia lamblia - giardiasis
  2. Entamoeba histolytica - amebiasis
  3. Cryptosporidium - diarrhea
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4
Q

Giardia lamblia - disease and symptoms / seen in

A

Giardiasis: 1. bloating 2. flatulence
3. foul smelling, fatty diarrhea
campers + hikers

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5
Q

Giardia lamblia - transmission / diagnosis / treatment

A

cysts in water
multinucleated trophozoites or cysts in stool
treatment: metronidazole

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6
Q

Entamoeba histolytica - disease and symptoms

A

Amebasis: 1. bloody diarrhea (dysentery)

  1. liver abscess (anchovy paste exudate)
  2. RUG pain
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7
Q

Entamoeba histolytica - transmission / treatment

A

cysts in water
treatment: metronidazole
or iodoquinol for asymptomatic cyst passers
- a luminal agent, eg. paromomycin) is also recommended to eradicate intestinal colonizationcyst
- drainage is not recommended

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8
Q

Entamoeba histolytica infection - diagnosis

A
  • serology and/or
  • trophozoites with RBCs in the cytoplasm
    or cysts with up to 4 nuclei in stool
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9
Q

Cryptosporidium - disease and symptoms

A 
severe nonbloody diarrhea in AIDS
Mild disease (watery diarrhea) in immunocompoment
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10
Q

Cryptosporidium - transmission / diagnosis

A

oocysts in water

diagnosis: oocysts on acid-fast stain

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11
Q

Cryptosporidium - treatment/prevention

A

prevention by filtering city water supplies
notazoxamide in immunocompetent hosts
no clear treatment for AIDS patient

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12
Q

Protozoa - CNS infection - bugs and diseases

A

Toxoplasma gondi - toxoplasmosis
Naegleria fowleri - rapidly fatal meningoencephalitis
Trypanosoma brucei - African sleeping diseas

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13
Q

Toxoplasma gondi infection and symptoms

A
  1. Congenital toxoplasmosis –> classic triad of chorioretinitis, hydrocephalus, intracranial calcification
  2. reactivation in aids –> brain abscess
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14
Q

Toxoplasma gondi transmission

A

cysts in undercooked meat (MC)
oocysts in cat feces
crosses placenta

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15
Q

Toxoplasma gondi - diagnosis

A

serology
biopsy (tachyzoite)
CT/MIR ring-enhancing lesion

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16
Q

Trypanosoma brucei - disease and symptoms

A

African sleeping disease: 1. enlarged lymph nodes

2. recurring fever 3. somnolence 4. Coma

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17
Q

African sleeping disease - transmission / diagnosis

A

Tsetse fly, a painful bit

diagnosis: Trypomastigote in blood smear

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18
Q

African sleeping disease - treatment

A

suramin for blood-borne disease

melarsoprol for CNS penetration

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19
Q

Naegleria fowleri - diagnosis

A

amoebas in spinal fluid

20
Q

Malaria - fever according to bug

A

P. vivax/ovale –> 48hr cycle (tertian: fever on first day and third day, thus fever are actually 48hr apart)
P. falciparum –> severe. irregular fever pattern
P. malariae –> 72 hr cycle (quartan)

21
Q

other complications of malaria, beside general symptoms

A

occlude capillaries in brain (cerebral malaria), kidney, lung (esp with P. Falciparum)

22
Q

Malaria - relapse vs recrudescence

A

Relapse occurs in P. vivax and P. ovale infection ressults from hypnozoites –> reactivation of hypnozoites in liver
Recrudescence occurs in P. malariae and P. falciparum infections and results from incomplete eradication of the parasites

23
Q

Malaria - diagnosis

A
  1. Blood smear: trophozoites ring within RBCs, schizont containing merozoites
  2. Red granules (Schuffner stippling) through RBC cytoplasm seen with P. vivax/ovale
24
Q

Malaria - treatment for every situation

A
  1. Chloroquine (for sensitive species)
  2. Mefloquine or atovaquone/proquanil (for resistant)
  3. IV quinidine or artesunate (If life threatening) –> test for G6PD
  4. P. vivax/ovale add primaquine for hypnozoite –> test for G6PD
25
Q

Protozoa visceral infections - bugs and disease

A
  1. Trypanosoma cruzi –> Chagas disease

2. Leishmania donovani –> Visceral leishmaniasis (kala-azar), cutaneous leismaniasis

26
Q

Leishmania donovani - disease and symptoms / aka

A 
A. Visceral leishmaniasis (kala-azar): 
1. spiking fevers
2. hepatosplenomegaly 
3. pancytopenia 
B. cutaneous leismaniasis: 1. Skin ulcers
27
Q

Leishmania donovani - transmission

A

sandfly

28
Q

Visceral leishmaniasis (kala-azar) - diagnosis / treatment

A

macrphages contating amastigotes
amphotericin B
sodium stibogluconate

29
Q

Trypanosoma cruzi - disease / map / transmission

A

Chagas disease
SOUTH AMERICA
transmission: Reduviid bug (kissing bug) feces, deposited in a painless bite

30
Q

Chagas disease sign

A

ROMANA SIGN: unilateral periorbital swelling –> characteristic of acute stage

31
Q

chagas disease - diagnosis / treatment

A

Trypomastigote in blood smear

- Benzidazole or nifurtimox

32
Q

Protozoa sexual transmitted infections - bugs and disease / symptoms

A

Trichomonas vaginalis –> vaginitis –> foul-smelling, greenish discharge, itching and burning

33
Q

bacterial vaginosis vs protozoal vaginitis according to

A

vaginitis: foul-smelling, greenish discharge, itching and burning
Bcterial vaginosis: gray vaginal discharge with fishy smell, nonpainful

34
Q

Trichomonas vaginalis - outside human form

A

cannot exits outside human because it cannot form cysts

35
Q

Trichomonas vaginalis - diagnosis / treatment

A

trophozoites (motile) on wet mount
strawberry cervix
- Metronidazole for patient and partner (prophylaxis)

36
Q

treatment for all protozoal infections (except malaria)

A

Giardiasis –> Metronidazole
amebiasis –> metronidazole, iodoquinol for asymptomatic cyst passers
cryptosporidium –> prevention by filtering city water supplies, nitazoxanide in immunocompetent, no clear treatment for aids
Toxoplasma gondi –> Sulfadiazine+pyrimethamine
Naegleria fowleri –> Amphotericin B
Trypanosoma brucei –> Suramin for blood-borne disease or melarsoprol for CNS penetration
Babesia –> atovaquone + azithromycin
Tripanosoma cruzi –> Benzidazole or nifurtimox
Leishmania donovavi –> amphotericin sodium stibogluconate
trichomonas vaginalis –> Metronidazole for patient and partner (prophylaxis)

37
Q

Babesiosis - epidimiology / diagnosis

A

ixode scapularis like lyme and anaplasmosis

thin blood smear: intraerythrocytic rings (Maltese cross)

38
Q

Babsiosis - manifestation

A
  • flu like
  • if severe: ARDS, CHF, DIC, splenic rupture
  • anemia, thrombocytopenia, increased bilirubinm LDH, LFTs
39
Q

Babesia - treatment

A
  • atovaquone + azithromycin

- Quinine + clindamycin (if severe)

40
Q

RFs for severe babesiosis

A
  1. immonucompr
  2. splenectomy
  3. older than 50
41
Q

complications of malaria in children

A

seizure, coma, hypoglycemia, met acidosis

42
Q

complications of malaria in adults

A

jaundice, acute renal failure, acute pulm edema

43
Q

C. parvum in immunocomprement

A

traveler’s diarrhea - prolonged, profuse, watery - self limited in 10-14 days

44
Q

E. histolytica - most common symptom

A

asymptomatic (only 10% has colitis) `

45
Q

malaria prevention

A

travelers new to endemic areas require chemoprophylaxis
atovaquone - proguanil, doxycycline or melfoquine (2 weeks prior to travels, continued during statyy, discont 4 weeks after returning
other measures to protect from mosquitos

46
Q

toxoplasmic encephalitis - stereotactic brain biopsy

A

only if not respond to antibiotic

Infectious diseases (13 decks)

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