Protozoa II

Question 1

What is leishmania an intracellular pathogen of?

Answer 1

macrophages

Question 2

What does leishmania become in a macrophage?

Answer 2

amastigote

Question 3

What is the immunity for leishmania?

Answer 3

TDTH

Question 4

What is leishmania transmitted by?

Answer 4

sandflies (africa/asia, south america tropical and subtropics)

Question 5

When is leishmania epidemic?

Answer 5

sand flies are in large numbers

Question 6

Are leishmania amastigotes in sandflies?

Answer 6

no they are promastigotes

Question 7

What are the stages of leishmania 7?

Answer 7

sandfly takes bloood–> promastigotes phago. by macrophages–> transform into amastigotes—>multiply in various cells—>sandfly takes blood meal and ingests macrophage–> amastigotes transform into promastigote stage in sandfly gut—>migrate to proboscis

Question 8

A variety of leishmania species including tropica and brazilienes cause what?

Answer 8

cutaneous leishmania- papules that turn red, ulcerates, forms satellite lesions (contained by Th1 after months)[oriental ulcer, chiclero ulcer, Baghdad boil]

Question 9

What does leishmania donovani cause? immunity? called what?

Answer 9

visceral leishmaniasis- immune sytem is not responsive, spectrum illness called Kala Azar (twice daily fevers)

Question 10

What leishmania causes mucocutaneous diseases?

Answer 10

braziliensis

Question 11

How long do sores take to develop after sandfly bite?

Answer 11

few weeks or months

Question 12

Can leishmania sores change in size and appearance over time

Answer 12

yes- start as papules or nodules and may end up as ulcers

Question 13

Are leishmania sores painless ? Do some peoples glands swell?

Answer 13

yes usually but some can be painfulyes near the sore

Question 14

Visceral leishmaniasis infects what organs to be life threatening? how long to develop?

Answer 14

1. usually spleen, liver and marrow2. Months to years

Question 15

Visceral leishmaniasis people present with what?

Answer 15

fever, weight loss, enlargement of liver/spleen, low blood counts and low platelets

Question 16

How do we prevent mucosal leishmaniasis?

Answer 16

ensure adequate treatment of original cutaneous infection

Question 17

How do we diagnose leishmaniasis?

Answer 17

lesions, biopsy, and antibody tests

Question 18

What are the 3 main treatments of leishmaniasis?

Answer 18

1. pentavalent antimonial compounds (not in US but can use sodium stibogluconate from CDC)2. liposomal amphotericin B (IV, visceral leish.)3. Miltefosine (cut. visa. and mucosal)

Question 19

Does amphotericin B deoxycholate and pentamidine isethionate as well as the azoles (ketoconazole, itraconazole and fluconazole) have merit for treating selected cases of leishmaniasis?

Answer 19

Yes-

Question 20

Is aminoglycoside paromomycin available in the US?

Answer 20

No

Question 21

What does trypanosome brucei cause?

Answer 21

african sleeping sickness

Question 22

What doe trypanosoma cruzi cause?

Answer 22

american trypanosomiasis (Chaga’s disease)

Question 23

What is african sleeping sickness transmitted by

Answer 23

Tse Tse fly

Question 24

What is Chaga’s transmitted by?

Answer 24

sucking/ kissing/ assassin bugs (Reduviid bugs)

Question 25

Where are bugs related to Chaga's found?

Answer 25

dirt floors of South/Central America, Southwest US

Question 26

What are the 2 forms of african sleeping sickness?

Answer 26

slow progressing chronic (west africa) and Acute 9 months (east africa)

Question 27

What are the symptoms of african sleeping sickness-

Answer 27

primary lesion around bite, fever, cervical lymphadenopathy, mental problems leading to death.

Question 28

What is interesting about african sleeping sickness surface glycoprotein?

Answer 28

variable- programmed set of changes, leading to IgM and then new waves; treated with a variety of drugs

Question 29

What is romana's sign and what disease has it?

Answer 29

conjunctivitis and swelling in American Trypanosomiasis

Question 30

What type of lesion does American trypanosomiasis have?

Answer 30

Chagoma primary lesion

Question 31

What disease has a lot of nonspecific effects that may lead to meningitis acutely or heart failure?

Answer 31

American trypanosomiasis (chaga's)

Question 32

What does american trypanosomiasis chronic disease lead to?

Answer 32

cardiac destruction, megaesophagus, megacolon

Question 33

What is american trypanosomiasis disease diagnosed with?

Answer 33

blood smear and at least two antibody tests

Question 34

What is american trypanosomiasis treated with?

Answer 34

nifurtimox or benznidazole