Protozoa Penyebab Infeksi Sistem Saraf

Question 1

Toxoplasma gondii
Hospes definitif?
Hospes perantara?

Answer 1

HD -> kucing, binatang sejenis
HP -> manusia, mamalia, burung

HD: host tempat reproduksi seksual
HP: host tempat berkembang tp tidak sampai kematangan seksual

Question 2

T. gondii, morfologi:
-Ookista?
-Takizoit?
-Kista?

Answer 2

-Lonjong
-Bulan sabit, 1 ujung runcing 1 bulat, inti di tengah
-Di otak bulat, di otot mengikuti sel otot

Question 3

T. gondii, cara infeksi (5)

Answer 3

-Kongenital
-Akuisita
-Lab
-Transplan organ
-Transfusi darah

Question 4

T. gondii, gejala klinis:
Lesi SSP?
Lesi retina?
Organ lain yg kena apa aja?

Answer 4

-Lesi SSP-> nekrosis, kalsifikasi, penyumbatan aquaductus sylvii -> hidrosefalus bayi
-Lesi retina-> edema, infiltrasi lekosit -> sikatrik, atrofi retina+koroid (Chorioretinitis), pigmentasi
-Organ lain: jantung, limpa, hati

Question 5

T. gondii, patfis?

Answer 5

Invasi usus -> difagosit -> ada yg mati ada yg berkembangbiak -> penyebaran hematogen+limfogen (parasitemia bbrp minggu) -> kista jaringan terbentuk stlh kekebalan

Question 6

T. gondii, congenitally infected children may suffer what? (2)

Answer 6

-Impaired vision
-Mental retardation

Question 7

T. gondii, faktor yang mempengaruhi kerusakan jaringan

Answer 7

-Umur
-Virulensi strain toxoplasma
-Jumlah parasit
-Organ yang diserang

Question 8

Manifestasi toxoplasmosis akuisita (4)

Answer 8

-Lelah
-Demam
-Cephalgia
-Exanthema

Question 9

Toxoplasmosis kongenital, tetrade sabin apa aja?

Answer 9

1. Hidrosefalus
2. Retinokoroiditis
3. Kalsifikasi intrakranial
4. Kelainan psikomotorik

Question 10

T. gondii, diagnosis takizoit gimana caranya?

Answer 10

Biopsi otak/sumsum tulang/LCS

Question 11

T. gondii, diagnosis tes serologis (4)

Answer 11

1. Sabin Feldman
2. IHA
3. IFA (IgM)
4. ELISA (IgM)

Question 12

T. gondii, infeksi akuisita interpretasi diagnosisnya dari IgG?

Answer 12

IgG tinggi 2x pemeriksaan, >= 3 minggu atau konversi dari negatif ke positif

Question 13

T. gondii, infeksi kongenital interpretasi diagnosisnya dari IgG dan anti IgM?

Answer 13

Anti IgM (+), IgG tetap dan naik pd 2-3 bulan

Question 14

T. gondii, terapi takizoit?

Answer 14

-Primetamin + Sulfonamid +As. folat
-Klindamisin
-Klaritromisin + azitromisin
-Atovaquone
-Spiramisin -> wanita hamil
-Yang wajib-> ibu hamil infeksi primer, kongenital, imunokompromaise

Question 15

T. gondii, diuji PCR pada pasien apa saja (4)

Answer 15

-Prenatal
-Postnatal
-Hamil
-Imunokompromais

Question 16

Granulomatous Amebic Encephalitis, etiology? (what species)

Answer 16

Acanthamoeba
-culbertsoni
-polyphaga
-castellanii
-astronyxis

Question 17

Acanthamoeba species, morphology:
Trofozoit?
Kista?

Answer 17

Trofozoit: irreguler
Kista: 2 lapis (ektokis, endokis)

Question 18

Acanthamoeba sp. , entry points to human body (3)

Answer 18

-eye
-nasal->LRT
-ulceration/broken skin

Question 19

Acanthamoeba sp. patfis?

Answer 19

Invasi jaringan -> granuloma (lama, kronis, minggu-bulan)

Question 20

GAE, clinical manifestation? (7)

Answer 20

-Fever
-Loss of coordination
-Muscular weakness / partial paralysis affecting 1 side of body
-Double vision
-Sensitivity to light
-Other neurologic problem

Question 21

GAE, diagnostic test? (3)

Answer 21

-Amoeba in LCS
-Brain scan
-Biopsy

Question 22

GAE, terapi?

Answer 22

-Ketoconazole
-Rifampin
-Trimethroprim-sulfamethoxazole
-Fluconazole, sulfadiazine
-Pentamidine, amphotericin, flucytosine, rifampin, itraconazole, chlorhexidine

Question 23

Primary Amebic Meningoencephalitis, protozoa etiology?

Answer 23

Naegleria fowleri

Question 24

N. fowleri lokasi utama di daerah kyk gmn?

Answer 24

daerah hangat musim panas

Question 25

3 form N. fowleri?

Answer 25

Cyst, trophozoite, flagellate

Question 26

Resistant form of N. fowleri?

Answer 26

Cyst

Question 27

Vegetative/feeding stage of N. fowleri?

Answer 27

Trophozoite

Question 28

Temporary form of N. fowleri which it nether feeds nor divides?

Answer 28

Flagellate

Question 29

N. fowleri morfologi
Cyst?
Trophozoite?
Flagellate?

Answer 29

-Bulat, double layer, ada porus
-Memanjang, anterior luas posterior runcing, kariosom besar sentral dan halo (daerah jernih) di sekelilingnya
-Pear shaped, flagel keluar dari anterior

Question 30

PAM, N. fowleri migrate to brain via which nerve?

Answer 30

Olfactory nerves

Question 31

Patfis PAM?

Answer 31

Invasi -> sekresi mukus -> parasit menembus epitel mukosa -> menembus plexus nervus, lamina cribiform, sampai subarachnoid space -> glukosa, protein, o2 tinggi dukung perkembangbiakan parasit -> trofozoit masuk ventrikel lewat foramen luschka dan magendie -> choroid plexus -> rusak ependym ventrikel 3,4, lateral -> ependymitis akut

Question 32

N. fowleri causes necropsy, explain

Answer 32

Daerah otak terinfeksi jadi lunak, selaput hiperemis purulen terutama di s. grisea

Question 33

N. fowleri can be found in which sinus? (2)

Answer 33

maxillaris dan sphenoidalis dengan eksudat

Question 34

PAM gejala (6), akut/kronis?

Answer 34

-demam
-mual
-parosmia
-ageusia
-koma
-kejang

gejala akut

Question 35

Terapi PAM california and mexico

Answer 35

C+M:
-Amphotericin B
-Rifampicin
-Dexomethasone

C:
-Miconazole (no longer available)
-Sulfisoxazole (discontinued after Naegleria diagnosed)
-Phenytoin

M:
-Fluconazole
-Ceftriaxone

Question 36

Malaria Cerebral, explain what it is

Answer 36

Perubahan kesadaran penderita dengan parasitemia oleh f. falciparum dan tidak ditemukan penyebab lain dari perubahan kesadaran itu

Question 37

Malaria cerebral terjadi jika infeksi P. falciparum menginefksi eritrosit > brp persen?

Answer 37

5%

Question 38

Klinis malaria cerebral (4)

Answer 38

-Koma dalam
-konvulsi
-nistagmus
-peningkatan icp
-dll

Question 39

Abses otak amoeba, terjadi akibat penyebaran secara…dari organ…

Answer 39

hematogen, hati/paru