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infectious disease > protozoan infections > Flashcards

protozoan infections Flashcards

1
Q

unicellular eukaryote with ability to form cyst

A

protozoa

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2
Q

different protozoa classified by movement

A

amoebas
flagellates
ciliates
sporozoas

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3
Q

protozoa stage which is dormant and highly resistant to environmental stress

A

cyst stage

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4
Q

stage that is active, reproductive, and feeding. form that typically causes disease.

A

trophozoite

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5
Q
  • caused by entamoeba
  • tropical/subtropical regions
  • transmitted by ingestion of cysts
  • fecal oral contaminated food and water
    –> person to person
    –> flies
    –> human excrement as fertilizer
  • penetrates intestinal wall, possible resulting in dysentery or extra intestinal disease
  • extra intestinal disease = liver abscess
A

amebiasis

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6
Q

3 species of amebiasis

A

E histolytica
E dispar
E moshkovskii

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7
Q

most symptomatic disease of amebiasis caused by

A

E histolytica

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8
Q
  1. infection from ingestion of amebic cysts from fecally contaminated food/water
  2. cysts remain viable in environment for weeks to months
  3. cysts pass through stomach to small intestine, where they turn into trophozoites
  4. trophozoites invade and penetrate the mucous barrier of colon causing tissue destruction and increased intestinal secretion and leads to bloody diarrhea
A

entamoeba: amebiasis

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9
Q

how does entamoeba histolytic cause intestinal destruction

A
  1. secretes proteinases that destroy proteins
  2. amebapore formation which are pores in the lipid bilayer of intestine that leads to cellular destruction
  3. disrupts tight junction proteins resulting in increased intestinal permeability
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10
Q

entamoeba: amebiasis symptoms

A
  • most frequently asymptomatic
  • bloody diarrhea
  • abd pain
  • colitis
  • fever
  • intestinal perforation
    -mucosal sloughing
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11
Q

severe complication of entamoeba: amebiasis

A
  • abscesses due to hematologic spread
  • liver MC
  • hepatomegaly
    -RUQ pain
  • weight loss
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12
Q

how to diagnose intestinal amebiasis

A
  • stool microscopy
  • stool antigen testing
  • stool PCR (preferred)
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13
Q

how to diagnose hepatic abscess

A

-Ultrasound, CT, or MRI
- anti amebic antibodies in serum
- elevated liver enzymes

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14
Q

entamoeba: amebiasis treatment

A

metronidazole or tinidazole + luminal agent

luminal agents:
- diloxanide
- iodoquinol
- paromomycin

and fluid replacement

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15
Q

entamoeba: amebiasis treatment alternative

A

tetracycline + chloroquine

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16
Q
  • free living ameba
  • flagellate form
  • thermophilic organism found in soil, fresh and polluted warm lake water, domestic water supplies, swimming pools, thermal water, sewers
A

naegleria fowleri

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17
Q
  • fulminant CNS infection caused by N fowleri
  • aspiration of contaminated water or soil
  • recent swimming in lakes or heated swimming pools
  • tap water exposure through neti pots
  • rapidly fatal
A

primary amebic meningoencephalitis (PAM)

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18
Q

PAM symptoms

A

early: HA, fever, stiff neck, lethargy

1-2 days later: photophobia, palsies of 3,4,and 6 cranial nerves, N/V, behavioral abnormalities, seizures, AMS

7-10 days: coma, death

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19
Q

how to diagnose PAM

A
  • elevated intracranial pressure
  • CSF: high WBC, elevated protein, low glucose
  • purulent meningitis
  • relevant history
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20
Q

how to diagnose naegleri fowleri

A

detection of motile trophozoites in CSF
–> centrifuged CSF wet mount prep immediately after getting sample

MRI: extensive edema and necrosis of the front lobes

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21
Q

treatment of PAM due to N. fowleri
(uncertain)

A

combination of:
amphoterecin B
rifampin
fluconazole
miltefosine
azithromycin
steroids

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22
Q
  • protozoal infection of the upper small intestine caused by Giardia lamblia
  • flagellated
  • most common protozoan parasite infection in the US
  • poor sanitation areas (households, daycare, contaminated water, food, fecal oral route)
A

giardia

23
Q

how does Giardia infection occur

A
  1. ingestion of cyst
  2. bind to small intestines and excitation releases trophozoites. causes symptoms.
  3. trophozoites then multiply and pass to large intestine where they produce cysts
  4. infectious cysts passed in stool
24
Q

high risk groups for Giardia

A
  1. travelers to endemic areas
  2. those drinking from contaminated water during recreational wilderness travel
  3. partners performing anal intercourse
  4. impaired immunity
25
Q

giardia symptoms acute phase

A
  • profuse and watery diarrhea
  • usually self limited
  • lasts days or weeks
  • monitor for dehydration
26
Q

guardia symptoms chronic disease symptoms

A
  • abd cramping
  • bloating
  • flatus
  • malaise
  • anorexia
  • stools greasy, frothy, foul smelling*
27
Q

how to diagnose Giardia

A

PCR stool assays

28
Q

giardia treatment

A

metronidazole

29
Q

giardia treatment if pregnant

A

paromycin

30
Q

-infection caused by plasmodium species
- single cell parasite spread via mosquito
- P falciparum
- endemic to most to the tropics, south and central America, Middle East, India, Southeast Asia, Africa

A

malaria

31
Q

human phase of malaria

A

asexual phase

32
Q

mosquito phase of malaria

A

sexual phase

33
Q

infected RBC stages of malaria

A
  1. early trophozoite: ring form
  2. late trophozoite: growing ring form
  3. further trophozoites growth digestion of HGB and leave behind hemozoin (schizont) (replicative phase)
  4. rupture
34
Q

hallmark of malaria

A

history of travel to endemic area

35
Q

uncomplicated malaria symptoms

A

anemia
jaundice
hepatomegaly
splenomegaly

36
Q
  • generates a sticky protein that coats the surface of the RBC
  • organ dysfunction
  • neurologic disease
  • severe anemia
  • hypotension/shock
A

severe complicated malaria

37
Q

how to diagnose malaria

A
  • Giemsa stained blood smears
  • rapid antigen test for plasmodium is alternative but can have false negative for P. falciparum
38
Q

treatment for P malariae

A

chloroquine

39
Q

treatment for P vivax or P ovale

A

chloroquine + primaquine (check G6PD)

40
Q

uncomplicated P falciparum malaria treatment

A

artemether lumefantrin

41
Q

severe malaria treatment

A

IV/IM artesunate

42
Q
  • caused by protozoal species toxoplasmosis gondii
  • found worldwide in humans, mammals, and birds
  • cats definitive host
  • mild fever, fatigue, non tender lymphadenopathy
A

toxoplasmosis

43
Q

4 clinical syndromes of T gondii

A
  1. primary infection in immunocompetent person: asymptomatic may be mild febrile illness
  2. congenital infection: maternal infection during pregnancy
  3. retinochoroiditis: symptoms present weeks to years after congenital infection
  4. disease in immunocompromised person
44
Q

1st stage of toxoplasmosis

A

primary infection in immunocompetent person

45
Q

2nd stage of toxoplasmosis

A

congenital
Hallmarks:
- the congenital triad: chorioretinitis, hydrocephalus, intracranial calcifications**
- blueberry muffin rash: thrombotic thrombocytopenia purpura

46
Q

3rd stage of toxoplasmosis

A

retinochoroiditis (ocular toxoplasmosis)
- inflammatory condition affecting the retina and choroid in the eye

47
Q

4th stage of toxoplasmosis

A

disease in the immunocompromised person
- reactivation in AIDS, cancer, and immunosuppressive drugs pts

48
Q

how to diagnose toxoplasmosis

A

serologic testing
- presence of IgM and/or IgG
- confirm IgG antibodies in 2 weeks

histopathologic examination
- tissue, blood, sputum, etc stained with standard histologic dyes looking for tachyzoites and or cysts

49
Q

toxoplasmosis treatment

A

immunocompetent: tx not neccessary

severe: pyrimethamine plus sulfadiazine with folinic acid

50
Q

what should pregnant women not do to prevent toxoplasmosis

A

don’t change cat litter box

51
Q
  • STD caused by protozoal trichomonas vaginalis
  • Male: nongonoccal urethritis, minimal discharge
  • female: vaginitis with copious discharge, malodorous, frothy, and yellow/green color
A

trichomoniasis

52
Q

how to diagnose trichomoniasis

A
  • wet mount= motile organism
  • point of care antigen and nucleic acid amplification assays
53
Q

trichomoniasis treatment

A

metronidazole
tinidazole

infectious disease (12 decks)

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