Quiz

Question 1

Describe the life cycle of Ascaris lumbricoides

Answer 1

Eggs in feces → Contaminated food/water introduce eggs via oral route → Once swallowed, eggs hatch and larvae invade intestinal mucosa → Follow portal circulation to the lungs → Larvae mature in the lungs where they go up the bronchial tree → Coughing pushes the worms up and into the throat where they are swallowed and will stay/grow in the intestines (and lay more eggs) → Live for 1-2 years

Question 2

What are the four main types of organisms that cause intestinal parasitosis?

Answer 2

a. Protozoa
b. Cestodes (tapeworms)
c. Trematodes (flukes)
d. Nematodes (worms that have long, round, unsegmented bodies)

Question 3

The _____ protozoa responsible for malaria undergoes _____ reproduction in humans, and _____ reproduction in mosquitoes.

Answer 3

a. Plasmodium
b. Asexual
c. Sexual

Question 4

Explain the two types of blood smears used to help diagnose malaria.

Answer 4

a. Thick smear - uses a larger volume of blood on the slide; is a more sensitive test to detect the presence of parasites
b. Thin smear - blood is smeared across the slide to form a very thin layer and is fixed in methanol before staining; is useful for differentiation of species

Question 5

What are the two main goals of migraine treatment? Give an example agent for each goal

Answer 5

a. Prophylactic (migraine prevention) → ex:Botox (Onabotulinumtoxin A)
b. Abortive (treatment/relief of symptoms) → ex:Triptans (such as sumatriptan)
i. Other examples: NSAIDs, opioids, any combination products with NSAIDs/opioids/triptans

Question 6

List 3 signs/symptoms of thyroiditis

Answer 6

a. fever 100.4-104 degree F
b. difficulty swallowing
c. lymphadenopathy
d. goiter

Question 7

__________ thyroiditis is an __________ disease in which the thyroid gland is attacked by a variety of cell- and antibody-mediated immune processes, causing primary __________.

Answer 7

a. Hashimoto’s
b. autoimmune
c. hypothyroidism

Question 8

What is another name for angioedema?

Answer 8

Quincke’s edema

Question 9

List 3 non-pharmaceuticals used to treat migraine.

Answer 9

a. drink water to avoid dehydration
b. rest in a dark room
c. place a cool cloth on the head
d. regular sleep and exercise
e. decrease caffeine intake

Question 10

__________ are __________ __________ __________ used as first line __________ migraine treatment; they narrow (constrict) blood vessels in the brain and relieve swelling.

Answer 10

a. triptans
b. serotonin receptor agonists
c. abortive

Question 11

What class is used as a first line treatment of A. lumbricoides? What is an alternative for pregnancy?

Answer 11

Benzimidazoles; Piperazine citrate

Question 12

What does microcytic normochromic anemia mean as far as the red blood cells?

Answer 12

Smaller red blood cells with normal amounts of hemoglobin within them.

Question 13

What are 3 signs/symptoms of SLE?

Answer 13

Fatigue, low grade fever, severe joint pain/muscle aches, butterfly rash on face, chest pain, sun sensitivity

Question 14

What is a possible cause of a malaria infection?

Answer 14

Organ transplant, blood transfusion, sharing needles or needle pricks

Question 15

What is migraine aura?

Answer 15

The person can tell that a migraine will occur in the near future

Question 16

Briefly explain the mechanism behind ACE-inhibitors causing a dry cough.

Answer 16

While ACE-inhibitors decrease Angiotensin II, they increase Bradykinin

Question 17

Name 2 out of 4 treatments that can be used as migraine prophylaxis.

Answer 17

Botox, Ibuprofen, Cefaly, Propranolol

Question 18

What is the first line treatment for Ascaris Lumbricoides infection?

Answer 18

In both adults and pediatric patients older than 2 years of age, the treatment for Ascariasis is Mebendazole (Vermox) 100 mg BID x 3 days

Question 19

What are the signs and symptoms of a Norovirus infection?

Answer 19

a. Sudden onset with an incubation period of ~24 hours
b. one or more of the following symptoms: nausea, vomiting, abdominal cramps and diarrhea
c. Vomiting is more prevalent in children; diarrhea is more prevalent in adults
d. headache, fever, chills and myalgia

Question 20

Briefly describe the route of transmission and infection in malaria

Answer 20

a. Female anopheline mosquito inoculates plasmodial sporozoites from its salivary gland during a blood meal
b. Microscopic motile forms of the malarial parasite are carried rapidly via the bloodstream to the liver, where they invade hepatic parenchymal cells and begin a period of asexual reproduction. A single sporozoite eventually may produce from 10,000 to >30,000 daughter merozoites.
c. The swollen infected liver cell eventually bursts, discharging motile merozoites into the bloodstream.
d. These merozoites then invade the red blood cells (RBCs) and multiply six- to twentyfold every 48–72 h.
e. When the parasites reach densities of ∼50/μL of blood (∼100 million parasites in the blood of an adult), the symptomatic stage of the infection begins.

Question 21

What drug class is commonly implicated in angioedema? What is the drug’s mechanism of action for causing angioedema?

Answer 21

Angiotensin converting-enzyme inhibitors; elevated levels of bradykinin occur due to ACE inhibition, which enhances vascular permeability to allow flow of plasma from the vasculature to the interstitial compartment.

Question 22

What drugs or drug classes may be used to treat severe angioedema?

Answer 22

epinephrine, corticosteroids, antihistamines

Question 23

What is the definitive technique for diagnosing Ascariasis?

Answer 23

Detection of Ascaris lumbricoides eggs in the stool

Question 24

What are some complications of Ascariasis?

Answer 24

a. Intestinal obstruction
b. Biliary obstruction
c. Appendicitis
d. Intestinal perforation
e. Eosinophilic pneumonia
f. Nutritional impairment (esp. in children)

Question 25

In what percent of patients do severe complications of Ascariasis occur?

Answer 25

Less than 0.1%

Question 26

What is the mechanism of action for the benzimidazoles?

Answer 26

Binds to tubulin and inhibits synthesis of microtubules

Question 27

What is the mechanism of action for Botox?

Answer 27

Acts at presynaptic neuromuscular junctions to prevent calcium dependent release of acetylcholine, relaxing muscles.

Question 28

What is the special consideration for albendazole in terms of pregnancy?

Answer 28

Avoid pregnancy for 1 month after discontinuing the drug

Question 29

Tapeworms belong to the group known as _______ while flukes belong to the group known as .

Answer 29

cestodes/trematodes

Question 30

List 2 significant diagnoses from MW’s PMH.

Answer 30

Anasarca

Acute Thyroiditis