random parasite facts

Question 1

5 flukes. Location, organism, sx. How do you treat flukes?

Answer 1

• Schistosomes are from snails
• Tx: praziquantel
• Urinary schistosomiasis
  
  • S. haematobium
  • Africa
  • Hematuria, dysuria, hydronephrosis, pyelo
  • Risk for SCC of bladder
• Intestinal
  
  • S. mansoni
  • Africa
  • Diarrhea, abdominal pain, intestinal ulceration/malabsorption
  • Iron deficiency anemia
• ​Hepatic
  
  • S. japonicum
  • Hepatosplenomegaly
  • Periportal fibrosis, portal htn
• Liver fluke
  
  • Clonorchis sinensis from undercooked fish
  • hangs out in biliary tract; gallstones, risk for cholangiocarcinoma
• Lung fluke
  
  • Paragonimus
  • Lung inflammation with hemoptysis

Question 2

Giardia vs Entamoeba histolytica on microscopy?

Answer 2

Giardia trophozoite: 2 nuclei

E. histolytica trophozoite: 4 nuclei

Cyst for both has 4 nuclei.

Question 3

Name the important cestodes. How do you treat them?

Answer 3

• Treat with praziquantel, except for echinococcus granulosus, which you treat with albendazole.
• Taenia solium - pigs - cysticercosis
• Taenia saginata - cows
• Diphyllobothrium - fish - B12 deficiency
• Echinococcus granulosus - hyatid cysts - anaphylaxis

Question 4

Protozoa. How do you treat them?

Leishmania, Toxo, Cruzi, Brucei, Giardia, Entamoeba, Cryptosporidium

Answer 4

• Leishmania
  
  • macrophage contains amastigotes
  • sandfly
  • spiking fevers, hepatosplenomegaly, pancytopenia
  • sodium stibogluconate
• Trypanosoma cruzi - Chagas - nifurtimox
• Trypanosoma brucei - sleeping sickness - suramin/melarsoprol
• Toxo - pyrimethamine, sulfadiazine
• Giardia - metronidazole
• Entamoeba - eats RBCs - metronidazole
• Cryptosporidium - nitazoxanide in immunocompromised