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Block 7 Week 4 > Schistosomiasis -Hunter > Flashcards

Schistosomiasis -Hunter Flashcards

1
Q

What is the risk of schistosomiasis (blood fluke)

A

1/6th of worlds pop

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2
Q

What are the major parasites that cause schistosomiasis?

A

Schistosoma mansoni; S. japonicum; S. haematobium

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3
Q

What are the minor parasites that cause schistosomias?

A

S. mekongi, S. intercalatum

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4
Q

S. manson and S. intercalatum is most commonly located in what country?

A

subsaharan Africa and western hemisphere of S. America

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5
Q

S. haematobium is limited to (blank) and is considered the (blank) schistosoma

A

Africa

urinary

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6
Q

S. Japoncium is found where?

A

china, philliapenes

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7
Q

Where do you find S. mekongi?

A

vietnam

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8
Q

Are the life cycles of the schistosomes similiar?

A

yes

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9
Q

Schistosoma is acquired through (blank)

A

wading through water

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10
Q

What is the life cycle of schistosomes?

A

cercariae enter skin-> migrate to lungs then liver-> then to mesentaric veins-> adults develop here -> males and females copulate and make eggs-> enter intestine-> passed in feces

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11
Q

Are schistoma mansoni eggs large?

A

yes

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12
Q

What is the female version of shistosomes and what does it need to survive

A

miracidia-> needs to be in a snail to survive

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13
Q

What am I talking about:

you need snails and a bad sewer system to have this pathogen survive

A

Schistosoma mansoni

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14
Q

The schistosoma egg cannot hatch until it hits (blank)

A

water

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15
Q

Adult schistomsome are (blank) to the immune system, the eggs are not

A

invisible

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16
Q

Since eggs of schistosomes have to erode its way through the blood vessel and into the bowel, eggs release (blank)

A

enzymes (this are crazy immunogenic)

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17
Q

In S. mansoni, what snail do you need for it to survive?

A

biomphalaria

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18
Q

In S. hematobium, what snail do you need for it to survive?

A

Bulinus

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19
Q

In S. Japonicum, what snail do you need for it to survive?

A

oncomelania

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20
Q

cercariae have a head that senses (blank)

A

amino acids

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21
Q

Use the names of schistosomes to describe life cycle:

A

cercariae- shistosomula- miracidia and cecariae

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22
Q

THe males shcistomsoma mansoni have 2 suckers that do what?

A

link them to the mesentaric veins.

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23
Q

How do the worms hide from the immune system?

A

worms have skin or tegument that allows them to acquire host moecules (such as RBC, glycotproeins and MHC molecules) (makes an antigenic disguise)

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24
Q

Cercarial penetration of skin can cause a transient (blank)

A

dermatitis

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25
Migration of (Blank) through lungs can cause (blank) that can be severe in heavy infections
schistosomules | pneumonitis
26
What adult worms do you find in the superior mesentaric veins?
mansoni and japonicum
27
What adult worms do you find in the vesicle plexus of bladder?
hematobium (cause no clinical symptoms)
28
Onset of egg production causes (blank)
katayama fever (allergic response)
29
Intestinal or urinary bladder symptoms are due to eggs passing though tissue to lumen-> which can result in what?
severe hemorrhagic cystitis | gastroenteritis
30
Eggs swept up into portal circulation to liver cause (blank) and a (blank)
granulomas | T-cell mediated delayed hypersensitivity reaction to eggs
31
Blockage of sinusoids by eggs leads to (blank) and (blank)
pipestem fibrosis | portal hypertension
32
What are the cinical and lab findings of schistosomiasis?
Hepatosplenomegaly Eosinophilia hyperimmunoglobulinemia
33
With portal hypertension you wil get (blank), so some patients with schistosomiasis will have this.
ascites
34
In schistosoma mansoni, Eggs will cause fibrotic liver which will cause (blank)
pulmonary hypertension
35
What do the schistosoma mansoni eggs look like
like a chicken head with a beak
36
Schistosoma hematobium are distinguished in a H and E by...
have a spine at the ends of their egg
37
If you see blood/burning in the urine then you should think of what schistoma?
schistosoma hematobium
38
Schistosoma hematbium is acquired in (blan)
africa
39
What do the eggs of schistosoma japonicum?
small, no lateral spine and a tiny penis looking thing
40
How do you treat schistomas?
praziquantel
41
How can the immune system kill a schistocyte?
if the schistocyte has an IgG switch to IgE and immune system recognizes and attacks via granule release
42
Wht are the four malarial parasites?
Plasmodium vivax Plasmodium ovale Plasmodium malariae Plasmodium falciparum
43
What is this: | sporocytes enter the skin and go straight to the liver and will rupture the hepatocyte and flood into the blood
Malaria
44
The leading cause of sepsis and septic shock is (blank)
malaria
45
What is the life cycle of plasmodium?
sporozites are injected into skin via mosquito-> merozites enter bloodstrem-> goes to liver-> ruptures heptocytes which releases merozoites->enters blood
46
(blank) form of plasmodium is what infects RBCS-> binds to target receptors of RBC and can get into it without rupture the RBC.
merozoite
47
Malaria is a (Blank) disease with many clinical manifestatins caused by proinflamatory and pyrogenic cytokines such as (blank)
systemic inflammatory disease | TNF-alpha
48
Where do you classical fever paroxysm?
``` malaria P-falciparum-daily P. Vivax- every other day P. Ovale- every other day P. Malaria-> every third day ```
49
What are important clinical and laboratory findings of malaria?
hepatosplenomegaly, anemia, hyperimmunoglobulinemia
50
What is the disease sequellae of malaria?
glomerulonephritis, nephrosis, cerebral malaria (most organ systems affected)
51
(blank) malarias relapse due to liver hypnozites that restablish infection
Vivax and Ovale
52
(blank) do not relapse but they can recrudesce (subclinical infection becomes active clinical disease)
Falciparum and malariae
53
Explain how malaria works
It is an intracellular amoebae which grows within the RBC by consuming the globin portion of hemoglobin leaving behind a black pigement-> eventually the RBC ruputre and the produced merocyte go out and infect other RBCs.
54
What is happening when you have rigors in malaria?
RBC are rupturing
55
What are the stages of malaria
Cold stage-> hot stage-> diaphoresis
56
What are the relapsing malarias?
P. vivax and P ovale
57
What are the recrudescing malaria?
p. falciparum and p malariae
58
A patient with plasmodium falciparium is the most common cause of (blank) and (Blank) in the world
sepsis and septic shock
59
Malaria loves the (blank) so kills fetuses :(
placenta
60
All malarias can cause immune complex disease which can cause (blank) .... worst in p malariae
glomerulonephritis
61
Treat falciparum malaria like (blank0
sepsis
62
IF you see a patient who is acutely febrile nad has traveled then think (blank)
malaria
63
In the ICU if you suspect malaria check blood (blank)
glucose
64
How should you treat a Falciparum malaria patient
Ensure correct fluid, electrolyte, and acid-base balance. Control fluid replacement to prevent circulatory overload and pulmonary edema. Anticipate renal and respiratory failure (dont give steroids, heparin, epi)
65
What will you see in the kidney with malarai?
lumpy bumpy appearance cuz of immune complex caused by malaria
66
You see (blank) on the outside of malaria infected RBCs
Knobs (excretions produced by parasite)
67
How do you know you have plasmodium vivax?
stippling on surface, lots of spots more than 12, RBCs get bigger
68
How do you know you have plasmodium ovale
Its an ovale... lol
69
How do yo know you have plasmodium malaria?
less than 12 dots, stippling, RBCs dont get bigger
70
How do you know you have plasmodium falciparum>
can see it sitting on a platelet, you can see the rings, can have multiparasites in one RBCs. can have aplique forms, the gametocyte is crescent moon shaped. (WHEN YOU SEE RINGS AND BANANAS!!!)
71
Susceptibility to vivax malaria is determined by the presence or absence of (Blank)
duffy blood group (parasite receptor)
72
(blank) allele is protective in west africa
HLA-B53
73
(blank) is a complex interaction of cell-mediate and humoral immune mechanism; immunity is species, strain and stage specific
Acquired immunity
74
Host RBCs dont have MHC on RBC so you dont get an (Blank) when parasites enter them
immune response
75
HOw can you get innate and acquired immunity?
Duffy blood group Sickle cell HLA b53 Antigenic variation and immunosuppresion
76
Is duffy positive or duffy negative helpful to plasmodium vivax
helpful, it allows vivax to enter the RBC
77
What are the drugs that kill the erythrocytic froms of malaria?
artemisinin (artemisinin combined therapy), chloroquine, doxycycline, halofantrine, quinidine, quinine, mefloquine, proguanil, pyrimethamine-sulfadoxine
78
What are the drugs that kill hepatic forms of erythrocytic forms of malaria and prevents relapses with vivax and ovale?
primaquine (contraindicated in G6PD deficiency)
79
Drug resistance in malaria is widespread; particularly (blank) resistance
chloroquine
80
(blank) is used for travelers
Chemoprophylaxis
81
How do you attempt to get rid of/ prevent malaria?
Mosquito control with long-lasting insecticidal nets and residual indoor insecticide sprayin There is no malaria vaccine
82
What do you use chloroquine (4-aminoquinoline) for?
Prophylaxis and Therapy for Blood Stage Parasites (Resistance)
83
What do you use primaquine for (8-aminoquinoline)?
Used to Purge Liver Stage Parasites (Hypnozoites of P. vivax and P. ovale)
84
Why didnt eradication of malaria work
DDT was bad for people | mosquitos became resistant to DDT and insecticides, lack of funding, lack of community participation
85
Whats the worst malaria?
P. falciparum
86
What are the clinical complications of p. malariae?
immune complex | glomerulonephritis-leading to nephrotic syndrome
87
What are the clinical complications of p. vivax (p. ovale)?
splenic rupture anemia (mild) debilitating fevers higher TNF alpha per parasite
88
What are the clinical complications of p. falciparum?
``` cerebral coma anemia pulmonary edema renal failure shock lactic acidosis hypoglycemia tropical splenomegaly pregnancy (maternal death, stillbirth, low birth weight, anemia) ```
89
HOw does malaria effect the mosquitos?
gametocytes in peripheral blood-> gametocytes are ingested with blood meal-> gamete formation occurs in stomach-> exflagellatio and fertilization occur in stomach-> oocyst formation occurs in wall of stomach-> sporozonite formation and release occur in stomach-> sporozites migrate to salivary gland-> sporozoite are injected into human host when infected mosquito takes second blood meal

Block 7 Week 4 (7 decks)

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