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Clinical Parasitology Lec > SECTION 1: INTRODUCTION TO PARASITOLOGY > Flashcards

SECTION 1: INTRODUCTION TO PARASITOLOGY Flashcards

1
Q

Organisms may develop unique relationships due to their (?) with one another. These relationships are very important to their survival.

A

habitual and long associations

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2
Q

is the living together of unlike organisms

A

Symbiosis

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3
Q

may involve protection or other advantages to one or both partners

A

Symbiosis

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4
Q

Different forms of symbiosis may be distinguished on the basis of whether or not the association is (?) to one of the two partners.

A

detrimental

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5
Q

is a symbiotic relationship in which two species live together and one species benefits from the relationship without harming or benefiting the other.

A

Commensalism

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6
Q

is a symbiosis in which two organisms mutually benefit from each other.

A

Mutualism

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7
Q

is a symbiotic relationship where one organism, the parasite, live in or on another, depending on the latter for its survival and usually, at the expense of the host.

A

Parasitism

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8
Q

Majority of animal parasites are (?) which are harmful and which frequently cause mechanical injury to their hosts.

A

pathogens

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9
Q

A (?) harbors a particular pathogen without manifesting any signs and symptoms.

A

carrier

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10
Q

is the process of inoculating and infective agent

A

Exposure

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11
Q

connotes the establishment of the infective agent in the host

A

infection

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12
Q

is the period between infection and evidence of symptoms. It is sometimes referred to as the clinical incubation period.

A

incubation period

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13
Q

also known as the biologic incubation period

A

pre-patent period

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14
Q

is the period between infection or acquisition of the parasite and evidence of demonstration of infection

A

pre-patent period

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15
Q

results when an infected individual becomes his own direct source of infection.

A

Autoinfection

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16
Q

happens when the already infected individual is further infected with the same species leading to massive infection with the parasite

A

superinfection or hyper infection

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17
Q

There are various sources of parasitic infections. The most common sources are

A

contaminated soil and water

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18
Q

Lack of (?) and the use of (?) or human excreta as fertilizer allow the eggs to get in contact with the soil.

A

sanitary toilets
night soil

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19
Q

Another possible source of infection is (?), which contain the infective stage of the parasite.

A

water and food

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20
Q

Consumption of (?) can result in several intestinal and liver fluke infections.

A

undercooked or raw fresh water fish

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21
Q

can also transmit infection

A

Arthropods

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22
Q

are vectors of malaria and filaria parasites

A

Mosquitoes

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23
Q

Other animals, whether (?), may also harbor the parasite.

A

wild or domesticated

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24
Q

Other sources include (?).

A

another person, his beddings and clothing, the immediate environment he has contaminated, or even one’s self

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25
Q

An (?) may be transmitted from its natural reservoir to a susceptible host in different ways.

A

infectious agent

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26
Q

There are different classifications for modes of transmission:

A
  1. Direct
  2. Indirect
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27
Q

contact w/ an infected person or animal, directly from the source to the susceptible host without involving an intermediate object

A

Direct

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28
Q

a) Droplet spread

A

Direct

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29
Q

b) Sexual intercourse

A

Direct

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30
Q

c) Kissing

A

Direct

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31
Q

d) Holding hands

A

Direct

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32
Q

e) Transplacental / Vertical - mother to fetus

A

Direct

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33
Q

a) Ingestion of contaminated food & drink

A

Indirect

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34
Q

b) Contact w/ contaminated soil

A

Indirect

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35
Q

c) Bite of an infected arthropod (vector)

A

Indirect

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36
Q

d) Through fomites

A

Indirect

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37
Q

Since the most common source of parasitic infection is contaminated food and water, the most likely portal of entry is the (?).

A

mouth

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38
Q

Majority of infections among cestodes, trematodes, and intestinal protozoans are

A

foodborne

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39
Q

from eating food harboring the infective larval stages

A

Taenia solium, Taenia saginata, and Diphyllobothrium latum

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40
Q

from drinking water contaminated with cysts

A

Entamoeba histolytica and Giradia lamblia

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41
Q

through ingesting raw or improperly cooked freshwater fish containing the parasitic larvae

A

Clonorchis, Opistorchis and Haplorchis

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42
Q

is another route of transmission

A

Skin penetration

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43
Q

enter via exposure of skin to soil

A

Hookworms and Strongyloides

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44
Q

species enter skin via water.

A

Schistosoma

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45
Q

also serve as vectors and transmit parasites through their bites

A

Arthropods

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46
Q

Examples are agents of malaria, filariasis, leishmaniasis and trypanosomiasis.

A

Arthropods

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47
Q

can cross the placental barrier during pregnancy

A

Toxoplasma gondii trophozoites

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48
Q

In transmammary infection with (?), the parasites may be transmitted through the mother’s milk.

A

Ancylostoma and Strongyloides

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49
Q

Other ways of acquiring the infection include inhalation of airborne eggs of (?), and sexual intercourse as in the case of (?).

A

Enterobius
Trichomonas vaginalis

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50
Q

Although parasitic life cycles range from simple to complex, they all have three common components

A

mode of transmission
a morphologic form
one (or more) forms

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51
Q

invades humans, known as the infective stage

A

a morphologic form

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52
Q

can be detected via laboratory retrieval methods, known as the diagnostic stage

A

one (or more) forms

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53
Q

Some parasites require only a (?), whereas others also require one or more (?).

A

definitive host
intermediate hosts

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54
Q

A parasitic life cycle consists of two common phases

A
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55
Q

One phase involves the route a parasite follows when (?).

A

in or on the human body

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56
Q

This information provides an understanding of the symptomatology and pathology of the parasite.

A

in or on the human body

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57
Q

Insights about the best the method of diagnosis and selection of appropriate antiparasitic medication may also be determined.

A

in or on the human body

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58
Q

The other phase, the route a parasite follows (?), provides crucial information pertinent to epidemiology, prevention, and control.

A

independently of the human body

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59
Q

A (?) may affect the entire body or body areas associated any of its parts.

A

parasitic disease

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60
Q

The major with such processes include the following:

A

(1) the gastrointestinal (GI) and urogenital (UG) tracts; other (2) blood and tissue; (3) liver, lung, and major organs; and (4) miscellaneous locations, eye, skin, and extremities

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61
Q

A wide variety of representative (?), may occur when a parasite infects a human host.

A

symptoms

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62
Q

Some persons remain (?), whereas other parasites produce severe symptoms and may result in death.

A

asymptomatic

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63
Q

The most commonly observed symptoms include (?).

A

diarrhea, fever, chills, abdominal pain, and abdominal cramping

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64
Q

Other symptoms, such as (?), may develop.

A

elephantiasis, anemia, vitamin deficiency, bowel obstruction, edema, enlargement of major organs, skin lesions, and blindness

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65
Q

an enlargement of areas such as the breast, leg, and scrotum caused by a parasite’s presence

A

elephantiasis

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66
Q

may be taken against every parasite infective to humans.

A

Prevention and control measures

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67
Q

designed to break the transmission cycle are crucial for successful parasite eradication.

A

Preventive measures

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68
Q

Examples of such measures include the following: (?).

A

education programs, use of insecticides and other chemicals, protective clothing, protective netting, proper water treatment, good personal hygiene, proper sanitation practices, proper handling and preparation of food, and avoidance of unprotected sexual relations

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69
Q

The vast capital expenditures required to accomplish these measures are not available in many endemic countries in the world. The problem of eradicating parasites is an ongoing process and is a key goal of international health groups such as the

A

World Health Organization (WHO)

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70
Q

The following are the specimens needed to properly diagnose the presence of parasites inside the human body.

A

1.Stool
2.Urine
3.Sputum
4.Blood
5. Cerebrospinal fluid
6. Tissue aspirates
7. Orifice swab
8. Tissue Biopsy

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71
Q
  • for intestinal protozoans, nematodes and helminthes
A

Stool

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72
Q
  • for the recovery of Trichomonas vaginalis and Schistosoma haematobium
A

Urine

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73
Q

Urine Collection:

A

mid-stream catch

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74
Q
  • Paragonimus westermani, larvae of nematodes
A

Sputum

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75
Q

Sputum

Must be digested using

A

4-5% sodium hydroxide

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76
Q
  • for malarial parasites, filarial worms, Leishmania and Trypanosoma
A

Blood

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77
Q
  • Acanthamoeba species
A

Cerebrospinal fluid

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78
Q

Cerebrospinal fluid Collection:

A

lumbar tap

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79
Q

Tissue aspirates:

A

a) Liver aspirate
b) Duodenal aspirate
c) Broncho-alveolar lavage

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80
Q

hydatid cyst and liver amoebic abscess

A

a) Liver aspirate

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81
Q

Giardiasis and Strongyloidiasis infection

A

b) Duodenal aspirate

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82
Q

Paragonimus westermani

A

c) Broncho-alveolar lavage

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83
Q

Duodenal aspirate Collection:

A

endoscopy

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84
Q

: duodenal contents collected for Giardia and Strongylodes

A

Duodenal drainage or “String test”

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85
Q

: Schistosomiasis, Amoebiasis, Balantidiasis and Shigellosis (Large intestines)

A

Sigmoidoscopy

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86
Q

Orifice swab

A

a) Vaginal swab
b) Perianal swab

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87
Q

Trichomonas vaginalis

A

a) Vaginal swab

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88
Q

Enterobius vermicularis and Taenia

A

b) Perianal swab

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89
Q

Tissue Biopsy

A

a) Muscle
b) Rectal

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90
Q

Trichinella spiralis

A

a) Muscle

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91
Q

granulomas secondary to Schistosomiasis

A

b) Rectal

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92
Q

There are parasites where the method of isolation and identification is through processing of (?).

A

blood

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93
Q

❖ Blood Films

A
  1. Fresh water smears
  2. Thin Dry smears
  3. Thick Dry smears
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94
Q

for diagnosis of Trypanosomes and microfilaria

A
  1. Fresh water smears
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95
Q

for the study of the morphology of the parasites and the blood cells

A
  1. Thin Dry smears
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96
Q

used for malaria survey among patients with chronic infections or who are undergoing anti-malaria therapy

A
  1. Thick Dry smears
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97
Q

❖ Stains

A
  1. Giemsa
  2. Rapid stains
  3. Permanent stains & Other stains
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98
Q

Rapid stains:

A

a) Wright’s stain
b) Leishmann stain
c) Field’s stain
d) Acridine orange
e) Jaswant Singh Battacharya (JSB) Stain for thick and thin films

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99
Q

Permanent stains & Other stains:

A

a) Iron Hematoxylin Stain
b) MIF Fixative Stain (Merthiolate iodine formaldehyde)
c) Chlorazol Black E
d) Modified Kohn’s
e) Wheatley Trichrome
f) Methenamine Silver
g) Fluorescent Staining

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100
Q

most preferred

A

Giemsa

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101
Q

Giemsa Composition

A

Stock solution 1 ml
Buffered water (pH 7.0 – 7.2) 49 ml

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102
Q

Giemsa Staining time:

A

30 minutes

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103
Q

Too dark :

A

acidic pH

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104
Q

Too red:

A

alkaline pH

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105
Q

– It is used to stain blood smears in the detection of blood parasites.

A

Wright’s stain

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106
Q

The stain distinguishes easily between blood cells and became widely used for performing differential white blood cell counts, which are routinely ordered when infections are expected.

A

Wright’s stain

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107
Q

The stain contains a fixative, methanol, and the stain in one solution.

A

Wright’s stain

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108
Q

Thin films of blood are fixed with methanol to preserve the red cell morphology so that the relationship between parasites to the red cells can be seen clearly.

A

Wright’s stain

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109
Q

Wright’s stain

✓ Fix with 1-2 drops of (?)
✓ Cover the film with (?): 5 minutes
✓ wash with (?), drain, dry and examine

A

methanol
10% Giemsa stain
distilled water

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110
Q

It is a mixture of Methylene blue, and Eosin dye, prepared in Alcohol medium and diluted with buffer or distilled water during staining procedure.

A

Leishmann stain

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111
Q

is a differential stain that is used to variably stain the various components of the cells and it can be used to study the adherence of pathogenic bacteria to the human cells

A

Leishmann stain

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112
Q

It differentially stains the human and bacterial cells and appeared as purple and pink colored bodies respectively.

A

Leishmann stain

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113
Q

is one of the best stains for routine blood stain to stain the Peripheral blood smear for the examinations of blood film under the microscope and is satisfactory for malaria and other blood parasites

A

Leishmann stain

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114
Q

Leishmann stain

✓ Add (?) of the stain: (?)
✓ Add (?) of buffered distilled water
✓ Mix thoroughly, let stand (?)
✓ Rinse, drain, dry and examine

A

7-8 drops; 1-2 minutes
12-15 drops
4-8 minutes

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115
Q

It is a histological method for staining of blood smears.

A

Field’s stain

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116
Q

It is used for staining thick blood films in order to discover malarial parasites.

A

Field’s stain

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117
Q

Field’s stain consists of -

A

two parts

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118
Q

Field’s stain A is

A

methylene blue and Azure 1 dissolved in phosphate buffer solution

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119
Q

Field’s stain B is

A

Eosin Y in buffer solution.

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5
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120
Q

is used as a fluorescent staining agent to detect the presence of malaria parasite in blood cultures and other bodily fluids

A

Acridine orange

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121
Q

is a fluorochrome dye that can interchalate into nucleic acid.

A

Acridine orange

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122
Q

standard method

A

Jaswant Singh Battacharya (JSB) Stain for thick and thin films

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123
Q

laboratories under the National Malaria Eradication Programme in India

A

Jaswant Singh Battacharya (JSB) Stain for thick and thin films

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124
Q
  • used for most of the original morphological descriptions of intestinal protozoa found in humans
A

Iron Hematoxylin Stain

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125
Q
  • diagnosis of Trichomonas
A

MIF Fixative Stain (Merthiolate iodine formaldehyde)

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126
Q
  • An acid dye, used as a fat and general tissue stain, and to stain protozoa in fecal smears or in tissues.
A

Chlorazol Black E

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127
Q
  • modification of the chlorazol black E staining technique
A

Modified Kohn’s

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128
Q
  • all-purpose (amoebae, flagellates)
A

Wheatley Trichrome

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129
Q
  • cyst
A

Methenamine Silver

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130
Q
  • Microsporidium
A

Fluorescent Staining

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131
Q

Infected erythrocytes are counted in relation to a predetermined number of WBCs

A

Thick Blood Film

132
Q

Standard: average of 8000/µl

A

Thick Blood Film

133
Q

All parasite species and forms (sexual and asexual) are counted

A

Thick Blood Film

134
Q

Thick Blood Film Formula:

A
135
Q

If parasites are ≥10, 200 leukocytes are counted:

A

of parasites/µl =# of parasites counted x 40

136
Q

If parasites are <10, 500 WBCs should be counted:

A

of parasites/µl = # of parasites counted x 16

137
Q

Earle and Perez method

A

of asexual parasites/ 5µl

138
Q

thick film is used

A

Thick Blood Film

139
Q

used only in research studies

A

Thick Blood Film

140
Q

% of parasitemia: P. falciparum

A

Thin Blood Film

141
Q

of infected red cells in 1000 RBCs

A

Thin Blood Film

142
Q

smear is scanned carefully, one ‘row’ at a time

A

Thin Blood Film

143
Q

total number of red cells and the number of parasitized red cells are tabulated separately

A

Thin Blood Film

144
Q

If 1000 red cells are counted:

A

• divide the number of parasitized red cells by 10 to get the percentage
• less than 1000 red cells counted
• # of parasitized cells/# of RBCs X 100

145
Q

less precise

A

“plus system”

146
Q

variation in the thickness of the film

A

“plus system”

147
Q

results in variation in parasite count

A

“plus system”

148
Q

= 1–10 per 100 thick fields

A

+

149
Q

= 11-100 per 100 thick fields

A

++

150
Q

= 1–10 per thick field

A

+++

151
Q

= >10 per thick field

A

++++

152
Q

(?) of fecal sample is essential for the isolation and proper diagnosis of infection.

A

Proper collection

153
Q

The following should be considered:

A
  1. Container
  2. Avoid contamination with urine, water and soil
  3. Label
  4. Handle carefully
154
Q

Container (for physical examination of the specimen)

A

sterile, disposable, wide mouth with tight-fitting lid, transparent

155
Q

Handle carefully because it is a potential source of infection unsuitable samples from patients receiving:

A

a. Barium
b. Oil
c. Bismuth
d. Kaolin
e. Antibiotics

156
Q

TYPES of FECAL SPECIMEN

A
  1. Liquid
  2. Soft
  3. Formed
157
Q

Liquid –

A

either diarrheic or saline-purged

158
Q

PRESERVATION a) Physical:

A
  1. Room temperature
  2. Refrigeration
159
Q

PRESERVATION b) Chemical

A
  1. Polyvinyl Alcohol (PVA)
  2. 5-10% formalin
  3. Merthiolate-Iodine-Formalin (MIF) or Thimerosal Iodine Formalin (TIF)
  4. Schaudinn’s Fixative
160
Q

used for the preservation of stained fecal+ smears; preservation of trophozoites

A

Polyvinyl Alcohol (PVA)

161
Q

▪ For concentration techniques or direct fecal smear

A

5-10% formalin

162
Q

▪ For cysts, helminthes and larvae

A

5-10% formalin

163
Q

▪ Not sufficient for preparing permanent stained fecal smears

A

5-10% formalin

164
Q

▪ Good for all stages

A

Merthiolate-Iodine-Formalin (MIF) or Thimerosal Iodine Formalin (TIF)

165
Q

▪ For liquid stools

A

Merthiolate-Iodine-Formalin (MIF) or Thimerosal Iodine Formalin (TIF)

166
Q

▪ For bulk feces, the solution is mixed in the proportion of 9.4 ml MIF and 0.6 ml Lugol’s for a gram of fecal material

A

Merthiolate-Iodine-Formalin (MIF) or Thimerosal Iodine Formalin (TIF)

167
Q

▪ For fresh materials and those recovered from intestinal mucosal linings

A

Schaudinn’s Fixative

168
Q

▪ For permanent staining

A

Schaudinn’s Fixative

169
Q

IMPORTANCE OF FECALYSIS

A
  1. To detect the presence of intestinal parasites
  2. For the detection of evidence of malfunction of some parts of the GIT, liver and pancreas
  3. For the detection of GIT bleeding
  4. For the detection of excessive fats in stool (steatorrhea)
  5. Used as a clue in medical and surgical diagnosis.
170
Q
  1. Physical Examination

❖ Form and Consistency: Normal:

A

soft to formed

171
Q

– seen in diarrhea and administration of saline cathartic

A

a) Very soft and watery

172
Q

– constipation due to lack of mucus

A

b) Excessively hard and scybalous

173
Q

– cholera

A

c) Rice water stool

174
Q

– early typhoid

A

d) Pea soup stool

175
Q

– syphilis, spastic colitis and obstruction at the lower portion of the colon

A

e) Flattened or ribbon like

176
Q
  • fibrocystic disease of the pancreas
A

f) Butter like

177
Q

– excessive carbohydrate fermentation

A

g) Gaseous and fermentative

178
Q

Color Normal:

A

light brown to dark brown due to stercobilin

179
Q
  • due to administration of santonin and senna
A

a) Yellow

180
Q

– seen after ingestion of Barium meals

A

b) Light clay or putty color

181
Q
  • bleeding in the lower GIT; undigested beets and tomatoes
A

c) Reddish or bloody

182
Q
  • bleeding in the upper GIT
A

d) Dark red/chocolate brown

183
Q
  • associated with digestion of blood due to bleeding in the upper GIT
A

e) Black/tarry

184
Q

– amoebiasis

A

f) Greenish

185
Q

Odor Normal:

A

foul to offensive due to indole, skatole and butyric acid

186
Q

– found in ulcerative and malignant tumor of the lower bowel

A

a) Putrid odor

187
Q
  • indicates gas formation, fermentation of carbohydrate, unabsorbed fatty acids
A

b) Sour/rancid odor

188
Q

– usually in alkaline stools, putrefaction of undigested protein.

A

c) Extremely foul odor

189
Q

– blood which is not visible to the naked eye and can only be detected by chemical means only

A

Occult blood

190
Q

Laboratory Examination for Occult Blood:

A

a) Benzidine test
b) Guaiac;s test
c) Hematest

191
Q

The (?) (due to peroxidase contained in the heme portion of hemoglobin) decomposes (?) to produce (?).

A

peroxidase-like activity of blood
H2O2
water and oxygen

192
Q

The (?) causes the oxidation of the colorless chromogen into a colored compound (blue)

A

liberation of oxygen

193
Q

Hematest Patient Preparation:

A

meat free diet for 3-5 days prior to the test

194
Q

The following structures may be seen microscopically:

A

a) Trophozoites and cysts of amoeba
b) Helminth eggs and larvae
c) RBC
d) Macrophages present in bacterial or parasitic infection
e) WBC
f) Fungi
g) Plant cells, pollen grain and spores
h) Epithelial cells
i) Calcium oxalate and triple phosphate crystals
j) Bacteria
k) Plant fibers, root hairs and animal cells ( similar to helminth ova)
l) Charcot-layden crystals

195
Q

indicative of inflammation

A

WBC

196
Q
  • due to hemorrhagic disorder, ulcers and contamination
A

RBC

197
Q

TECHNIQUES

A
198
Q

– simplest and most frequently used

A

DIRECT FECAL SMEAR

199
Q
  • for the observation of the motility of trophozoites
A

a) 0.85% sodium chloride/NSS

200
Q

– for protozoan cysts and helminth ova

A

b) D’antonis solution/Lugol’s Iodine

201
Q

KATO THICK SMEAR (KTS)
▪ Reagents:

A

Distilled water 100 ml
Glycerin 100 ml
3% malachite green 1 ml

202
Q

Use cellophane as cover slip

A

KATO THICK SMEAR (KTS)

203
Q
  • used in the detection of a small number of parasites which are not detected using DFS
A

CONCENTRATION TECHNIQUES

204
Q

– uses either specific gravity or centrifugation

A

Sedimentation Method

205
Q

– concentrates helminth eggs, larvae and protozoan cysts

A

Formalin-Ether techniques

206
Q

– used for formed stools; applicable for helminth eggs and larvae

A

Acid-Ether Sedimentation

207
Q

– time-consuming

A

Simple sedimentation

208
Q
  • for concentration of microfilariae’ utilizes venous blood as specimen
A

Knott Concentration Technique

209
Q

Allows the separation of helminth eggs, protozoan cysts and larvae (1.05 – 1.15) using chemical solutions of higher specific gravity (1.12-1.21)

A

Flotation method

210
Q

Eggs and cysts float to the surface of the solution while fecal materials sink to the bottom

A

Flotation method

211
Q

Superior to sedimentation for concentrating cysts and eggs other than operculated, schistosomal and infertile Ascaris eggs

A

Flotation method

212
Q
  • valuable method for concentrating cysts and eggs
A

Zinc Sulfate centrifugal flotation technique

213
Q
  • specific gravity: 1.18 (hydrometer); 1:20 formalinized feces
A

Zinc Sulfate centrifugal flotation technique

214
Q
  • Cryptosporidium (rounded oocysts)
A

Sugar Flotation Technique/Sheather’s Sugar Flotation

215
Q
  • uses sodium chloride solution
A

Wilie’s Brine

216
Q

Lane’s Direct Centrifugal Technique
Magnesium Sulfate Techniques

A
217
Q

• D’Antonis

A

Temporary Staining

218
Q

1% Isotonic Eosin Solution & 2% Brilliant Cresyl Blue

A

Temporary Staining

219
Q

Eosine in saline

A

Temporary Staining

220
Q

Buffered Methylene Blue (ex. Nairs Methylene Blue)

A

Temporary Staining

221
Q

1% Isotonic Eosin Solution & 2% Brilliant Cresyl Blue
- Trophozoites-
- Background-

A

blue green
pink

222
Q

Permanent Staining

A

Gomori’s Trichrome Stain
Lawless’ Permanent Mount Stain
Modified Acid-Fast stain
Iron Hematoxylin Stain
MIF Fixative stain ( Merthiolate iodine formaldehyde)
Chlorazol Black E
Modified Kohn’s

223
Q

The trichrome technique of Wheatley for fecal specimens is a modification of Gomori’s original staining procedure for tissue.

A

Gomori’s Trichrome Stain

224
Q

It is a rapid, simple procedure which produces uniformly well stained smears of the intestinal protozoa, human cells, yeast cells, and artifact material in about 45 min or less.

A

Gomori’s Trichrome Stain

225
Q
  • Wheatley’s modification
A

Gomori’s Trichrome Stain

226
Q
  • For intestinal protozoa
A

Gomori’s Trichrome Stain

227
Q

A rapid permanent-mount stain technic for the diagnosis of the intestinal protozoa

A

Lawless’ Permanent Mount Stain

228
Q

Rapid method of staining trophozoites and cysts

A

Lawless’ Permanent Mount Stain

229
Q

Protozoa – blue to purplish color

A

Lawless’ Permanent Mount Stain

230
Q
  • Cryptosporidium, Isospora and Cyclospora
A

Modified Acid-Fast stain

231
Q
  • Two separate stains: Carbol fuchsin and methylene blue
A

Modified Acid-Fast stain

232
Q
  • lacks specificity
A

Modified Acid-Fast stain

233
Q
  • Use of the modified Ziehl-Neelsen stain for faecal smears has already been established for coccidian protozoa, in particular, oocysts of Cryptosporidium species, but it is also useful to confirm the presence of oocysts of Isospora belli and Cyclospora cayetanensis
A

Modified Acid-Fast stain

234
Q
  • used for most of the original morphological descriptions of intestinal protozoa found in humans.
A

Iron Hematoxylin Stain

235
Q
  • On oil immersion power (1,000 x ), one can examine the diagnostic features used to identify the protozoan parasite.
A

Iron Hematoxylin Stain

236
Q

can be used with either fresh, SAFpreserved, or PVA-preserved specimens.

A

Iron Hematoxylin Stain

237
Q

diagnosis of Trichomonas

A

MIF Fixative stain ( Merthiolate iodine formaldehyde)

238
Q

An acid dye, used as a fat and general tissue stain, and to stain protozoa in fecal smears or in tissues.

A

Chlorazol Black E

239
Q

modification of the chlorazol black E staining technique

A

Modified Kohn’s

240
Q

Enterobius vermicularis and Taenia

A

Cellulose Tape Preparation/Graham Scotch Tape Method

241
Q

Cellulose Tape Preparation/Graham Scotch Tape Method Collection:

A

morning before the patient washes or defecates

242
Q

Commercial collection kits are available

A

Cellulose Tape Preparation/Graham Scotch Tape Method

243
Q

provides an estimate of worm burden

A

Egg Count Technique

244
Q

Determines the degree of infection (light, moderate or heavy)

A

Egg Count Technique

245
Q

For recovery of hookworms, Ascaris and Trichuris

A

Egg Count Technique

246
Q

Egg Count Technique Methods:

A
  1. Direct Smear Egg Count (Method by Beaver)
  2. Dilution Egg Count
  3. Thick Smear Egg Count
  4. Dilution-Filtration Egg Count
247
Q

Method by Beaver

A

Direct Smear Egg Count

248
Q

= eggs per gram (epg)

A
  • 1.5 mg feces (667)
249
Q

= epg

A
  • 2.0 mg feces (500)
250
Q

– uses 0.1 N NaOH

A

Dilution Egg Count

251
Q
  • Stoll’s Egg Counting Technique
A

Dilution Egg Count

252
Q

– KTS for schistosomes

A

Thick Smear Egg Count

253
Q

– Schistosomes

A

Dilution-Filtration Egg Count

254
Q

is a laboratory tool used to determine a given parasite’s resistance to extant drug therapy.

A

Egg hatch assay (EHA)

255
Q

Fresh eggs are incubated from the parasite of interest and serial dilutions of the drug of interest are applied.

A

Egg Hatching Technique

256
Q

The percentage of eggs that hatch or die is determined at each concentration and a drug response curve may be plotted.

A

Egg Hatching Technique

257
Q

The data can then be transformed and analysed to give further statistics such as an ED50.

A

Egg Hatching Technique

258
Q

This technique is labour intensive, expensive and can take some time, however an egg hatch assay will give and accurate and reliable result.

A

Egg Hatching Technique

259
Q

✓ For accurate detection of the organisms as a supplement to other methods

A

CULTURE METHODS

260
Q

✓ For obtaining a rich yield of organisms to be used as antigen in immunologic diagnosis

A

CULTURE METHODS

261
Q

✓ For in-vitro screening of drugs

A

CULTURE METHODS

262
Q

✓ For investigating the physiology of organisms

A

CULTURE METHODS

263
Q

✓ As a source for inoculating susceptible experimental animals

A

CULTURE METHODS

264
Q

CULTURE METHODS for PROTOZOA

A

a) Balamuth’s Monophasic Medium
b) Boeck & Drbohlav’s Diphasic as Modified by Dobell and Laidlaw
c) Cleveland & Collier’s
d) Trussel and Johnson’s medium
e) Axenic Culture Method

265
Q
  • All liquid medium commonly used for the isolation and maintenance of Entamoeba histolytica and some other intestinal protozoa.
A

Balamuth’s Monophasic Medium

266
Q
  • It is satisfactory for Balantidium coli, although the quality and amount of starch may need to be adjusted
A

Balamuth’s Monophasic Medium

267
Q
  • Use of egg yolk
A

Balamuth’s Monophasic Medium

268
Q
  • Egg slant
A

Boeck & Drbohlav’s Diphasic as Modified by Dobell and Laidlaw

269
Q
  • E. histolytica
A

Boeck & Drbohlav’s Diphasic as Modified by Dobell and Laidlaw

270
Q
  • Concentrate from saline centrifugal sedimentation of feces rather than the feces is recommended.
A

Boeck & Drbohlav’s Diphasic as Modified by Dobell and Laidlaw

271
Q
  • Use of whole hen’s eggs
A

Boeck & Drbohlav’s Diphasic as Modified by Dobell and Laidlaw

272
Q
  • This medium is highly specific for E. histolytica , which grows luxuriantly on this medium.
A

Cleveland & Collier’s

273
Q

Other intestinal amoebae do not grow readily on this medium.

A

Cleveland & Collier’s

274
Q

The technique of overlaying the medium with fresh sterile horse serum-saline mixture, as reported by Cleveland and Collier, was reported to be the best method of isolation of E. histolytica .

A

Cleveland & Collier’s

275
Q

Proteose peptone and infusion from liver provide amino acids and other nitrogenous substances that support growth of E. histolytica .

A

Cleveland & Collier’s

276
Q

Sodium chloride maintains the osmotic balance of the medium and sodium a-glycerophosphate acts as a phosphorous source.

A

Cleveland & Collier’s

277
Q

Isolation of Trichomonas vaginalis

A

Trussel and Johnson’s medium

278
Q
  • histolytica
A

Axenic Culture Method

279
Q
  • Axenic cultivation has been an essential component of numerous immunological and biochemical studies
A

Axenic Culture Method

280
Q
  • Monophasic clear liquid for rapid growth of dense populations of amebae
A

Axenic Culture Method

281
Q

CULTURE METHOD for LEISHMANIA & TRYPANOSOMES

A

a) Novy, MacNeal and Nicole (NNN) Diphasic
b) Cellular Media

282
Q
  • For Trypanosoma cruzi and Toxoplasma
A

b) Cellular Media

283
Q
  • Use of sterile defibrinated rabbit blood
A

Novy, MacNeal and Nicole (NNN) Diphasic

284
Q
  • Best medium
A

Novy, MacNeal and Nicole (NNN) Diphasic

285
Q

IMMUNOLOGIC or SEROLOGIC TESTS

A

a) Indirect Hemagglutination (IHA)
b) Flocculation or Agglutination
c) Indirect Fluorescent Antibody (IFA)
d) Gel Diffusion (Ouchterlony) and Countercurent Electrophoresis (CEP)
e) Enzyme -linked immunosorbent assay (ELISA)
f) Sabin-Feldman Dye Test
g) Circumoval Precipitin Test (COPT)
h) Radioimmunoassay (RIA)
i) Radioallergosorbent Test (RAST)
j) Immunoblotting/Western Blot
k) Complement Fixation (CF)

286
Q

involves antigen-antibody reactions

A

IMMUNOLOGIC or SEROLOGIC TESTS

287
Q

PRINCIPLE: Patient serum and commercial sheep blood cells coated with the appropriate antigen are required. The serum and cells are combined and allowed to react. The test sample is then examined for the presence of red blood cell agglutination

A

Indirect Hemagglutination (IHA)

288
Q

USES: amoebiasis, Chaga’s disease, malaria, toxoplasmosis, cystisercosis, hydatid cyst, filariasis, schistosomiasis

A

Indirect Hemagglutination (IHA)

289
Q

PRINCIPLE: The patient serum is added to known cultured parasites. This mixture is observed for the presence of parasite clumping.

A

Flocculation or Agglutination

290
Q

USES: Leishmaniasis, Chaga’s disease

A

Flocculation or Agglutination

291
Q

PRINCIPLE: Microscopically visible parasites fixed on a slide are allowed to react with test serum. The slide is washed and treated with anti-human globulin with fluorescein (sandwich method)

A

Indirect Fluorescent Antibody (IFA)

292
Q

PRINCIPLE: Patient serum and known antigens are placed in adjacent wells located on the agar gel. The antigen and antibody are allowed to migrate across the agar towards one anther. Specific patterns of precipitate ( precipitin bands) result between the inoculated wells and are then interpreted.

A

Gel Diffusion (Ouchterlony) and Countercurent Electrophoresis (CEP)

293
Q

USES: Detect amebiasis and fascioliasis infections

A

Gel Diffusion (Ouchterlony) and Countercurent Electrophoresis (CEP)

294
Q

PRINCIPLE: Test serum is allowed to react with an antigen (coat the surface of plastic well). Anti-human IgG antibody conjugated with enzyme is added. If specific antibody was present in the test serum, the anti-human IgG antibody labeled with an enzyme attaches to the antigen-antibody complex. The addition of a suitable substrate generates a visible color reaction.

A

Enzyme -linked immunosorbent assay (ELISA)

295
Q

USES: T. gondii, T. vaginalis, leishmaniasis, malaria, schistosomiasis etc.

A

Enzyme -linked immunosorbent assay (ELISA)

296
Q

✓ Modification of the standard ELISA for increased sensitivity and specificity in detecting antibodies of the IgM class to Toxoplasma

A

Antibody Capture or Double Sandwich ELISA

297
Q

✓ Plastic well are coated with anti-human IgM antibodies

A

Antibody Capture or Double Sandwich ELISA

298
Q

✓ After washing, the test serum is added followed by further washing and addition of the test antigen

A

Antibody Capture or Double Sandwich ELISA

299
Q

✓ The final reagent is an antigen-specific antibody to which the color reagent has been conjugated

A

Antibody Capture or Double Sandwich ELISA

300
Q

✓ The plates are read spectrophotometrically

A

Antibody Capture or Double Sandwich ELISA

301
Q

✓ This method can be used for assay of parasite-specific IgE antibodies by starting with anti-human IgE

A

Antibody Capture or Double Sandwich ELISA

302
Q

is based on the fact that live Toxoplasma tachyzoites can actively take up methylene blue dye from the culture medium, whereas parasites that are killed because of complement-mediated lysis do not take up the dye and remain colorless.

A

Sabin-Feldman Dye Test

303
Q

Specifically designed for the diagnosis of Toxoplasmosis

A

Sabin-Feldman Dye Test

304
Q

is a serological test used for diagnosis of schistosomiasis japonica.

A

Circumoval Precipitin Test (COPT)

305
Q

Soluble egg antigens of Schistosoma japonicum block the formation of the circumoval precipitin by serum from infected humans.

A

Circumoval Precipitin Test (COPT)

306
Q

Consequently, circumoval precipitin inhibition was used to monitor purification of the soluble egg antigens of S. japonicum.

A

Circumoval Precipitin Test (COPT)

307
Q

PRINCIPLE: Radioimmunoassay (RIA) is a very sensitive in vitro assay technique used to measure concentrations of antigens by use of antibodies. As such, it can be seen as the inverse of a radiobinding assay, which quantifies an antibody by use of corresponding antigens

A

Radioimmunoassay (RIA)

308
Q

is a radioimmunoassay test to detect specific IgE antibodies to suspected or known allergens for the purpose of guiding a diagnosis about allergy

A

Radioallergosorbent Test (RAST)

309
Q

In this test, the parasite antigen is first bound to an inert sorbent or matrix to which the test serum is allowed to react. After washing, radio-labeled antibody (IgE or IgG) is added to the sorbent. After another washing to remove excess labeled antibody, the remaining radioactivity is a measure of antigen-specific IgG or IgE in the test serum

A

Radioallergosorbent Test (RAST)

310
Q

PRINCIPLE: CSF and serum may be used. By using electrophoresis technique, the DNA containing portion of the patient sample is transferred to a polyacrylamide gel. This process results in the separation of protein antigens in the gel. A blotting technique is employed to transport the proteins onto a paper.

A

Immunoblotting/Western Blot

311
Q

USES: giardiasis

A

Immunoblotting/Western Blot

312
Q

PRINCIPLE: Three ingredients is necessary to for performing the first phase: patient serum, a commercial antigen source, known amount of complement. The complement is “fixed” by the antibodies present in the serum. In the 2nd phase, sensitized sheep’s rbc is added to the mixture. The absence of free complement prevents lysis of these cells ( positive). If the patient sera does not contain Ab, complement is free to lyse ( negative)

A

Complement Fixation (CF)

313
Q

USES: leishmaniasis, Chaga’s disease, pneumocystosis, paragonimiasis

A

Complement Fixation (CF)

314
Q

Animal Used: hamster

A

ANIMAL INOCULATION TESTS

Leishmania

315
Q

Specimen: aspirates from biopsy materials from cutaneous ulcers, lymph nodes, spleen, liver

A

ANIMAL INOCULATION TESTS

Leishmania

316
Q

Animal Used: Guinea pigs or white rats (Trypanosoma gambiense and T. rhodesiense)

A

ANIMAL INOCULATION TESTS

317
Q

White mice (Trypanosoma cruzi)

A

ANIMAL INOCULATION TESTS

318
Q

An experimental bug (vector) is allowed to take a blood meal from the patient

A

XENODIAGNOSIS

319
Q

The intestinal contents of the bug is assessed for the presence of diagnostic stages of the parasite

A

XENODIAGNOSIS

320
Q

Over the years, parasites which were once considered commensal have evolved to become human pathogens.

A
321
Q

During this time, tremendous knowledge was obtained of the epidemiology, parasite-host relationships, life cycles, disease processes and symptoms, treatment, and prevention and control of parasites.

A
322
Q

In addition, parasites are classified based on their individual characteristics.

A
323
Q

Traditional as well as new methodologies for parasite identification allow for accurate laboratory diagnosis.

A
324
Q

Parasitology is an interesting and exciting field of the clinical laboratory sciences.

A
325
Q

The continued development of high-tech, highly sensitive parasite test methodologies provides the key to the future of parasitology.

A
326
Q

Because it is highly unlikely that parasites will totally be eradicated in the near future, competent practitioners educated in the field of parasitology are essential to ensure proper parasite identification.

A

Clinical Parasitology Lec (21 decks)

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