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Block 7 Week 4 Colt > Shistosomiasis and Malaria - Hunter > Flashcards

Shistosomiasis and Malaria - Hunter Flashcards

1
Q

what are the major parasites that cause shistosomiasis?

A

S. mansoni, japonicum, haematobium

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2
Q

What are the minor parasites that cause shistosomiasis?

A

S. mekongi, intercalatum

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3
Q

What is the common name for shistosomiasis?

A

blood fluke

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4
Q

Cercarial penetration of skin causes a transient (blank)

A

dermatitis

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5
Q

Migration of schistosomules through the lungs can cause a (blank) that can be sever in heavy infections

A

pneumonitis

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6
Q

Onset of egg production causes (blank)

A

katayama fever

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7
Q

What is the geographic distribution of S. mansoni?

A

Sub-saharan Africa, Brazil, and some parts of the Carribean including Puerto Rico

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8
Q

S. haematobium is limited to which continent?

A

Sub-saharan Afrika

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9
Q

Which bug is found in the Mekong delta of Vietnam?

A

S. mekongi

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10
Q

What is the distribution of S. japonicum?

A

China, Japan, and the Phillipines

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11
Q

What is the vertebrate reservoir for shistosomiasis?

A

monkeys and primates

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12
Q

How do you get blood flukes?

A

by being exposed to infected bodies of water

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13
Q

How does the blood fluke enter the body? what is this form of parasite called?

A

The cercariae enter via the skin

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14
Q

From the skin, where does teh shistosomule travel?

A

To the lungs

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15
Q

From the lungs, where does the shistosomule then go?

A

From the lungs to the liver

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16
Q

From the liver, the adult flukes live in the (blank) veins

A

mesenteric veins

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17
Q

How do fluke eggs get out of the body?

A

They erode into the lumen of the large intestine and are exceted in the feces

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18
Q

Once in the feces, the shistosomes must infect what other animal to complete their life cycle before reinfecting higher primates?

A

snails!

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19
Q

What is the mortality rate of untreated shistosomiasis?

A

25%

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20
Q

Shistosomes have distinct sexes, meaning that to become infected you must acquire….

A

both a female and male fluke

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21
Q

What genus of snail does S. mansoni infect?

A

Biomphalaria

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22
Q

What genus of snail does S. hematobium infect?

A

Bulinus

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23
Q

What genus of snail does S. japonicum infect?

A

Oncomelania

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24
Q

Adult mansoni and japonicum worms live the in (blank) while the adult hematobium lives in the (blank)

A

superior mesenteric veins

vesicle plexus of the bladder

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25
Q

T/F: adult worms cause no clinical symptoms

A

true

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26
Q

What causes intestinal or bladder symptoms with blood fluke infection?

A

eggs passing through tissue to the lumen; causes severe hemorrhagic cystitis and gastroeneteritis

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27
Q

Eggs that are swept up portal circulation to the liver cause (blank)

A

granulomas caused by delayed T-cell hypersensitivity to the eggs

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28
Q

What are the clinical and lab findings that support shistosomiasis infx?

A

HSN, eosinophilia, hyperimmunoglobulinemia

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29
Q

Which shistosome has a terminal spine?

A

S. hematobium

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30
Q

Which shistosome has a lateral spine?

A

S. mansoni

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31
Q

Which shistosome is the smallest of the three?

A

S. japonicum

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32
Q

What drug is used to treat. S. hematobium?

A

praziquantel

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33
Q

What developmental stage of the shistosome are we able to form immunity against?

A

schistosomule

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34
Q

What is the mechanism by which we can attack the schistosomule?

A

IgE-eosinophil mediated ADCC

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35
Q

90% of cases of malaria arises where in the world?

A

Afrika

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36
Q

Malaria is endemic in how many countries worldwide?

A

90

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37
Q

What percent of the world population is at risk for malaria?

A

45%

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38
Q

What percent of the world population contracts malaria every year?

A

10%

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39
Q

What is the most common age at the time of death from malaria?

A

4

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40
Q

Up to (blank) percent of African infants are born with the malaria parasite

A

23%

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41
Q

What are the four malaria parasites?

A

vivax
ovale
malariae
falciparum

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42
Q

Besides Afrika, where else is malaria endemic?

A

south america (brazil, uruguay, paraguya, Argentina), India, phillipines

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43
Q

(blank) are injected when an infected mosquito bites you

A

sporozoites

44
Q

Sporozoites travel via the blood stream and remain in the liver in the (blank) stage

A

hypnozoite (latent) stage

45
Q

Sporozoites in the blood are known as (blank)

A

merozoites

46
Q

Infected liver cells rupture, releasing (blank)

A

merozoites

47
Q

What type of reproduction does the sporozoite undergo in the liver?

A

asexual

48
Q

are there clinical symptoms associated with the reproduction of sporozoites in the liver

A

no

49
Q

What is the leading causes of sepsis and septic shock worldwide?

A

malaria

50
Q

The name for the life cycle of malaria within the mosquito is known as:

A

sporogony

51
Q

Gametocytes released into the peripheral blood are taken up by the mosquito during a blood meal and in the stomach (blank and blank) ocurr to the gametocytes

A

exflaggelation and fertilization

52
Q

Oocyst formation in the mosquito occurs where?

A

in the wall of the stomach

53
Q

Sporozoites are released from the oocyst in the mosquito and travel to the (blank)

A

salivary glands, which then travels to the next human host

54
Q

T/F: merozoites are the things transferred back to the mosquitoes

A

false; only the gametocyte forms

55
Q

What is the name for the conglomeration of parasitic material within the hepatocytes
?

A

schizont

56
Q

what form of malaria infects red blood cells?

A

merozoite

57
Q

What is the form of malaria that is growing within the RBC

A

trophozoite

58
Q

What is the byproduct of malarial consumption of intracellular RBC hemoglobin?

A

hemozoin

59
Q

Malaria is a systemic inflammatory disease that is mediated by what cytokine?

A

TNFa

60
Q

Classic fever paroxysm in malaria corresponds with what event?

A

rupture of RBCs

61
Q

Describe the fever associated with falciparum malaria?

A

sporadic, daily

MALIGNANT TERTIAN

62
Q

Describe the fever associated with vivax malaria?

A

every other day

BENGIGN TERTIAN

63
Q

Describe the fever associated with ovale malaria?

A

every other day

OVALE TERTIAN

64
Q

Describe the fever associated with malariae malaria?

A

every third day

QUARTAN

65
Q

What are the important clinical findings in malaria?

A

anemia
HSN
hyperimmunoglobulinemia

66
Q

Desribe the disease sequellae of malaria

A

glomerulonephritis, nephrosis, cerebral malaria (most organs affected)

67
Q

Which two species of malaria relapse?

A

vivax and ovale

68
Q

What malarial developmental form can reestablish infection after being latent in the liver?

A

hynpozoites

69
Q

Falciparum and malariae do not relapse but rather (blank)

A

recrudesce (subclinical infection that becomes active clinical disease)

70
Q

What type of malaria has a fever that lasts for two days and drops on the third?

A

falciparum

71
Q

What types of malaria have a fever that lasts one day and relapses on the third?

A

vivax and ovale

72
Q

What type of malria has a fever that lasts one day and relapses on the fourth?

A

malariae

73
Q

At what body temp during fever do you feel cold?

A

38C

74
Q

At what body temp do you feel hot with fever?

A

40C

75
Q

After how long with a fever do you begin to sweat?

A

4 hours

76
Q

From what temperature range are rigors present?

A

36-40C

77
Q

why does the fever never really break in falciparum malaria?

A

brood release from RBCs is not synchronized; constant fever is why it is called malignant tertain.

78
Q

why do you get glomerulonephritis with malaria?

A

immune complex formation that blocks the kidneys

79
Q

T/F: a pt with falciparum malaria is a septic patient and should be treated like one

A

true

80
Q

T/F: malaria can grow in the placenta

A

true

81
Q

Do all malarias produce immune complex or just one type?

A

all of them do

82
Q

What supportive treatments are actually dangerous for someone with malaria?

A

corticosteroids, heparin, and epi

83
Q

Immunofluoresence studies of the glomerulus of a pt with malaria will have what appearance?

A

LUMPY-BUMPY WHICH IS CHARACTERISTIC OF IMMUNE COMPLEX DEPOSITION

84
Q

What allows falciparum malaria to adhere to the deep vasculature?

A

“knobs” of PfEMP1 (plamsodium falciparum erythrocyte membrane protein 1) which binds to adhesins in the endothelium

85
Q

describe the maturation cycle o malaria within RBC?

A

merozoites enter the RBC and go to ring form
Ring form becomes sparse looking trophozoites
Trophozoites come together to form larges masses called schizonts
Schizonts rupture the red blood cell and release gametocytes and merozoites

86
Q

What is the mortality rate of cerebral malaria?

A

> 90%

87
Q

which malaria causes cerebral malaria?

A

falciparum

88
Q

What changes to the RBCs do you see on peripheral smear for vivax?

A

RBCs become large, stippled, see active ameboid parasite within

89
Q

What are the changes to the RBC that you see in ovale?

A

RBC becomes oval shaped and large with stippling

90
Q

What do you see in malariae on peripheral smear?

A

lots of schizonts

91
Q

what do you see in falciparum malaria on peripheral smear?

A

signet ring and applique (ring on the edge of the RBC)

92
Q

T/F: you can have a mixed infection with more than one type of malaria

A

true

93
Q

Susceptibility to malaria is determined by what blood group?

A

Duffy blood group

94
Q

Which sickle cell phenotype gives you increased SURVIVAL from malaria

A

HbA/HbS

95
Q

T/F: acquired immunity to malaria is by both cell mediated and humoral responses

A

true

96
Q

T/F: there is antigenic variation between malaria strains

A

true

97
Q

Cells that are duffy (pos/neg) are at a greater risk of being infected by malaria

A

positive (FyA)

98
Q

Is the hyperimmunoglobulinemia functional Ig that is response to the malaria?

A

no, it is nonsense Ig

99
Q

T/F: sickle cell disease gives you both increased survival and decreased risk of infection with malaria

A

FALSE; only increased survival

100
Q

What is truly diagnostic for falciparum malaria?

A

banana shaped gametocytes

101
Q

What are the drugs that kill the erythrocytic form of malaria?

A 
CHLOROQUINE
artemisnin
doxycycline
halofantrine
quinidine, quinine, mefloquine
proguanil
pyrimethamine-sulfadoxine
102
Q

What drug kills hepatic forms of malaria and prevents relapse with vivax and ovale?

A

primaquine

103
Q

Primaquine is contraindicated in pts with what disease?

A

G6PD def

104
Q

T/F: there is widespread resisantce to chloroquine

A

true

105
Q

T/F: there is no vaccine for malaria

A

true

106
Q

What were the reasons that lead to the failure of worldwide eradication of malaria?

A

The emergence of drug resistant parasites
Widespread mosquito resistance to DDT and other available insecticides
Wars and massive population movements
Difficulties in obtaining sustained funding from donor countries
Lack of community participation in host countries

Block 7 Week 4 Colt (9 decks)

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