Shistosomiasis and Malaria - Hunter Flashcards
1
Q
what are the major parasites that cause shistosomiasis?
A
S. mansoni, japonicum, haematobium
2
Q
What are the minor parasites that cause shistosomiasis?
A
S. mekongi, intercalatum
3
Q
What is the common name for shistosomiasis?
A
blood fluke
4
Q
Cercarial penetration of skin causes a transient (blank)
A
dermatitis
5
Q
Migration of schistosomules through the lungs can cause a (blank) that can be sever in heavy infections
A
pneumonitis
6
Q
Onset of egg production causes (blank)
A
katayama fever
7
Q
What is the geographic distribution of S. mansoni?
A
Sub-saharan Africa, Brazil, and some parts of the Carribean including Puerto Rico
8
Q
S. haematobium is limited to which continent?
A
Sub-saharan Afrika
9
Q
Which bug is found in the Mekong delta of Vietnam?
A
S. mekongi
10
Q
What is the distribution of S. japonicum?
A
China, Japan, and the Phillipines
11
Q
What is the vertebrate reservoir for shistosomiasis?
A
monkeys and primates
12
Q
How do you get blood flukes?
A
by being exposed to infected bodies of water
13
Q
How does the blood fluke enter the body? what is this form of parasite called?
A
The cercariae enter via the skin
14
Q
From the skin, where does teh shistosomule travel?
A
To the lungs
15
Q
From the lungs, where does the shistosomule then go?
A
From the lungs to the liver
16
Q
From the liver, the adult flukes live in the (blank) veins
A
mesenteric veins
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
18
Q
Once in the feces, the shistosomes must infect what other animal to complete their life cycle before reinfecting higher primates?
A
snails!
19
Q
What is the mortality rate of untreated shistosomiasis?
A
25%
20
Q
Shistosomes have distinct sexes, meaning that to become infected you must acquire….
A
both a female and male fluke
21
Q
What genus of snail does S. mansoni infect?
A
Biomphalaria
22
Q
What genus of snail does S. hematobium infect?
A
Bulinus
23
Q
What genus of snail does S. japonicum infect?
A
Oncomelania
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
25
T/F: adult worms cause no clinical symptoms
true
26
What causes intestinal or bladder symptoms with blood fluke infection?
eggs passing through tissue to the lumen; causes severe hemorrhagic cystitis and gastroeneteritis
27
Eggs that are swept up portal circulation to the liver cause (blank)
granulomas caused by delayed T-cell hypersensitivity to the eggs
28
What are the clinical and lab findings that support shistosomiasis infx?
HSN, eosinophilia, hyperimmunoglobulinemia
29
Which shistosome has a terminal spine?
S. hematobium
30
Which shistosome has a lateral spine?
S. mansoni
31
Which shistosome is the smallest of the three?
S. japonicum
32
What drug is used to treat. S. hematobium?
praziquantel
33
What developmental stage of the shistosome are we able to form immunity against?
schistosomule
34
What is the mechanism by which we can attack the schistosomule?
IgE-eosinophil mediated ADCC
35
90% of cases of malaria arises where in the world?
Afrika
36
Malaria is endemic in how many countries worldwide?
90
37
What percent of the world population is at risk for malaria?
45%
38
What percent of the world population contracts malaria every year?
10%
39
What is the most common age at the time of death from malaria?
4
40
Up to (blank) percent of African infants are born with the malaria parasite
23%
41
What are the four malaria parasites?
vivax
ovale
malariae
falciparum
42
Besides Afrika, where else is malaria endemic?
south america (brazil, uruguay, paraguya, Argentina), India, phillipines
43
(blank) are injected when an infected mosquito bites you
sporozoites
44
Sporozoites travel via the blood stream and remain in the liver in the (blank) stage
hypnozoite (latent) stage
45
Sporozoites in the blood are known as (blank)
merozoites
46
Infected liver cells rupture, releasing (blank)
merozoites
47
What type of reproduction does the sporozoite undergo in the liver?
asexual
48
are there clinical symptoms associated with the reproduction of sporozoites in the liver
no
49
What is the leading causes of sepsis and septic shock worldwide?
malaria
50
The name for the life cycle of malaria within the mosquito is known as:
sporogony
51
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
exflaggelation and fertilization
52
Oocyst formation in the mosquito occurs where?
in the wall of the stomach
53
Sporozoites are released from the oocyst in the mosquito and travel to the (blank)
salivary glands, which then travels to the next human host
54
T/F: merozoites are the things transferred back to the mosquitoes
false; only the gametocyte forms
55
What is the name for the conglomeration of parasitic material within the hepatocytes
?
schizont
56
what form of malaria infects red blood cells?
merozoite
57
What is the form of malaria that is growing within the RBC
trophozoite
58
What is the byproduct of malarial consumption of intracellular RBC hemoglobin?
hemozoin
59
Malaria is a systemic inflammatory disease that is mediated by what cytokine?
TNFa
60
Classic fever paroxysm in malaria corresponds with what event?
rupture of RBCs
61
Describe the fever associated with falciparum malaria?
sporadic, daily
| MALIGNANT TERTIAN
62
Describe the fever associated with vivax malaria?
every other day
| BENGIGN TERTIAN
63
Describe the fever associated with ovale malaria?
every other day
| OVALE TERTIAN
64
Describe the fever associated with malariae malaria?
every third day
| QUARTAN
65
What are the important clinical findings in malaria?
anemia
HSN
hyperimmunoglobulinemia
66
Desribe the disease sequellae of malaria
glomerulonephritis, nephrosis, cerebral malaria (most organs affected)
67
Which two species of malaria relapse?
vivax and ovale
68
What malarial developmental form can reestablish infection after being latent in the liver?
hynpozoites
69
Falciparum and malariae do not relapse but rather (blank)
recrudesce (subclinical infection that becomes active clinical disease)
70
What type of malaria has a fever that lasts for two days and drops on the third?
falciparum
71
What types of malaria have a fever that lasts one day and relapses on the third?
vivax and ovale
72
What type of malria has a fever that lasts one day and relapses on the fourth?
malariae
73
At what body temp during fever do you feel cold?
38C
74
At what body temp do you feel hot with fever?
40C
75
After how long with a fever do you begin to sweat?
4 hours
76
From what temperature range are rigors present?
36-40C
77
why does the fever never really break in falciparum malaria?
brood release from RBCs is not synchronized; constant fever is why it is called malignant tertain.
78
why do you get glomerulonephritis with malaria?
immune complex formation that blocks the kidneys
79
T/F: a pt with falciparum malaria is a septic patient and should be treated like one
true
80
T/F: malaria can grow in the placenta
true
81
Do all malarias produce immune complex or just one type?
all of them do
82
What supportive treatments are actually dangerous for someone with malaria?
corticosteroids, heparin, and epi
83
Immunofluoresence studies of the glomerulus of a pt with malaria will have what appearance?
LUMPY-BUMPY WHICH IS CHARACTERISTIC OF IMMUNE COMPLEX DEPOSITION
84
What allows falciparum malaria to adhere to the deep vasculature?
"knobs" of PfEMP1 (plamsodium falciparum erythrocyte membrane protein 1) which binds to adhesins in the endothelium
85
describe the maturation cycle o malaria within RBC?
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
What is the mortality rate of cerebral malaria?
>90%
87
which malaria causes cerebral malaria?
falciparum
88
What changes to the RBCs do you see on peripheral smear for vivax?
RBCs become large, stippled, see active ameboid parasite within
89
What are the changes to the RBC that you see in ovale?
RBC becomes oval shaped and large with stippling
90
What do you see in malariae on peripheral smear?
lots of schizonts
91
what do you see in falciparum malaria on peripheral smear?
signet ring and applique (ring on the edge of the RBC)
92
T/F: you can have a mixed infection with more than one type of malaria
true
93
Susceptibility to malaria is determined by what blood group?
Duffy blood group
94
Which sickle cell phenotype gives you increased SURVIVAL from malaria
HbA/HbS
95
T/F: acquired immunity to malaria is by both cell mediated and humoral responses
true
96
T/F: there is antigenic variation between malaria strains
true
97
Cells that are duffy (pos/neg) are at a greater risk of being infected by malaria
positive (FyA)
98
Is the hyperimmunoglobulinemia functional Ig that is response to the malaria?
no, it is nonsense Ig
99
T/F: sickle cell disease gives you both increased survival and decreased risk of infection with malaria
FALSE; only increased survival
100
What is truly diagnostic for falciparum malaria?
banana shaped gametocytes
101
What are the drugs that kill the erythrocytic form of malaria?
```
CHLOROQUINE
artemisnin
doxycycline
halofantrine
quinidine, quinine, mefloquine
proguanil
pyrimethamine-sulfadoxine
```
102
What drug kills hepatic forms of malaria and prevents relapse with vivax and ovale?
primaquine
103
Primaquine is contraindicated in pts with what disease?
G6PD def
104
T/F: there is widespread resisantce to chloroquine
true
105
T/F: there is no vaccine for malaria
true
106
What were the reasons that lead to the failure of worldwide eradication of malaria?
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
