STEP 1 Protozoa 1 Flashcards

1
Q

Name 3 protozoa GI infections STEP 1 cares about

A
  1. Giardia lamblia
  2. Entamoeba histolytica
  3. Cryptosporidium
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2
Q

Giardia causes giardiasis…how does that look exactly? Think poop

A

Bloating and flatulence.

Foul-smelling, fatty diarrhea…I love my life right now

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3
Q

Who gets Giardia?

How to remember the poop associated with Giardia?

A

Hikers and campers who do not clean their water.

“Ghirardelli chocolates for fatty poops”

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4
Q

Transmission of giardia?

A

Cysts in water

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5
Q

How to diagnose giardiasis?

A

Trophozoites or cysts in stool

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6
Q

How to treat giardiasis?

A

Metronidazole

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7
Q

What does Entamoeba histolytica cause?

A

Amebiasis

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8
Q

Clinical presentation of Amebiasis?

  1. stool
  2. does an abscess occur? where?
  3. Pain? location?
A
  1. Bloody stool (dysentery)
  2. Liver and colon abscess…“anchovy paste” exudate for the liver bit
  3. RUQ pain
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9
Q

What does histology show with amebiasis?

A

**“Flask-shaped ulcer” if submucosal abscess of colon ruptures

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10
Q

How is amebiasis transmitted?

A

Cysts in water

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11
Q

Diagnosis of amebiasis? 2

A
  1. Serology and/or trophozites (with RBCs in the cytoplasm)

2. Cysts in the stool

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12
Q

Treatment of amebiasis:

Symptomatic and asymptomatic

A

Symptomatic: Metronidazole

Asymptomatic cyst passer: Iodoquinol

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13
Q

What does cryptosporidium cause in immunocompromised patients? In immunocompetent patients?

A

Severe diarrhea in AIDS patients…Milwaukee

Mild, watery diarrhea in immunocompetent patients

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14
Q

How is cryptosporidium transmitted?

How is cryptosporidium diagnosed?

A

Oocysts in water.

Oocysts on acid-fast stain

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15
Q

How to treat cryptosporidium?

A

Nitazoxanide in immunocompetent (or immunocompromised) hosts

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16
Q

Toxoplasma gondii causes two types of infection:

A

Acquired or congenital

17
Q

What does acquired Toxoplasmosis look like on CT/MRI? In which patient population is Toxo prevalent?

A

Brain abscess in HIV patients.

Looks like “ring-enhancing brain lesions”

18
Q

What is the classic triad of congenital toxo?

A
  1. Chorioretinitis*
  2. Hydrocephalus
  3. Diffuse intracranial calcifications

*The chorioretinitis may present as blurry vision, detached retina, or glaucoma

19
Q

Transmission of toxo? 3

A
  1. Cysts in meat
  2. Oocysts in cat feces
  3. Transplacental transmission
20
Q

For fear of toxo, pregnant women should avoid which animal and their poop?

A

Cats and cat poop

21
Q

Diagnosis of toxo? 3

A
  1. Serology
  2. Biopsy (looking for tachyzoites–crescent shaped (they mean trophozoite)
  3. Toxo PCR via LP
22
Q

How to treat Toxo? 3

A
  1. Sulfadiazine
  2. Pyrimethamine (which cause bone marrow suppression)
  3. Leucovorin** (not in STEP 1 but used to treat the bone marrow suppression)
23
Q

Naegleria fowleri causes what?

A

Rapidly fatal meningoencephalitis

24
Q

Naegleria transmission

A

Swimming in FRESHWATER lakes and streams.

Enters via the CRIBRIFORM plate

25
Naegleria diagnosis?
Ameobas in the spinal fluid
26
Treatment for naegleria? Prognosis?
Prognosis is not good. Very few reported survivors of a naegleria infection. Best treatment at the moment is Amphotericin B
27
Trypanosoma brucei is the causative agent of...?
African sleeping sickness
28
Clinical presentation of Trypanosoma infection
1. Enlarged lymph nodes 2. Recurring fever--due to antigenic variation (**differentiate from malaria) 3. Somnolence 4. Coma
29
Trypanosoma transmission
Tsetse fly...painful bite
30
Trypanosoma diagnosis
Blood smear
31
Trypanosoma treatment: 2 Which for blood-borne *Which for CNS penetration *If you miss #2 go slap your face
1. Suramin--blood borne | 2. Melarsoprol--CNS
32
Two types of Trypanosoma brucei? | **How to treat them? not on STEP 1
1. T. b. rhodesiense (suramin, melarsoprol) 2. T. b. gambiense (pentamidine, eflornithine) * *My point here is to show that suramin and melarsoprol only work on rhodesiense